If you notice rectal bleeding, a lump in the anus, or rectal pain, it could be bleeding hemorrhoid causing the problem. Even though most cases of hemorrhoids are mild and can be treated with home care, you should consult your doctor to be on the safe side and get the best advice to keep them away. The more hemorrhoid symptoms linger, the more trouble they can create for you and require invasive treatment before getting relief. It is best to see a doctor for your symptoms as timely help can save you a lot of pain and discomfort and prevent the need for invasive treatment. The physicians at Manhattan Gastroenterology have years of experience and qualifications to confirm the diagnosis of hemorrhoids and eliminate other possible complications from bleeding hemorrhoids.

Also known as piles, hemorrhoids are enlarged veins in the rectum and anus. They are a regular part of the body, but they can turn painful when they become irritated or swollen for any reason. They are just like varicose veins that are seen in the legs.

Bleeding hemorrhoids are a cause of concern, but they do not always require medical intervention. Adding high-fiber foods and drinking plenty of water can reduce the risk of hemorrhoids and bleeding. If bleeding is heavy or persistent, you notice dark red blood, or feel severe pain, contacting an experienced doctor may be the best option. The doctor will discuss treatment options and conduct the necessary tests to rule out other conditions.

Hemorrhoids are of two types:

  • Internal hemorrhoids – develop in the rectum.
  • External hemorrhoids – develop around the anal opening, beneath the skin.

Both internal and external hemorrhoids can turn into thrombosed hemorrhoids. It means that a blood clot forms inside the vein. Thrombosed hemorrhoids are not dangerous but can cause severe pain and inflammation that can affect your normal activities.

Why Do Hemorrhoids Bleed?

Bleeding Hemorrhoids
Bleeding Hemorrhoids

Hemorrhoids can cause severe rectal bleeding due to ulceration or breaking and necrosis or cell death of the surrounding skin. Straining or passing hard and dry stool can damage the surface of hemorrhoids that makes them bleed. Blood from hemorrhoids looks bright red on a piece of toilet paper.

Internal and external hemorrhoids can bleed if they are not cared for properly. In some cases, thrombosed hemorrhoids can also burst if they become too full. It is essential to learn why hemorrhoids bleed and what you can do to seek relief from the pain, discomfort, and bleeding they can cause.

For some people, hemorrhoids do not cause any symptoms or pain, but for others, they can cause itching, bleeding, and a sensation of burning and discomfort that can be pretty intense and irritating. A bleeding hemorrhoid is usually a sign of irritation or damage to the wall of hemorrhoid. It should resolve on its own over time, but you need self-care and treatment to speed up the recovery process, soothe the discomfort and prevent it from returning.

Signs and Symptoms of a Mild Condition

A few drops of bright red blood after a bowel movement are the most common symptoms of a mild hemorrhoidal condition. You may notice the blood in the toilet, streaked on the stool, or simply visible on the toilet paper when you wipe.

Other symptoms of hemorrhoids include:

  • Itching and irritation around the anus
  • A small lump or bulge on or near the anus
  • Feelings as if your bowels have not emptied
  • Pressure around the anus

At times you may feel that your internal hemorrhoid is protruding through the anus. It may not go back on its own and get trapped, which leads to discomfort and pain. Usually, it can be pushed back inside and does not need medical treatment, but if it seems to be slipping out and begins to bleed, you should consult a doctor.

Pain and Discomfort Associated With Bleeding Hemorrhoids

If the hemorrhoid bleeds internally, a blood clot can form inside, creating a bluish-colored lump. It is known as a thrombosed hemorrhoid, and it requires medical attention. Thrombosed hemorrhoids can cause significant levels of pain.

In some cases, thrombosed hemorrhoids can also rupture, releasing the clot and bleeding heavily. This condition can turn serious, and you must consult a doctor if you have a thrombosed hemorrhoid to prevent excessive bleeding and complications. The best time to deal with a thrombosed hemorrhoid is within 72 hours of clot formation. If it is not removed, the pressure from a thrombosed hemorrhoid can damage the surrounding tissues.

