Burst Hemorrhoid: What You Need to Know

Medically Reviewed By Lauren Castiello, MS, AGNP-C
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Hemorrhoids are often painful, itchy, and generally uncomfortable. Occasionally, pressure from a blood clot inside a hemorrhoid may cause it to burst. Read on to learn more about burst hemorrhoids, how to treat them, and when to call your doctor.

Overview

A needle about to pop a balloon
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Hemorrhoids, also known as piles, are distended blood vessels in the anus and lower rectum. Hemorrhoids can occur internally or externally. Internal hemorrhoids occur just inside the rectum underneath the mucosa. External hemorrhoids occur under the skin near the anus.

Most hemorrhoids do not cause serious problems. Only about 5% of people with hemorrhoids have symptoms.

Internal hemorrhoids may cause bright red bleeding without pain. They may also prolapse, which is when hemorrhoidal tissue protrudes from the anus. Prolapsed internal hemorrhoids may also cause itching and irritation, mucus discharge, or a feeling that stool is stuck at the anal opening.

External hemorrhoids are situated outside the rectum on the skin near the anal opening. This skin is very sensitive and is also tightly connected to the structures beneath it.

Learn more about the symptoms of hemorrhoids.

Thrombosis in a hemorrhoid

In some cases, a hemorrhoid may burst from high pressure within it.

A thrombosed hemorrhoid occurs when a blood clot forms inside the hemorrhoid. This can cause intense pain as the blood pools in the hemorrhoid and the pressure inside it goes up.

What happens when a hemorrhoid bursts

When pressure inside a hemorrhoid becomes severe, the skin overlying the hemorrhoid can break down. This allows leakage of the clotting blood within the hemorrhoid.

A burst hemorrhoid is an open wound. Furthermore, its location means it is likely to be exposed to bacterial contamination from feces. If bacteria penetrate into the area of the wound, a serious infection may occur. In this case, you may need antibiotics or specialized wound care to heal the area.

In addition, since hemorrhoids contain blood vessels, a burst hemorrhoid may cause significant bleeding.

Because of the risks of bleeding and infection, it is dangerous to try to “pop” a hemorrhoid at home. This is true even when using sterile tools. Always contact your doctor for treatment of symptomatic hemorrhoids.

What to do if a hemorrhoid bursts

Bleeding from the anus is always unusual and should be evaluated by a physician. This is because there are other possible causes of rectal bleeding. These include colon cancer, anal fissures, and polyps. Your doctor may try to rule out these more serious causes before diagnosing bleeding as hemorrhoid related.

If a hemorrhoid bursts, you can apply pressure to the area using a clean cloth or sanitary napkin. The hemorrhoid may continue to bleed, especially after passing stool. However, the bleeding should not be heavy.

Seek immediate medical care if any of the following symptoms accompany a burst hemorrhoid:

  • a large amount of bleeding or bleeding that persists
  • fever
  • pus leaking from the area
  • severe pain

Diagnosis

Your doctor will take a detailed history of your condition. They will ask about your bowel habits and whether there have been changes in the frequency and consistency of your bowel movements.

Your doctor will assess your hemorrhoids via a visual inspection of the area. They may then perform a digital examination with a gloved finger to feel for internal hemorrhoids.

Your doctor may want to visualize the inside of your lower digestive system as well. Anoscopy is a procedure involving the use of a small camera, approximately the size of a finger, to visualize the anus and rectum. Sigmoidoscopy and colonoscopy use larger, more specialized cameras to visually examine your colon further.

Treatments

Depending on the type, position, and size of the hemorrhoids, your doctor may suggest conservative at-home treatments. These may include:

  • warm sitz baths
  • increasing dietary fiber intake
  • increasing water intake
  • getting regular exercise
  • ice packs
  • over-the-counter pain medications
  • topical wipes and ointments

Use any medications exactly as directed, and tell your doctor about any medications you are taking.

Sitz baths are warm water soaks of the affected area, with or without medication. You can take a sitz bath in a clean bathtub or in a specially designed bowl that sits inside your toilet bowl. Taking a sitz bath involves the following steps:

  1. Gather your supplies, including a clean towel, any ordered medication, and your sitz bath bowl if using one.
  2. Fill your bath with enough warm water to cover the affected area. Water should be at a comfortable temperature. Mix any medications into the bath.
  3. Sit with the affected area under the water for 10–20 minutes. Replenish the warm water as needed to maintain a comfortable temperature. Note that the sitz bath may sting at first, but this should resolve.
  4. Carefully leave the tub or stand up from the toilet. Monitor yourself for any dizziness or lightheadedness. Ask someone you trust to help you if needed.
  5. Dry your anal area with a clean towel.
  6. Wash your hands.
  7. Apply any ointments or creams that your physician suggests, then wash your hands again.
  8. Drain and clean the tub or sitz bath bowl.

Using a sitz bath several times per day may be beneficial. Contact your doctor if your symptoms persist after 1 week of at-home treatment.

Medical treatments

Depending on the type and location of a burst hemorrhoid, your doctor may treat it in an office setting. If the burst hemorrhoid is severe, infected, or bleeding, you may require hospitalization.

In-office or hospital treatments for hemorrhoids may include:

  • rubber band ligation, in which a small rubber band is placed around a hemorrhoid; this cuts off blood supply and causes the hemorrhoid to fall off painlessly after a few days
  • sclerotherapy, which involves injecting a hemorrhoid with an irritant that causes it to scar and die off
  • infrared photocoagulation, which involves using an infrared source to heat the hemorrhoid, causing it to fall away
  • hemorrhoidectomy, which is the surgical removal of either internal or external hemorrhoids

Your doctor may also prescribe pain-relieving creams or ointments containing lidocaine and hydrocortisone. These will relieve the burning and itching that hemorrhoids cause. If an infection is present, your doctor may also prescribe antibiotics. Take these as directed.

Outlook

Burst hemorrhoids can be serious because of the risks of bleeding and infection. Any rectal bleeding is unusual and needs medical evaluation. Do not ignore rectal bleeding.

It is possible for hemorrhoids to recur, although surgery reduces the risk of recurrence.

Prevention

The best way to avoid a burst hemorrhoid is to prevent hemorrhoids from forming in the first place. The following steps may help prevent hemorrhoids:

  • Avoid straining to pass stool.
  • Avoid sitting on the toilet for long periods of time.
  • Drink adequate fluids daily.
  • Eat a high fiber diet.
  • Take a fiber supplement with your doctor’s approval.
  • Get adequate exercise to promote bowel function.

Summary

Burst hemorrhoids can be unpleasant, painful, and potentially serious. If pressure inside a hemorrhoid causes it to burst, bleeding and infection may result.

Contact your physician for any rectal bleeding and for fever or pus accompanying a burst hemorrhoid.

Eating a high fiber diet, increasing fluid intake, and getting regular exercise can help prevent hemorrhoids. Avoid straining to pass stool or sitting on the toilet for long periods.

If you are experiencing symptoms consistent with a hemorrhoid, contact your doctor.

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Medical Reviewer: Lauren Castiello, MS, AGNP-C
Last Review Date: 2022 Dec 8
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