Symptoms
- Bright red blood on toilet paper or in the bowl
- A lump or swelling at the anus
- Tissue that bulges out during bowel movements (prolapse)
- Itching, irritation or discomfort
- Sudden severe pain and a hard lump, which can mean a clotted external hemorrhoid
Why bleeding should be checked
Hemorrhoids are the most common cause of rectal bleeding, but other conditions, including anal fissures, polyps and colorectal cancer, can cause similar symptoms. Rectal bleeding should always be evaluated, and a colonoscopy may be recommended depending on your age and history.
Seek urgent care for heavy rectal bleeding, bleeding with dizziness or weakness, or black, tarry stools.
Talk with Dr. Arsenous about your options.
Treatment options
Most patients start with more fiber, plenty of water, avoiding straining and prolonged sitting on the toilet, and short-term creams or sitz baths.
For internal hemorrhoids that keep bleeding or prolapse, office procedures such as rubber band ligation can be effective. For large, prolapsing or mixed internal and external hemorrhoids that do not respond, surgical removal (hemorrhoidectomy) gives the most lasting result. A very painful clotted external hemorrhoid can sometimes be removed in the office within the first few days.
Recovery after hemorrhoidectomy
Hemorrhoidectomy is usually same-day surgery. The first one to two weeks are uncomfortable. Pain medicine, stool softeners, fiber and warm sitz baths help a great deal. Most people return to work in about one to two weeks, and healing is complete within several weeks.