People may not even know that they have a problem with internal hemorrhoids or external hemorrhoids until the day they look in the toilet and they see bright red blood inside the bowl after a bowel movement. This is often alarming and very concerning as it appears to be more blood than it often is. The combination of blood in water makes the bleeding look severe. In addition, hemorrhoidal bleeding is most often painless.
It is important to be evaluated by a medical professional if you are experiencing rectal bleeding. Bright red blood per rectum is most often due to hemorrhoids, something more serious could be overlooked if not properly diagnosed. Other things that could possibly cause rectal bleeding include colorectal cancer, colitis, polyps, or vascular malformations. Anorectal fissures may also cause bleeding and are often painful.
Hemorrhoids are the most common cause for lower GI bleeding in patients. They do not typically cause massive blood losses that require emergent blood transfusions. That being said, patients may experience chronic blood loss, from inadequately treated hemorrhoids, that could potentially be substantial enough to cause iron deficiency anemia. In this situation, iron supplements may be required to assist in the regeneration of blood cells.
Once a diagnosis of hemorrhoids is made, and more serious diagnoses are ruled out, it is important to get appropriate treatment, depending on the severity of the hemorrhoids. Relieving the pressure on the hemorrhoidal veins will help to stop the bleeding.
Ways to decrease the pressure include, but are not limited to weight loss, relief of constipation, frequent position changes, and exercise. Adding fiber to your diet and decreasing fat content will help to develop more regularity with bowel movements. Drinking 8-10 glasses of water daily will also combat constipation. If dietary changes alone are not helpful, you may consider over the counter stool softeners such as colace or senekot, or fiber supplements such as Metamucil or Benefiber.
Rectal bleeding from hemorrhoids may create rectal irritation that becomes bothersome to many people. While you are having a hemorrhoidal flare, you may consider sitting in a sitz bath 3 times daily with warm water for approximately 10 minutes. If a sitz bath is unavailable, sitting in a shallow bath tub of warm water may also help. The warm water will increase blood flow to the area as well as relax the anal sphincter. This will give you symptomatic relief, as well as assist in the healing process.
Additional Resources:
