Hemorrhoids: Causes, Symptoms, and Proper Care - Gastroenterology and Hepatology

Hemorrhoid issues?

Hello, Doctor.
I had a colonoscopy a year ago, and everything was normal with no polyps.
Today, after having a bowel movement, I wiped and did not notice any blood.
However, due to my anxious personality, I kept checking for blood repeatedly.
Even though I had already wiped clean, I pressed with toilet paper again, and then I noticed a little bit of blood (I'm not sure if I caused a small tear).
At the same time, I am experiencing a slight flare-up of hemorrhoids with mild pain.

I would like to ask, Doctor, since I am always worried that I might miss any bleeding, I have developed a habit of wiping with toilet paper repeatedly.
Could this habit actually lead to skin irritation around the anus, causing bleeding, which then makes me overly concerned? What is the normal post-bowel movement practice? In my home, we have a bidet.
After using the bidet for washing, is it sufficient to pat dry with toilet paper once or twice? Or if there is bleeding, would it be noticeable enough that I wouldn't need to keep checking with toilet paper? Thank you, Doctor.

A Bao, 30~39 year old female. Ask Date: 2022/02/25

Dr. Chen Shidian reply Gastroenterology and Hepatology

After bowel movements, simple cleaning or patting dry is sufficient.
If concerned, you can check for occult blood in the stool annually.

Reply Date: 2022/02/25

More Info

Hemorrhoids, also known as piles, are swollen veins in the lower rectum and anus that can cause discomfort, pain, and bleeding. Understanding the causes, symptoms, and proper care for hemorrhoids is essential for managing this common condition effectively.

Causes of Hemorrhoids
Hemorrhoids can develop due to increased pressure in the lower rectum, which can be caused by several factors:
1. Straining during bowel movements: This is often due to constipation or diarrhea, leading to increased pressure on the veins in the rectal area.

2. Sitting for prolonged periods: Especially on the toilet, which can exacerbate pressure on the rectal veins.

3. Obesity: Excess weight can increase pressure on the pelvic veins.

4. Pregnancy: The weight of the fetus can put pressure on the pelvic veins, leading to hemorrhoids.

5. Aging: As people age, the tissues that support the veins in the rectum can weaken.

6. Genetics: A family history of hemorrhoids can increase the likelihood of developing them.

Symptoms of Hemorrhoids
Common symptoms of hemorrhoids include:
- