The first thing to consider is thrombosed external hemorrhoids. Thrombosed external hemorrhoids are mostly caused by constipation, dry stools, straining during bowel movements, straining or irregular diet. Most thrombosed external hemorrhoids are associated with severe pain, localized pain to the nucleus and a dark purple surface. You should pay attention to a light diet, avoid spicy and stimulating foods, keep your stools soft and clear, and pay attention to the cleanliness of the anal area after the stool.