What causes hemorrhoids to bleed?

Written by Ren Zheng Xin
Gastroenterology
Updated on September 08, 2024
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Internal hemorrhoids can easily cause rectal bleeding. The main reason is the varicosity of hemorrhoidal veins. During defecation, dry and hard stools scratch the hemorrhoidal veins causing them to rupture and bleed. Additionally, due to the long-term presence of hemorrhoids, the hemorrhoidal veins become overstretched, making the vein walls thin and fragile, and easily damaged during bowel movements. For hemorrhoid-induced rectal bleeding, treatment can be administered through medications aimed primarily at reducing bleeding symptoms and alleviating the varicosity of the hemorrhoidal veins. Sitz baths can also be used to reduce swelling around the anus. If medication provides limited relief, minimally invasive or surgical treatments may be considered.

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Hemorrhoids bleeding symptoms

Hemorrhoids bleeding during bowel movements is actually a common symptom in clinical settings and is a typical symptom of hemorrhoids. This bleeding generally occurs during defecation, sometimes soiling the fingers with blood, and can also cause a spraying type of bleeding. Furthermore, excessive exhaustion, irregular eating patterns, staying up late, and heavy alcohol consumption may exacerbate this bleeding, which are typical symptoms of hemorrhoids. The blood from hemorrhoids is usually bright red, and this condition is intermittent in nature, often not mixing with the stool. Thus, the bleeding generally stops after defecation ceases, and this condition can worsen with the patient's bowel movements among other issues. Additionally, if bleeding of a different color occurs, it may be caused by upper gastrointestinal bleeding, thus it is important to distinguish this from hemorrhoidal bleeding.

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Written by Chen Tian Jing
Colorectal Surgery
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What's causing hemorrhoids to itch?

Hemorrhoids cause secretions to flow out from within the anal canal, particularly in the case of internal hemorrhoids. When severe, these secretions can flow outside the anus due to changes in the position of the anus or the patient's body, irritating the local skin and mucosa around the anus, thus leading to symptoms of itching. Additionally, with repeated prolapse of internal hemorrhoids, the mucosa may get trapped at the anal opening and cannot retract normally, also causing irritating itching and possibly even pain and bleeding due to repeated friction. To treat the itching from hemorrhoids, it is first necessary to alleviate the increased secretion from internal hemorrhoids. Options include using anti-inflammatory suppositories or gels, and washing the anal area with saline water or herbal washes that have antipruritic effects.

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How to treat hemorrhoids bleeding

In clinical practice, the treatment of hemorrhoidal bleeding primarily depends on the severity of the bleeding. If a patient experiences frequent hemorrhoidal bleeding and the volume of blood loss is significant, it is recommended to adopt surgical treatments early. Prolonged bleeding can lead to severe anemia, severely impacting the patient's health. Possible surgical options include sclerotherapy, internal hemorrhoid ligation, or surgeries like PPH and TST. However, if the hemorrhoidal bleeding is infrequent and the volume of blood loss is minimal, the first step should be to improve the diet. Consuming more seasonal fresh fruits and vegetables, maintaining smooth bowel movements, not spending too long on bowel movements or straining excessively, and using hemorrhoidal suppositories or ointments for anal administration after bowel movements are recommended.

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Written by Xu Jun Hui
General Surgery
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Do hemorrhoids bleed and hurt?

Simple hemorrhoids bleeding generally has no pain symptoms. Pain only occurs when the hemorrhoids are inflamed or when there is prolapsed or thrombosed external hemorrhoids. Hemorrhoids are caused by the tortuous dilation of hemorrhoidal venous plexus. Some patients have symptoms of hemorrhoidal prolapse, some have rectal bleeding with fresh blood that is separate from the stool, and a few have both prolapse and bleeding. If the prolapse of hemorrhoids is severe, or if there is a significant amount of bleeding, surgical treatment is recommended. If the bleeding is minor and the hemorrhoids are not severe, conservative treatment can be implemented, including topical medication and maintaining smooth bowel movements. It is advised to avoid alcohol, spicy and irritating foods, and to keep the perianal area clean and hygienic.

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What should a pregnant woman do if she has bleeding hemorrhoids?

Due to the impact of hormone levels during pregnancy, pregnant women are easily prone to significantly slower gastrointestinal motility, which can lead to constipation. Frequent constipation can persistently irritate the local area around the anus, easily causing hemorrhoids. Therefore, it is essential to have a nutritious diet that is light and includes plenty of coarse fibrous vegetables and fresh fruits during pregnancy, as these can promote gastrointestinal motility and alleviate symptoms of constipation. If there is bleeding at the site of anal hemorrhoids after defecation, it is necessary to seek medical attention promptly for examination, hemostasis, anti-inflammatory treatment, and symptomatic treatment.