When to See a Doctor for Bleeding Hemorrhoids?

Minor bleeding or a few drops of blood after a bowel movement are not concerning, and they can be managed with home remedies and changes in diet. However, if your hemorrhoids are bleeding regularly between bowel movements and you notice frequent blood in your underwear or large quantities of blood in the toilet, call your gastroenterologist.

You should seek immediate medical help if you experience:

  • Severe pain
  • Constant bleeding
  • A bluish lump on the anus that suggests a thrombosed hemorrhoid
  • Difficulty in walking, sitting, or standing
  • Pain and discomfort despite the use of over-the-counter hemorrhoid medications and home remedies
  • Black stools or tar-like that indicate bleeding

Thrombosed hemorrhoids should not be taken lightly as they need immediate treatment. Without proper treatment, thrombosed hemorrhoids can compress and damage blood vessels in surrounding healthy tissues. If your symptoms of hemorrhoids do not improve after seven days, visit a gastroenterologist.

Also, tell your doctor if you notice any of the following with bleeding:

  • Changes in stool consistency or color
  • Anal pain
  • Changes in bowel movement habits
  • Weight loss
  • Fever
  • Abdominal pain
  • Lightheadedness
  • Nausea or vomiting
  • Dizziness

The doctor evaluates your condition based on your symptoms and a rectal exam by inserting a gloved finger into the rectum to feel for swollen veins. If needed, the doctor may also examine the anal canal with an anoscope, a small, rigid, tubular instrument for further analysis of your hemorrhoids.

Treatments for Bleeding Hemorrhoids

Medical treatment becomes necessary if your hemorrhoids do not get better with home treatment and self-care. Your doctor will recommend the most suitable treatment option for your condition based on the severity of your symptoms.

The good thing about hemorrhoid treatments is that many of them can be done in the clinic and do not require general anesthesia. They include:

  • Rubber band ligation. This non-invasive clinical procedure involves applying a tiny rubber band to the base of internal hemorrhoid. It restricts blood flow, causing hemorrhoids to wither and fall off within 3 to 10 days.
  • Sclerotherapy – During this procedure, the doctor injects a medicated solution into the hemorrhoid. The results are almost similar to the rubber band litigation, and the hemorrhoids die and fall off within a few days. This treatment requires multiple injections, administered after a few weeks, depending on the type of hemorrhoids you have.
  • Bipolar, laser, or infrared coagulation – This method uses heat or laser light which causes internal hemorrhoid to lose its blood supply so that it eventually withers away after 1 to 2 weeks.
  • Electrocoagulation – A controlled electrical current dries up hemorrhoids, creating scar tissue, and it falls off eventually.

The doctor may also prescribe medications to reduce the swelling and irritation in the anal area and produce a more effortless bowel movement.

If your hemorrhoids are larger and more severe and these treatments fail to provide the desired relief, your doctor may recommend more extensive surgery to deal with them and stop the bleeding. Surgery also becomes necessary if you have prolapsed or internal hemorrhoids that begin to hang out of the anus and cause substantial discomfort. The doctor will determine which procedure will work best, considering the severity of your hemorrhoids.

Hemorrhoids are common, and a large population suffers from them at one time or another, but this does not lessen their severity or need for treatment. Even if they are not severe, but you have been trying to treat them with self-care and home remedies without success, it is essential to get medical help timely. Visit Manhattan Gastroenterology NYC to consult with specialists to learn more about bleeding hemorrhoids and the best treatment options to seek quick relief. The top-rated gastroenterologists recommend treatment based on your symptoms and the level of pain you are going through. They will help you make smart lifestyle and dietary changes that will give you a chance to feel better quickly and prevent hemorrhoids from returning.

Updated on Sep 1, 2023 by Dr. Shawn Khodadadian (Gastroenterologist) of Manhattan Gastroenterology