Abstract
A 50-year-old female patient presented with severe pain, discomfort, and swelling in the anal region, clinically diagnosed as thrombosed haemorrhoids and she has been constipated for the last 10 years. The patient declined conventional surgical or pharmacological interventions and opted for homeopathic treatment. She was prescribed Paeonia officinalis 200C based on symptom similarity. Follow-up after 20 days revealed marked improvement, with complete resolution of pain, discomfort and she has relief in constipation also. Physical examination confirmed the dissolution of the thrombus and normalization of the affected area. This case highlights the potential role of individualized homeopathic therapy in managing acute thrombosed haemorrhoids.
Keywords – homoeopathy, thrombosed hemorrhoids, constipation, Paeonia officinalis.
Introduction
Thrombosed haemorrhoids, also known as perianal hematomas, are a painful condition characterized by the formation of blood clots within the external hemorrhoidal veins. They typically present with acute onset of severe pain, swelling, and sometimes bluish discoloration around the anal region. This condition can significantly impair the quality of life and daily functioning of patients. While conventional treatment options include analgesics, topical agents, and surgical excision in severe cases, some patients seek alternative therapies due to concerns about side effects, invasiveness, or personal preference.
This case report describes the successful management of thrombosed haemorrhoids in a 50-year-old female patient using Paeonia officinalis 200C, highlighting the potential effectiveness of homeopathy in treating acute anorectal conditions.
Case History
A 50-year-old female complains of severe pain and discomfort around anal region for a week and she is constipated for 10 years.
Chief Complaint of Patient
- Pain and discomfort when sitting, walking or having bowel movement.
- Itching around anus
- Straining in stool and burning around anal region
- Throbbing pain along with backache
- Fetid eructation day and night
History of Present Complaint
Onset – acute
Treatment adopted – no other treatment taken
Family History
Maternal: nothing specific
Paternal: nothing specific
Past History:
Patient is constipated for 10 years
Personal History
Mind & disposition: Irritable, confused and extroverted
anxiety about health
Married or single: Married
No. of children: 3
Health of children: Good
Marital relations: Good
Physical Generals
Diet: Vegetarian diet
Desire: Spicy food
Disagrees: Nothing specific.
Thirst: Increased, 3-4 lit. per day.
Tongue: Clean
Taste: No altered taste as mentioned by the patient.
Salivation: Moderate as per patient.
Perspiration: More on back and neck, no specific odour and no staining on clothes as mentioned by patient.
Stool: Dry hard stool difficult to pass.
Urine: Passes urine every 3-4 hours with no burning and no specific odour.
Bathing: Regularly.
Covering: Not specific
Sexual relations: Good.
Dwelling place: Well ventilated house with proper sunlight
Appetite: Proper, eat well at proper time.
Aversion: Nothing specific.
Habits / Addictions: No addictions as mentioned by patient.
- Tobacco: No
- Alcohol: No
- Coffee / Tea: tea drinker
- Drugs etc: No
- Thermal reaction: chilly
- Sleep: disturbed
- Dream: Daily routine.
Gynaecological History
Menarche: 14 years
Menstrual Cycle: Regular
Leucorrhoea: Normal
Menopause: Not applicable.
General Examination
Anaemia: NAD
Jaundice: Not detected
Neck glands: Not swollen
Blood pressure: 130/90 mmhg
Tongue: Clean
Pulse: 76bpm
Temperature: Afebrile
Respiration:17/min
Systemic Examination
Brief examination of other systems
Respiratory System: Normal vesicular breathing heard all over the lung field.
Gastrointestinal System: Liver, spleen not palpable. No free fluid in the abdomen. Normal peristaltic sounds.
Physical Examination: Redness in perianal area, reveals hard, painful lump
Digital Rectal Examination: Tenderness in perianal region
Cardiovascular System: Apex normally placed, S1, S2 heard normal, no added sounds.
Nervous System: Higher functions cranial nerves and speech were intact.
Motor system: Power and tone normal. No involuntary movement or atrophy detected.
Laboratory Investigations Advised
Not required
Provisional Diagnosis- Thrombosed haemorrhoid
Differential Diagnosis
Anal fissure, perianal abscess, anal fistula, rectal prolapse
Symptoms:
Swollen vein causing pain and discomfort along with clot formation
Miasm: Psora & sycosis
Prescribing Totality
- RECTUM, HEMORROIDS-thrombotic
- RECTUM, HEMORROIDS-congested
- RECTUM, Itching
- RECTUM, HEMORROIDS, external
- Pain and discomfort when sitting, walking or having bowel movement.
- Itching around anus
- Straining in stool and burning around anal region
- Throbbing pain along with backache
- Fetid eructation day and night
Mentals – very extroverted, irritable, confused
Anxiety about health
Sleep – disturbed
Final Selection of Medicine with Comments Regarding Selection of Remedy
- RECTUM, HEMORROIDS-thrombotic
- RECTUM, HEMORROIDS-congested
- RECTUM, Itching
- Modalities – worse by warm and heat
Prescription
Rx
Paeonia officinalis 200 X OD X 3days 4 globules
To be taken once a day for 3 days
Rubram SULPH 200 X BD X 7 days
DR PRACHI MAHAJAN
04/03/2025
Follow Up:
| Date | Observation & interpretation | Remedies |
| 25/03/2025 | Pt. is better Pain and discomfort is reduced, clot has been dissolved | SAC LAC 300 X BD FOR 15 DAYS |
| 5/04/2025 | Relief in hemorroids but unsatisfactory stool along with backache | Aesculus 30 x BD FOR 5 DAYS |
| 16/04/2025 | Complete relief in pain & discomfort in anal region along with satisfactory passage of stool patient is very satisfied. | Rubrum 200 x BD for 7 days |
About the Author:
Dr PRACHI MAHAJAN
MD scholar department of practice of medicine in government homoeopathic medical college and hospital Bhopal, Madhya Pradesh.
GUIDED BY:
DR PRAVEEN JAISWAL MD(HOD), Phd(HOM)
HOD & PROFESSOR OF DEPARTMENT OF PRACTICE OF MEDICINE, Government homoeopathic medical college and hospital Bhopal, Madhya Pradesh
