Usually self-limiting with resolution in 1 week
Consider conservative treatment (sitz baths and bulk laxatives) if:
Thrombosis has been present >72 hrs
Swelling has started to shrink
Pain is tolerable
Conservative treatment may also include topical 0.3% nifedipine and 1.5% viscous lidocaine
Consider Perianal block for pain relief
Consider excision if:
Patient is not immunocompromised, child, pregnant woman, has portal hypertension, coagulopathic
Thrombosis is acute (<72 hrs)
Extremely painful
See<unk>  Excision
Thrombosis has been present >72 hrs
Swelling has started to shrink
Pain is tolerable
Patient is not immunocompromised, child, pregnant woman, has portal hypertension, coagulopathic
Thrombosis is acute (<72 hrs)
Extremely painful
See<unk>  Excision
External hemorrhoid
Anal fissure
Internal hemorrhoid
Anal fistula
Anal malignancy
Rectal prolapse
Anal tags
Anorectal abscess