Bright red bleeding from hemorrhoids that streaks through feces or drips into the toilet brings everyone to the doctor. As scary as the bright red blood may look, hemorrhoids are fairly easy to manage and it helps to know what you are dealing with. Remember too that if you put a few drops of food coloring in toilet water the whole bowl looks red, so the bleeding from hemorrhoids looks scarier than it is.
What are hemorrhoids?
Hemorrhoids are swollen veins in your rectum or anus. The type of hemorrhoid you have depends on where it occurs.
Internal hemorrhoids are inside your rectum where you may not see or feel them. Internal hemorrhoids are scary to people because they may not hurt, and you may not see or feel them, but they do cause bleeding.
What causes hemorrhoids?
Internal hemorrhoids may bulge outside your anus (called a prolapsed hemorrhoid) and may go back inside on its own, or you may have to push it back in.
External hemorrhoids are in the veins outside the anus and they make themselves known. You may feel a tender lump on the edge of your anus, and it may be itchy or painful, and may bleed. You may see blood on the toilet paper or in the toilet after a bowel movement.
Hemorrhoids are caused by increased pressure in the veins of your anus or rectum. Straining to have a bowel movement when you are constipated is a common cause. Sitting too long, obesity and heavy lifting are also causes of hemorrhoids.
You are not alone. Just about everyone has a hemorrhoid at some time. Pregnant women get hemorrhoids because of the strain from carrying the baby and from giving birth.
What can I do about hemorrhoids?
Preventing constipation is the most important thing. While you have hemorrhoids you need to keep your poop really soft, with little straining, for them to heal. Here are some other things to remember:
- Stool softeners (over the counter Dulcolax, Senna and Colace are examples.)
Is there surgery for hemorrhoids?
- Including more fiber in your diet: fresh fruits, leafy vegetables, and whole-grain breads and cereals are good sources of fiber.
- Drinking plenty of fluids/water.
- Exercise regularly.
- Take warm baths to help relieve the pain.
- Apply a cream that contains witch hazel or use a numbing ointment.
- Creams that contain hydrocortisone can be used for itching or pain (Anusol HC is an example.)
Some of my patients hate them and want to get rid of their hemorrhoids. Most painful hemorrhoids stop hurting on their own in 1 to 2 weeks. If yours keep causing problems, talk to your doctor about a referral to a colorectal surgeon who can get rid of them. Rubber band ligation, sclerotherapy (injecting them with a chemical) and surgical removal are options.
Do I need to see the doctor?
Most importantly, while bleeding that is bright red is often from hemorrhoids, you need to let your doctor decide that. If you notice bleeding you need to see your doctor to make sure this is not a more serious problem such as cancer.
- Dr O.