What Are Bleeding Hemorrhoids?
Millions of people experience anal pain from swollen, sometimes bleeding, veins in the anal area. These are called hemorrhoids, also known as piles. They are commonly found in people who are always constipated, many pregnant women, obese individuals and in many who are over 50 years of age. The most common cause is forceful straining during bowel movements and normal labor and delivery.
Swollen veins are like varicose veins in the anal opening (external hemorrhoids) or inside the anal canal (internal hemorrhoids). During bowel movements, prolonged sitting or standing and any activity that increases pressure within the pelvis, symptoms of hemorrhoids may be experienced such as pain, irritation, itchiness and sometimes bleeding. Bleeding may be noted as blood streaks in the stool, but it can worsen to the point of being seen as blood dripping or flowing into the toilet bowl.
Although this may appear frightening to some, bleeding hemorrhoids are not a serious medical problem and can be prevented and treated effectively.
Treatment for Bleeding Hemorrhoids
Bleeding hemorrhoids can be prevented and managed by some conservative measures which can be dome at home such as:
- Eating a fiber-rich diet consisting of fruits, vegetables and whole grains – 25 grams of fiber per day for women and 38 grams for men
- Taking more non-alcoholic fluids, around six to eight servings of eight fluid ounces per day
- Using stool softeners and fiber supplements like psyllium (Metamucil) or methylcellulose (Citrucel)
- Regular exercise can also help prevent constipation and reduce weight, thus decreasing pelvic pressure.
Usually blood streaks may disappear when constipation is relieved. However, when bleeding persists or becomes worse, outpatient treatments may be necessary.
Non-surgical medical treatments or fixative procedures for bleeding hemorrhoids may be done by a doctor in the clinic such as:
- Rubber band ligation – rubber bands are used to tie the hemorrhoids at their base. No incisions are done but the bands cause the swollen veins to shrink within a few days. Possible risks of this procedure are severe pain and infection after the procedure.
- Sclerotherapy – a chemical is injected into the veins which results in their shrinkage
- Infrared coagulation – heat is used to shrink the blood vessels. Others may also use laser and electrical coagulation techniques.
In cases where home remedies and medical treatments fail to stop bleeding from hemorrhoids, surgery may be needed. This is usually done on large external hemorrhoids and internal hemorrhoids that still bleed even after performing fixative procedures. This consists of excision of the hemorrhoids in an operation called hemorrhoidectomy which is done under anesthesia. Hemorrhoidectomy is done on an outpatient basis and the patient may go home after anesthesia wears off and there are no complications.
After surgery the patient is advised to avoid straining by doing the home treatments to prevent constipation. Possible risks are bleeding, pain and infection after the procedure. Late problems may include narrowing of the anal canal, rectal prolapse and formation of a fistula or an abnormal passage from the anus to the outer skin.
Hemorrhoids may recur even after surgery so recommendations for maintaining a healthy lifestyle of proper diet and exercise are given.
NDDIC, “Hemorrhoids”, https://digestive.niddk.nih.gov/ddiseases/pubs/hemorrhoids/
WebMD, “Hemorrhoids”, https://www.webmd.com/a-to-z-guides/hemorrhoids-topic-overview