Posted by: Center for Digestive Health in Hemorrhoids

Hemorrhoids

Almost three out of four adults will experience hemorrhoids at least periodically during their lifetime. Hemorrhoids are swollen veins in the lower rectum and anus. Internal hemorrhoids develop inside the rectum, external hemorrhoids form under the skin around the anus. Women who are pregnant are more likely to get hemorrhoids. The likelihood that hemorrhoids will develop also tends to increases as you age.

What causes hemorrhoids?

Increased pressure in the lower rectum can cause hemorrhoids. When there is pressure in this region, the veins around the anus may stretch in response. They may bulge and swell. Some of the causes of hemorrhoids include:

  • Straining to have a bowel movement
  • Sitting on the toilet for long periods of time
  • Bouts with chronic constipation or diarrhea
  • Obesity
  • Pregnancy
  • Anal intercourse
  • Eating a diet low in fiber
  • Heavy lifting

Symptoms of Hemorrhoids

Hemorrhoid symptoms vary depending on the type you have. You may have an internal hemorrhoid, or an external one. Symptoms of an external hemorrhoid may include:

  • Anal pain or aching specifically when sitting
  • Anal itching
  • At least one hard, tender lump near the anus

For most individuals, external hemorrhoids go away in a matter of a few days. However, too much straining, rubbing, or cleaning around the anus can worsen symptoms. If you have internal hemorrhoids, symptoms may include:

  • Bleeding from the rectum
  • Bright red blood in stool, on toilet paper or in the toilet after passing a bowel movement
  • A hemorrhoid that has fallen through the anal opening (called a prolapse)

If you have an internal hemorrhoid that hasn’t prolapsed, it’s not usually painful. But a prolapsed internal hemorrhoid can be uncomfortable and painful. It is important to see a GI specialist for a proper diagnosis. Hemorrhoids are the most common cause of anal discomfort and symptoms. But not every anal symptom is directly related to hemorrhoids. Some of the symptoms experienced by hemorrhoidal suffers are similar to those of other conditions. For example, rectal bleeding is often a sign of other bowel diseases including ulcerative colitis, Crohn’s disease, or cancer of the rectum or colon.

Is bloody stool common with hemorrhoids?

Bleeding is common with hemorrhoids. It usually occurs after a bowel movement. It’s not unusual to see streaks of blood or traces of blood on toilet tissue after wiping.  You may even see blood in the toilet or in the stool you just passed. When you see blood from bleeding hemorrhoids, it’s usually bright red. If the blood is darker, it is usually indicative of problems higher in the gastrointestinal tract. You should consult with your doctor or a GI specialist immediately if you notice dark blood in your stool.  

Anal fissures are small tears in the lining of the anus. These tears are usually present after a bout of constipation or diarrhea. They are also a common cause of blood with stools. Your doctor can recommend actions you can take to prevent diarrhea and constipation. A GI specialist can determine if blood in your stool is from anal fissures, hemorrhoids, or another condition.

Hemorrhoid Home Care Options

Every bleeding hemorrhoid doesn’t require medical treatment. If you only see a small amount of blood and your symptoms are minimal and mild, you can try a few things at home to see if they will help. Check with your primary care about trying one or more of these methods at home for relief.

  • Sit in the tub. Fill your tub with warm water and sit in it for about 10 minutes. Doing this two or three times a day can help relieve hemorrhoid irritation and pain.
  • Apply ice. Try applying a cloth covered ice pack to swollen areas for about 10 minutes at a time. This can help relieve inflammation and pain associated with hemorrhoids.
  • When you gotta go, go! – When you have the urge to have a bowel movement, don’t wait and don’t fight the urge. Waiting can make the stool a lot harder to pass. This is more likely to irritate hemorrhoids.
  • Use over-the-counter hemorrhoid creams. Most OTC hemorrhoid creams contain steroids that will help to reduce inflammation and discomfort.

How does a doctor diagnose hemorrhoids?

Your primary care may exam you, or he may refer you to a GI specialist. A physical exam may be all that is necessary to determine if you are suffering from hemorrhoids. If you are not yet 50 years old, it’s likely that rectal bleeding may be caused by hemorrhoids. The doctor may use a gloved finger to exam the rectum. Or they may use a short, lighted scope to see inside the rectum.

Sometimes, bloody stool or rectal bleeding is a sign of more serious problems. It is often associated with anal, colon, or rectal cancer. If the first exam is not enough for the doctor to confirm the blood found in the stool is due to hemorrhoids, he may recommend further testing. A GI specialist may use a sigmoidoscope to examine the lower portion of the colon, or he may use a colonoscope to examine the entire colon for other sources of blood in your stool so an accurate diagnosis can be made. Then treatment can be recommended appropriately.

