Hemorrhoid attacks may have obvious symptoms of swelling and pain, and different types of hemorrhoid attacks can cause pain, so it is important to differentiate the specific situation and treat it accordingly. Thrombosed external hemorrhoids are swollen and painful, probably due to blood clots. Small thrombosed external hemorrhoids can be treated with topical hemorrhoid cream and medicated fumigation sitz baths after a bowel movement, and the symptoms will be relieved. If the symptoms are not relieved, or if the thrombosed external hemorrhoid is large, undergo a specialist examination and, if necessary, surgical treatment. Inflammatory external hemorrhoids that are swollen and painful may be inflammatory connective tissue and can be controlled by using a potassium permanganate solution with a 1:5000 water sitz bath. Topical topical hemorrhoid creams can also be used, mostly to control the symptoms. If the internal hemorrhoid is prolapsed, it must be plugged back, that is, reset to relieve pain, otherwise it will cause impaction, ischemia, necrosis, and pain medication can be taken when pain is obvious. If the hemorrhoid is swollen and painful, you need to consider surgery if conservative treatment does not work, or if there is a tendency for it to get worse. Another condition, hemorrhoids with pain may also be perianal abscess, or anal fistula with acute infection, both of which require surgical treatment and should not be mistaken for hemorrhoids. So if you have painful hemorrhoids, you should go to the hospital in time to identify the cause and then treat it accordingly.