What to know about bleeding hemorrhoids

Hemorrhoids are swollen blood vessels in and around the anus and rectum. Many people are not aware that they have hemorrhoids until they bleed, become uncomfortable, or start causing pain.

According to the American Society of Colon and Rectal Surgeons, around 5% of people with hemorrhoids experience symptoms, such as pain, discomfort, and bleeding.

A small number of these people may require surgical treatment. However, people can usually treat hemorrhoids at home.

In this article, we cover the symptoms of bleeding hemorrhoids. We also provide information on home remedies, medical treatments, and when to see a doctor.

Symptoms

Bleeding hemorrhoids may form a lump around the anus that a person can feel while wiping.

Bleeding hemorrhoids usually occur after a bowel movement.

A person may see traces or streaks of blood on the tissue after wiping. Sometimes, small amounts of blood may be visible in the toilet bowl, or in the stool itself.

The blood from bleeding hemorrhoids is usually bright red. People should notify a doctor if the blood they see is darker, as this can indicate a problem higher up in the gastrointestinal tract.

Other hemorrhoid symptoms include:

feeling a lump or bulge around the anus while wiping

feeling that stool is stuck inside the anus during or after a bowel movement

difficulty cleaning up after a bowel movement

itching around the anus

irritation around the anus

mucus-like discharge from the anus

a feeling of pressure around the anus

Sometimes, a blood clot can develop within the hemorrhoid. This is called a thrombosed hemorrhoid.

As a thrombosed hemorrhoid swells, pressure from surrounding tissues can cause it to rupture and bleed.

The blood from a thrombosed hemorrhoid tends to be dark and clotted. They are often very painful, and they usually require treatment.

Home remedies

A warm bath can help relieve hemorrhoid pain and irritation.

Not all bleeding hemorrhoids require medical treatment.

If a person loses only a small amount of blood and their symptoms are mild, they may be able to treat the hemorrhoids at home.

Some home remedies include:

Taking tub or sitz baths: A sitz bath is a small plastic tub that fits over the toilet seat. A person fills the bath with warm water and sits in it for about 10 minutes, two to three times per day. This can help relieve hemorrhoid pain and irritation.

Applying ice: Applying cloth covered ice packs to swollen areas for 10 minutes at a time can help reduce hemorrhoid pain and inflammation.

Not delaying bowel movements: A person should try not to delay having a bowel movement when they have the urge to go. Waiting can make stool harder to pass and is more likely to irritate hemorrhoids.

Applying over-the-counter hemorrhoid creams: These creams usually contain steroids that reduce hemorrhoid inflammation.

Increasing fiber and water intake: This softens stool, making it easier to pass. Less straining during bowel movements gives hemorrhoids a chance to heal.

When to see a doctor

According to an article in the journal Clinics in Colon and Rectal Surgery, hemorrhoids are the most common reason people seek help from colon and rectal surgeons.

Signs and symptoms a person should see their doctor as quickly as possible include:

constant hemorrhoid pain

constant bleeding from the hemorrhoid

noticing more than a few drops of blood in the toilet bowl

a bluish lump on the anus, which indicates that the hemorrhoid is likely thrombosed

A person should see a doctor as soon as possible if they suspect that they have a thrombosed hemorrhoid. Without treatment, thrombosed hemorrhoids can compress and damage blood vessels in surrounding healthy tissues.

According to an article in the journal Clinics in Colon and Rectal Surgery, a surgeon should ideally remove a thrombosed hemorrhoid within 48–72 hours of symptoms first appearing.

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Medical treatments

Medical treatments for bleeding hemorrhoids depend on symptom severity and whether the hemorrhoid is internal or external.

Internal hemorrhoids form inside the rectum. External hemorrhoids form beneath the skin around the anus.

Treatment options for internal hemorrhoids include:

Infrared photocoagulation: This office based procedure uses a laser to damage hemorrhoidal tissue, causing it to shrink and slough off.

Rubber band ligation: This treatment involves placing a small band at the base of an internal hemorrhoid to cut off its blood supply. The hemorrhoid usually falls off around 5–7 days later.

Sclerotherapy: This treatment involves injecting chemicals into the hemorrhoid to make it shrink. This treatment is only suitable for mild hemorrhoids.

Treatment options for external hemorrhoids include:

In-office removal: Sometimes, a doctor can remove a hemorrhoid in their office. This involves numbing the area with a local anesthetic, then cutting the hemorrhoid away.

Hemorrhoidectomy: This surgical approach to hemorrhoid removal is usually for severe, large, or recurrent hemorrhoids. It is more invasive than in-office removal. Some surgeries may require general anesthesia.

Learn more about hemorrhoid surgeries here.

People can ask their healthcare provider about the various treatment options available to them.

Prevention

Regular exercise may help prevent hemorrhoids.

Hemorrhoids are often the result of excessive straining during a bowel movement.

A doctor may therefore recommend the following tips to ease bowel movements and prevent hemorrhoids:

Gradually increase intake of whole grains, fruits, vegetables, and other sources of dietary fiber: People can try adding one serving of fiber per day until they reach a daily fiber intake of 20–35 grams. This helps regulate bowel movements.

Take a fiber supplement once or twice daily: A person should always check with their physician to ensure that a fiber supplement will not interfere with other medications.

Drink between eight and 10 glasses of water daily: The intestines draw water into the stools, making them easier to pass.

Exercise: This mimics an intestinal movement called peristalsis, which helps move the stool through the intestines.

Avoid lifting heavy objects: Heavy lifting causes extra strain in the pelvis, causing the blood vessels to stretch and blood to pool. Lifting can therefore increase the risk of hemorrhoids.

Summary

Bleeding hemorrhoids may be concerning, but they are not always painful, and they do not always require medical intervention.

Adopting a healthful diet and drinking plenty of water can help reduce the symptoms of bleeding hemorrhoids.

A person should see their doctor if pain or bleeding become worse, or if they suspect that they have a thrombosed hemorrhoid. A doctor will be able to recommend appropriate treatment options.

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