Diagnosis Of Rectal Bleeding
Do not assume the rectal bleeding is from hemorrhoids. A physical exam, rectal exam, sigmoidoscopy, and in some cases colonoscopy is mandatory to identify the cause of the bleeding and help rule out other conditions such as colon or rectal cancer. Associated change in bowel habits, weight loss, and abdominal pain mandate additional testing. New onset rectal bleeding in someone over the age of 40 that is not typical of hemorrhoids or does not respond to banding requires further testing with colonoscopy. Selected patients under the age of 40 may also need colonoscopy as colon cancer does occasionally occur in younger individuals. Sexually transmitted diseases of the rectum such as HPV, syphilis, gonorrhea, or herpes may also cause rectal bleeding.
How Do Healthcare Providers Treat Hemorrhoids
You should see your healthcare provider if symptoms get worse or interfere with your daily life or sleep. Also seek help if signs dont improve after a week of at-home treatments. Your provider may treat hemorrhoids with:
- Rubber band ligation: A small rubber band placed around the base of a hemorrhoid cuts off blood supply to the vein.
- Electrocoagulation: An electric current stops blood flow to a hemorrhoid.
- Infrared coagulation: A small probe inserted into the rectum transmits heat to get rid of the hemorrhoid.
- Sclerotherapy: A chemical injected into the swollen vein destroys hemorrhoid tissue.
Surgical treatments include:
- Hemorrhoidectomy: Surgery removes large external hemorrhoids or prolapsed internal ones.
- Hemorrhoid stapling: A stapling instrument removes an internal hemorrhoid. Or it pulls a prolapsed internal hemorrhoid back inside the anus and holds it there.
What Are The Symptoms Of Hemorrhoids
Internal hemorrhoids rarely cause pain unless they prolapse. Many people with internal hemorrhoids dont know they have them because they dont have symptoms.
If you have symptoms of internal hemorrhoids, you might see blood on toilet paper, in stool or the toilet bowl. These are signs of rectal bleeding.
Signs of external hemorrhoids include:
- Itchy anus.
- Hard lumps near the anus that feel sore or tender.
- Pain or ache in the anus, especially when you sit.
- Rectal bleeding.
Prolapsed hemorrhoids can be painful and uncomfortable. You may be able to feel them bulging outside the anus and gently push them back inside.
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Getting Rid Of Hemorrhoids
How Do You Treat External Hemorrhoids Diagnosis
External hemorrhoids appear as bumps and/or dark areas surrounding the anus. If the lump is tender, it suggests that the hemorrhoid is thrombosed. Any lump needs to be carefully followed, however, and should not be assumed to be a hemorrhoid since there are rare cancers of the anal area that may masquerade as hemorrhoids.
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Rectal Bleeding Tumors Colon Polyps And Other Causes
Tumors and polyps
Polyps: Lumps of tissue or polyps bulge out from the lining of the colon. Bleeding occurs when large polyps develop, which can be hereditary. Usually harmless, some types can be precancerous.
Tumors: Both benign and malignant forms frequently appear in the colon and rectum. People older than 50 years of age are most affected. However, tumors also appear in younger people.
- Few people with tumor or polyps will have rectal bleeding. When bleeding does occur, it is usually slow, chronic, and minimal.
- If cancerous lesions are advanced, additional symptoms such as weight loss, a change in the caliber of stools, a sense of rectal fullness, or constipation may be experienced.
- Diagnosis requires evaluation with colonoscopy.
Trauma: Rectal bleeding from a traumatic cause is always a critical concern. Rectal damage from a gunshot wound or foreign body insertion can result in extensive infection or rapid and fatal blood loss. Prompt emergency evaluation is necessary.
Upper gastrointestinal source: A common source of rectal bleeding is bleeding from the upper gut, usually the stomach or duodenum. This can occur after someone has swallowed a foreign object that causes injury to the stomach lining, bleeding stomach ulcers, or Mallory-Weiss tears.
- Long-term, chronic alcohol consumption can also cause ulcers, esophageal varices, and gastritis. All of these upper GI tract problems can bleed so briskly that people may note blood in the stool or in the rectum.
How Are Bleeding Hemorrhoids Treated
A bleeding hemorrhoid is usually a sign of irritation or damage to the wall of the hemorrhoid. This should resolve on its own over time, but there are several things you can do at home to speed up the process and soothe any discomfort.
However, if there is no clear source of bleeding or if the bleeding doesnt go away within a week, see your doctor. Experts note that hemorrhoids are often self-diagnosed, which can be dangerous. Many medical conditions, including cancer and inflammatory bowel disease , can have similar symptoms. Its important to receive a proper diagnosis from your doctor.
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How To Handle Bleeding Hemorrhoids During Pregnancy
There are many different ways you can handle bleeding hemorrhoids while pregnant. Tucks Pads are a very popular medical pad with Witch Hazel that can bring lots of relief.
Of course, you can use products like hemorrhoid pillow, suppositories, creams, and supplements if your doctor approves it.
Tucks Pads are great because they are a bit thicker and can go in-between your underwear and the bleeding hemorrhoid.
Many women swear by putting their tucks pads in the freezer and then applying them when they are cold.
You can also use natural remedies like warm baths or ice packs.
A combination of products and natural remedies will be your best bet for postpartum hemorrhoids bleeding.
Acutely Thrombosed Or Strangulated Internal Hemorrhoids
Patients with acutely thrombosed or strangulated internal hemorrhoids usually present with severely painful and irreducible hemorrhoids. The incarcerated hemorrhoids may become necrotic and drain. This situation is quite difficult to treat particularly in a case of extensive strangulation or thrombosis ,3A), or the presence of underlying circumferential prolapse of high-graded hemorrhoids. Manual reduction of the hemorrhoid masses, with or without intravenous analgesia or sedation, might help reducing pain and tissue congestion. Urgent hemorrhoidectomy is usually required in these circumstances. Unless the tissues are necrotic, mucosa and anoderm should be preserved as much as possible to prevent postoperative anal stricture. In expert hands, surgical outcomes of urgent hemorrhoidectomy were comparable to those of elective hemorrhoidectomy.
Complicated hemorrhoids. A: Strangulated internal hemorrhoid B: Acutely thrombosed external hemorrhoid.
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Are Bleeding Hemorrhoids Common
Usually, when people have bleeding hemorrhoids, they are referring to internal hemorrhoids and the painless rectal bleeding often associated with it.
Internal hemorrhoids are common, so much so that nearly half of adults around the age of fifty develop either type of hemorrhoid.
Pregnant women also commonly experience bleeding hemorrhoids.
What Are Bleeding Hemorrhoids
Hemorrhoids also known as piles are swollen veins inside your anus for the rectal column. Sometimes you will experience symptoms with your hemorrhoids like pain discomfort, itching bleeding and also burning sensation while you are sitting down or during your Bowel movement.
If your hemorrhoids are very mild you may not experience any of the symptoms other than straining during your morning break in your washroom.
There are two types of hemorrhoids: internal hemorrhoid and external hemorrhoid.
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Diagnosis And Classification Of Hemorrhoids
The most common presentation of hemorrhoids is painless rectal bleeding during defecation with or without prolapsing anal tissue. The blood is normally not mixed in stool but instead coated on the outer surface of stool, or it is seen during cleansing after bowel movement. The blood is typically bright red since hemorrhoid plexus has direct arteriovenous communication. Patients with complicated hemorrhoids such as acutely thrombosed external hemorrhoids and strangulated internal hemorrhoids may present with anal pain and lump at the anal verge. It is uncommon that patients with uncomplicated hemorrhoid manifest any anal pain. In fact, severe anal pain in patient with hemorrhoids is more likely due to anal fissure and anorectal abscess.
A precise history and thorough physical examination, including digital rectal examination and anoscopy, are imperative for the diagnosis of hemorrhoids. Unless bright red blood is clearly seen from hemorrhoids, any patients with rectal bleeding should be scheduled for flexible sigmoidoscopy or colonoscopy, especially those being at risk of colorectal cancer.
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How To Stop Bleeding Hemorrhoids
The first thing most people worry about when they have minor rectal bleeding is that they have a cancer. But its the cause of rectal bleeding only 1 to 2 percent of the time.
Two problems are usually responsible for blood on the paper, on the stool or in the toilet: hemorrhoids and anal fissures. The good news is that both problems are usually easy to fix.
Rectal Bleeding Anorectal Disorders
Anorectal disorders are the most common causes of minor rectal bleeding.
Hemorrhoids: Hemorrhoids are swollen rectal veins in the anal and rectal area. They can cause burning, painful discomfort, and bleeding.
- External hemorrhoids are small swellings that are easy to see and quite painful. Anal itching is common.
- Internal and external hemorrhoids are usually painless. A person may note a rectal mass sensation with bowel movements.
- Symptoms from the swelling of the hemorrhoids are brought on by hard stools and straining with bowel movements. Treatment of hemorrhoids focuses on relieving these symptoms with the use of stool bulking agents and softeners.
- In cases of thrombosed hemorrhoids, a clot forms within the swollen vein. This causes moderate to severe pain and requires minor surgery to remove them.
Anal fissure: This is a tear in the lining of the rectum caused by the passage of hard stools.
- An anal fissure can lead to mild rectal bleeding of bright red blood. Exposed nerves and vessels result in moderate to severe pain. Pain worsens with bowel movements then decreases in between bowel movements.
- In both hemorrhoids and anal fissures, symptoms generally improve with use of stool softeners and bulking agents, increasing fiber in the diet, pain control, and frequent warm water baths.
Infection: Bacterial dysentery is commonly the source of infectious, bloody diarrhea.
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How To Stop Haemorrhoids Bleeding
If you are looking to manage your piles, there are a number of options.
A high fibre diet, including plenty of fresh fruit and vegetables and whole grain foods will all help to keep your movements regular and avoid your having to be too forceful when going to the toilet. Drinking 1-2 litres of non-caffeinated drinks each day is also recommended.
There are topical treatments such as creams and ointments that give temporary relief.
Keeping the area clean and dry will help relieve some of the other symptoms, such as itching, which of course means that youre less likely to want to scratch the area.
How To Stop Rectal Bleeding
This article was co-authored by Dale Prokupek, MD. Dale Prokupek, MD is a board certified Internist and Gastroenterologist who runs a private practice based in Los Angeles, California. Dr. Prokupek is also a staff physician at Cedars-Sinai Medical Center and an associate clinical professor of medicine at the Geffen School of Medicine at the University of California, Los Angeles . Dr. Prokupek has over 25 years of medical experience and specializes in the diagnosis and treatment of diseases of the liver, stomach, and colon, including chronic hepatitis C, colon cancer, hemorrhoids, anal condyloma, and digestive diseases related to chronic immune deficiency. He holds a BS in Zoology from the University of Wisconsin Madison and an MD from the Medical College of Wisconsin. He completed an internal medicine residency at Cedars-Sinai Medical Center and a gastroenterology fellowship at the UCLA Geffen School of Medicine.There are 10 references cited in this article, which can be found at the bottom of the page. This article has been viewed 90,663 times.
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Does Spicy Food Cause Hemorrhoids To Bleed
Spicy foods are known to cause inflammation in hemorrhoids, and this can result in bleeding.
Bleeding can occur if you have internal hemorrhoids and typically happens after a bowel movement.
The spice and heat in the foods you consume can disrupt your blood vessels, causing them to swell and become irritated.
If you have hemorrhoids, your physician will probably tell you to stay away from spicy foods.
For severe bouts of a hemorrhoid flare-up, milder foods that are full of fiber are going to be the most beneficial.
Your diet dictates your hemorrhoids, and the more fiber you include in it, the less likely you will experience hemorrhoid flare-ups.
Can Hemorrhoids Bleed When Passing Gas
Hemorrhoids are not known to cause bleeding when passing gas.
Many experts believe that the rectal bleeding that arises from having internal hemorrhoids is from a hard stool passing through the bowels.
The hard stool scrapes the lining that is located inside the rectum, and this is where the bleeding originates.
However, hemorrhoids can make passing gas uncomfortable, as well as when you are sitting and standing in certain positions.
If you are experiencing bleeding when passing gas, let your doctor know right away.
Your doctor may want to perform additional examinations if this is a persisting issue for you.
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Dietary And Lifestyle Modification
A meta-analysis of 7 clinical trials comprising of 378 patients with hemorrhoids showed that fiber supplement had a consistent benefit of relieving symptom and minimizing risk of bleeding by approximately 50%. Although there is relatively little information of the efficacy of dietary and lifestyle modification on the treatment of hemorrhoids, many physicians include advice on dietary and lifestyle modification as a part of conservative treatment of hemorrhoids and as a preventive measure. The advice usually includes increasing the intake of dietary fiber and oral fluid, having regular exercise, refraining from straining and reading on the toilet, and avoiding drug causing constipation or diarrhea.
How To Treat Bleeding Hemorrhoids
Though its not a very pleasant topic to think about, the fact is that hemorrhoids are one of the most common gastrointestinal problems. The National Institutes of Health estimates that about 1 in 20 Americans will develop hemorrhoids at some point during their life. For most people, though, getting hemorrhoids is a temporary problem that isnt much of a cause for concern. Sometimes the problem is more severe and the hemorrhoids cause rectal bleeding in those cases, a more proactive treatment approach is usually necessary.
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How Long Do Hemorrhoids Take To Heal
For many people, hemorrhoids last and last. Ongoing pain is especially common for people over age 50. For many people, hemorrhoidal pain returns years after treatment, and for many others the condition comes and goes, becoming more common over time.
Do Hemorrhoids Ever Go Away on Their Own?
Sometimes they do. Smaller hemorrhoids are apt to go away in just a few days. It’s a good idea during this time to avoid further irritating your rectal area by keeping the area as clean as you can.
How Can You Make Hemorrhoids Go Away?
Tougher cases of hemorrhoids may not go away on their own. After trying home remedies and over-the-counter options without success, you will need to talk to your doctor about other treatment options.
Preventing And Treating Haemorrhoids
Haemorrhoid symptoms often settle down after a few days, without needing treatment. Haemorrhoids that occur during pregnancy often get better after giving birth.
However, making lifestyle changes to reduce the strain on the blood vessels in and around your anus is often recommended. These can include:
- gradually increasing the amount of fibre in your diet good sources of fibre include fruit, vegetables, wholegrain rice, wholewheat pasta and bread, pulses and beans, seeds, nuts and oats
- drinking plenty of fluid particularly water, but avoiding or cutting down on caffeine and alcohol
- not delaying going to the toilet ignoring the urge to empty your bowels can make your stools harder and drier, which can lead to straining when you do go to the toilet
- avoiding medication that causes constipation such as painkillers that contain codeine
- losing weight
- exercising regularly can help prevent constipation, reduce your blood pressure and help you lose weight
These measures can also reduce the risk of haemorrhoids returning, or even developing in the first place.
Medication that you apply directly to your back passage or tablets bought from a pharmacy or prescribed by your GP may ease your symptoms and make it easier for you to pass stools.
Surgery carried out under general anaesthetic is sometimes used to remove or shrink large or external haemorrhoids.
Read more about treating haemorrhoids and surgery for haemorrhoids.
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