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Hemorrhoid Bleeding

Hemorrhoid Bleeding

Hemorrhoids are a common condition that may also be referred to as piles. Hemorrhoids are swollen veins in your lower rectum and anus similar to varicose veins. In most cases, hemorrhoids often naturally heal on their own without the need for medical treatment. In some cases, a hemorrhoid may require at-home therapies or medical treatments.

Patients may experience various symptoms related to hemorrhoids, with the most common symptoms being bleeding or itching. While pain is not a symptom of internal hemorrhoids many patients with hemorrhoids suffer from associated conditions that cause pain. While these symptoms may be unpleasant or alarming, numerous innovative treatments are available to improve these sensations and promote healing.

What Causes Hemorrhoids to Bleed?

Hemorrhoidal bleeding is a possible side effect patients may experience with internal or external hemorrhoids. External hemorrhoids can bleed from excessive straining or pressure placed on the rectum or anal cavity. As hemorrhoids develop due to increased stress and pressure in the lower rectum, any action that increases this pressure may cause a hemorrhoid to bleed.

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Hemorrhoid Bleeding

Some of the most common reasons for hemorrhoids to bleed include:

  • Firm stools: Overly firm stools can irritate the anal lining and cause hemorrhoids to break or bleed. If you are experiencing constipation or very firm stool, you may strain longer and harder in an attempt to pass the bowel movement. Constipation and straining can apply pressure to the anal lining and cause hemorrhoids to bleed.
  • Irritation from wiping: If you have external hemorrhoids, you may notice they become irritated or uncomfortable when you try to wipe after a bowel movement. It is generally recommended to be gentle when wiping, as being too rough can worsen pain and uncomfortable symptoms caused by hemorrhoids. Repeated or overly firm wiping can even lead a hemorrhoid to become damaged or bleed.
  • Straining during bowel movements: As hemorrhoids are often caused by straining during bowel movements, it is no surprise excessive straining or force when passing stool may cause a hemorrhoid to bleed. Straining during a bowel movement applies pressure to sensitive hemorrhoids that can tear the hemorrhoid’s exterior, resulting in bleeding. Many people may notice small amounts of blood on toilet paper after wiping.
  • Low-fiber diet: A low fiber diet can worsen hemorrhoidal symptoms, as low fiber intake often causes or exacerbates constipation, leading to straining during a bowel movement. Some low-fiber foods you may want to limit or avoid entirely include fried foods, salty foods, processed meats, dairy products, red meat and white flour.
  • Dietary choices: Your nutritional habits play a large role in the health of your bowel movements and whether you experience any worsening hemorrhoid symptoms. If you have hemorrhoids, you should limit alcohol and caffeine intake, as these often make bowel movements less comfortable and cause additional straining. You should also limit your intake of spicy foods, which may irritate hemorrhoids or worsen painful symptoms.
  • Swollen hemorrhoids: When a hemorrhoid continues to grow or swell, it increases the risk of this hemorrhoid becoming damaged, torn or burst. With more blood pooling into a hemorrhoid, a person’s risk of hemorrhoidal bleeding increases.
  • Heavy lifting: It is generally recommended to avoid heavy lifting for those with hemorrhoids, especially in highly sensitive or severe cases. Lifting heavy items can directly worsen hemorrhoidal symptoms and cause pain and discomfort. When you lift something heavy, excess strain and pressure is placed on the internal organs and rectum’s veins, increasing the risk for potential bleeding.
  • Excess time on the toilet: Spending excess time on the toilet can increase the strain and pressure on the lower rectum and worsen hemorrhoidal symptoms. A toilet seat is cut out, meaning the rectum sits lower than the rest of the bottom, allowing gravity to take effect. The blood begins to pool in the veins of the rectum, potentially creating or enlarging hemorrhoids.
  • Pregnancy: Pregnancy increases the blood flow to the pelvic area and increases pressure as the baby grows. Pregnancy can also cause the veins that run along the anus to swell and become inflamed. Hormones during pregnancy also fluctuate, slowing the bowels down and potentially leading to constipation. These bodily changes can cause hemorrhoids to develop, worsen existing hemorrhoids and cause hemorrhoids to bleed.
  • Anal intercourse: Anal intercourse can greatly disturb the anal lining and can damage the lining of hemorrhoids. Unfortunately, because many people may not realize they have internal hemorrhoids, they may not think they are at risk of hemorrhoidal bleeding. The pressure, strain and damage anal intercourse causes can often result in hemorrhoids breaking and bleeding.

Are Bleeding Hemorrhoids Serious?