What are the treatment options for hemorrhoids?

Most external hemorrhoids do not require medical treatment. Making some lifestyle changes like eating more fiber, hydrating well, and getting more exercise can help them improve. OTC ointments can help with temporary discomfort. Some internal hemorrhoids may improve using the same techniques. When internal hemorrhoids become severe, you may need to see a GI specialist.

There are various treatment options that inhibit the blood flow to the hemorrhoid. Once the blood flow has been reduced, scar tissue will form, and the hemorrhoids shrink or go away. Some procedures that may be used to treat hemorrhoids effectively include:

  • Rubber Band LigationA small band is placed at the base of the internal hemorrhoid to reduce the blood supply. It will usually fall off within seven days after the procedure.
  • Infrared photocoagulation – A special laser is used to damage the tissue in the internal hemorrhoid. Once the tissue is damaged, it will shrink, then slough off.
  • Sclerotherapy – This treatment is for mild cases of hemorrhoids. It involves injecting chemicals into the hemorrhoid so that it shrinks.

Sometimes hemorrhoids are removed in the doctor’s office. If hemorrhoids are large, severe, or recurrent, they can be removed surgically. The procedure is more invasive than an in-office removal and may require general anesthesia.

Hemorrhoids and Pregnancy

Because the uterus is so enlarged during the third trimester, it can put more pressure on the pelvis and the veins near the rectum and anus. Increased levels of progesterone can also contribute to hemorrhoids. Why? Because progesterone causes the walls veins to relax, and this makes them more susceptible to swelling. Many women do not experience hemorrhoids until they are pregnant. It’s very common to get hemorrhoids during pregnancy, even if you haven’t had them before. But if you have had hemorrhoids before, you are more likely to get them while you are pregnant. Some women don’t experience them until after natural childbirth. During pushing contractions to help the baby move through the birth canal, more pressure is exerted on the blood vessels near the anus. Oftentimes, they go away without treatment.  However, once you have had hemorrhoids, you are more likely to have them later.

Hemorrhoids are not generally harmful to the health of you or your baby. Most of the time they will just go away after you give birth. Symptoms should be easily controlled with home care. Check with your doctor before using any home treatment options or medications to ensure they are safe for you and your baby.

How do Hemorrhoids Cause Bloody Stool?

Hemorrhoids are caused by increased pressure near the anus. When blood vessels located near the anus swell because of the extra pressure, they often bleed. Usually, the blood caused by hemorrhoids is a small amount, like a few drops you notice on toilet paper after wiping. Sometimes other things like constipation can contribute to hemorrhoidal bleeding.

Is Blood in the Stool Just Indicative of Hemorrhoids?

A medical doctor will need to determine the exact cause of bloody stools. Even small amounts of blood in stool should be examined by a doctor to be on the safe side, especially if you’ve never noticed it before. If you notice blood in your stool or when you wipe, a doctor can make sure it’s not due to an underlying condition or a complication. Just a little bit of blood occasionally is usually not a cause for concern. You will want to pay attention to what the blood in stool looks like. Use these questions to guide your assessment.

  • How much blood is there?
  • How often has it occurred?
  • What color is the blood?

Answering these questions can help prepare you for the questions a medical professional will ask. It can also help them zero in on a problem. Bloody stools can come from any area along the gastrointestinal tract. It can come from areas including:

  • The esophagus
  • The stomach
  • Small or large intestine
  • The rectum

Most of the time if the blood is red it originated from the lower portions of the digestive tract or the rectum. If blood is dark or black, it usually originated in the upper digestive tract. Another factor that can help determine where the blood came from and what is causing it is whether or not it is mixed with the stool. While hemorrhoids are a common cause for bloody stool, there are many other causes including:

A GI specialist can evaluate you and run some specific tests to determine if they are due to any underlying causes.

Complications Associated with Hemorrhoids

Although very rare, there are a few complications that can arise from hemorrhoids.

  • If you have excessive or chronic bleeding from your hemorrhoids, it may cause anemia. That just means you don’ have enough healthy red blood cells to properly distribute oxygen to your body’s cells.
  • Even though they are not dangerous, occasionally a blood clot may form in a hemorrhoid. They can be painful and sometimes they need to be lanced and drained.
  • If blood flow is cut off, a hemorrhoid may become ‘strangulated.” This can be extremely painful.

Contact a GI Specialist at Pinnacle GI Partners

If you suspect you have hemorrhoids or have noticed blood in your stools, schedule an appointment with a qualified GI specialist. Getting a correct diagnosis is the first step to getting effective treatment if needed. You can have great peace of mind knowing your hemorrhoids are treatable. Also, if there is a more serious condition, discovering it early is your best chance of successful treatment. Call us today with your questions and concerns.

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