Please note: anal bleeding can also be a symptom of colorectal cancer so if you are experiencing bleeding it is important to see a physician in order to rule out anything more serious.

While a bleeding hemorrhoid may be alarming, they are not serious or a sign of concern in most cases. The lining of a hemorrhoid is often sensitive and delicate, meaning it can easily be torn or damaged during a bowel movement, especially if the stool is firmer than usual. It is important to note the difference between blood in your stool and blood around your stool.

Blood around your stool means it is likely the stool came into contact with a bleeding hemorrhoid as it was passed. Bleeding hemorrhoids often continue to cause pain or discomfort afterward. On the other hand, if a thrombosed hemorrhoid bursts, some patients may notice a relief of pressure when a hemorrhoid fully drains. Unfortunately, before bursting, these hemorrhoids are often particularly sensitive and painful.

If you do not have any intense or irregular pain before noticing hemorrhoidal bleeding, you may have a hemorrhoid that was briefly irritated or inflamed. In these more mild cases, over-the-counter treatments and at-home remedies may help alleviate uncomfortable symptoms. In most cases, bleeding from a burst thrombosed external hemorrhoid often lasts from just a few seconds to several minutes.

You may notice occasional bleeding between bowel movements. In most cases, a burst hemorrhoid does not require medical attention. Soaking the affected area can help improve symptoms and ease irritation.

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When to See a Physician About Hemorrhoids

While many hemorrhoids may not need immediate medical attention, you will want to pay attention to any severe or intense symptoms you may notice. In most cases, it is generally recommended to see a physician for any signs of anal bleeding to rule out more serious causes and conditions. Additionally, while hemorrhoid symptoms tend to come and go in ‘flare-ups,’ without definitive treatment these symptoms will continue to recur. 

It is possible anal bleeding may be caused by another condition. In some cases, anal bleeding may be a symptom of a more serious underlying medical condition. If you notice severe anal pain, significant weight loss, fever, lightheadedness or nausea in addition to anal bleeding, you should consult a physician immediately.

Hemorrhoid Bleeding

Other symptoms you may want to be aware of include severe abdominal pain, changes in stool color or irregular bowel movements. It is important to note that an inflamed or irritated hemorrhoid may lead to intermittent anal bleeding over a period of time. Additional conditions, other than hemorrhoids, that may cause anal bleeding include inflammatory bowel disease, ulcers, anal fissures and colorectal cancer.

External vs. Internal Hemorrhoid Bleeding

Both internal and external hemorrhoids may experience bleeding or similar symptoms. Understanding the type of hemorrhoids you have can help you choose a treatment plan that is right for your unique needs. Internal hemorrhoids develop within the lining of the anal canal, meaning they are not visible to the naked eye. Although internal hemorrhoids develop within the anal canal, they often prolapse and are mistaken for external hemorrhoids. On the other hand, external hemorrhoids form on the exterior of the anus, making them easier to see, feel or notice.

Internal Hemorrhoid Symptoms

Internal hemorrhoids develop inside the rectum, making it unlikely that most people will detect them unless they present noticeable symptoms. Many patients only discover they have internal hemorrhoids if they notice blood around after a bowel movement. In more severe cases, an internal hemorrhoid can grow so large it slips out of the anus, known as a prolapsed hemorrhoid. When this occurs patients will also experience: itching, swelling and even soiling as that tissue causes a ‘foot in the door.’ effect.

The internal lining of the rectum has fewer pain-sensing nerves, meaning internal hemorrhoids rarely cause intense pain or discomfort. Although internal hemorrhoids do not cause pain, patients often suffer from associated conditions such as fissures which cause pain.

External Hemorrhoid Symptoms

External hemorrhoids are the most common type of hemorrhoid and often present the most noticeable symptoms. External hemorrhoids are much easier to notice, as they form beneath the skin around the anus. You may notice hard, sensitive lumps around the anus that present as swollen blood vessels when using the restroom. External hemorrhoids are often much more sensitive, as this area has more pain-sensing nerves.
External hemorrhoids may cause painful irritations and even itching sensations around the anus. While many people may feel the desire to itch a hemorrhoid, this often worsens hemorrhoidal symptoms. Some of the most common symptoms of external hemorrhoids include pain, irritation and inflammation.

Thrombosed Hemorrhoid Symptoms

Thrombosed hemorrhoids are a type of hemorrhoid that occur when sacs along the anal lining are pushed through the outside of the anus and begin to fill with blood clots. Unfortunately, thrombosed hemorrhoids can be quite uncomfortable and painful, causing everyday activities to be uncomfortable or, in severe cases, impossible to perform.

When blood pools into external hemorrhoids, a blood clot forms. Some of the most common symptoms of thrombosed hemorrhoids include intense pain, inflammation, irritation and a firm lump near the anus. In some cases, thrombosed hemorrhoids may cause itchiness or bleed during a bowel movement.

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Bleeding Hemorrhoid Treatment & Relief

Internal and external hemorrhoid bleeding may be alarming for many people. Fortunately, numerous treatments and remedies for internal hemorrhoid bleeding can alleviate discomfort and various symptoms. In many cases, mild hemorrhoids can even be effectively treated with over-the-counter medication or at-home remedies.

The specific treatment you may benefit from depends on the severity of your symptoms and if you have internal or external hemorrhoids. If you do not experience relief from at-home remedies or over-the-counter medication, you may want to consider seeing a hemorrhoid specialist. There are many minimally invasive medical treatments available to improve hemorrhoid symptoms. 

Some hemorrhoid treatments include:

  • Rubber band ligation: Rubber band ligation is a non-surgical definitive hemorrhoid treatment option where the base of a hemorrhoid is tied off with a rubber band, reducing the blood flow to the hemorrhoid. This hemorrhoid treatment is designed for internal hemorrhoids and causes a hemorrhoid to fall off in approximately five to seven days following the procedure.  The CRH O’Regan system is a form of hemorrhoid banding that is quick, painless and effective, click here to see if this treatment option is right for you. 

  • Sitz bath: A sitz bath is a helpful treatment to temporarily reduce the irritation caused by bleeding hemorrhoids. A sitz bath is available at most pharmacies and allows a person to soak the rectum and hips to ease irritation and discomfort. Soaking in warm water can help to heal bleeding hemorrhoids and minimize irritation. It is important to avoid using hot water, as this can irritate the sensitive skin of the anus.

  • Over-the-counter creams: An over-the-counter hemorrhoid cream can help temporarily reduce hemorrhoid irritation and inflammation. In many cases, an over-the-counter topical agent can be an effective addition to a sitz bath and other hemorrhoid treatments. Topical agents are available for external hemorrhoids, and suppositories are available for internal hemorrhoids.  While these over the counter creams can provide temporary relief from symptoms, long lasting relief requires a more definitive option like rubber band ligation. 

  • Fiber supplements: Some people may experience relief in hemorrhoid symptoms by introducing a fiber supplement into their diet. Before starting a fiber supplement, you should check with your doctor first to ensure this supplement will not interfere with any medications or dietary restrictions.

  • Stool softeners: Overly firm stool can cause straining and lead to irritation of hemorrhoids. Stool softeners can help prevent excessive straining during a bowel movement, making them ideal for many hemorrhoid patients. Check with your physician to see if stool softeners may be right for you.

  • Ice compresses: If you are experiencing swelling or inflammation from hemorrhoids, you may want to consider cool compresses or ice packs. You can apply cloth-covered ice packs to inflamed areas for 10 minutes to reduce pain, irritation and inflammation.

  • Avoid excess time on the toilet: Hemorrhoids are often caused and worsened by straining during a bowel movement. Additionally, sitting for extended periods of time during a bowel movement can cause strain and pressure on hemorrhoids and worsen symptoms. You should only go to the restroom when you feel the need to and avoid spending prolonged periods on the toilet.

  • Sclerotherapy: Sclerotherapy is an innovative hemorrhoid treatment that can help improve the severity of a hemorrhoid. This treatment involves injecting a chemical solution into the hemorrhoid, damaging the blood vessels that directly flow into the hemorrhoid. 

  • Infrared Coagulation: Infrared Coagulation is a laser-based treatment that can shrink hemorrhoidal tissue, allowing the hemorrhoid to fall off over time. This innovative hemorrhoid treatment is often recommended for small or medium internal hemorrhoids. The goal of infrared photocoagulation is to cut off the blood supply to the hemorrhoid.  This type of treatment is effective, however, it does have a higher recurrence rate.

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CRH O’Regan System for Banding

The CRH O’Regan System for banding is an innovative hemorrhoid treatment that uses gentle suction to capture the hemorrhoidal tissue for banding. Our approach to hemorrhoid banding is quick, effective and painless, requiring no sedation or extensive preparation.  The best part is that the recurrence rate is on par with surgery without the potential risks, complications and downtime. Hemorrhoid banding with CRH banding is a simple one minute procedure that is done in an office appointment.

Patients can return to normal activities the same day following their hemorrhoid banding. Another benefit of CRH banding is no aftercare is required for this procedure, as it is a gentler option. Learn more about our CRH system and find a clinic utilizing the CRH O’Regan System near you.

Hemorrhoid Bleeding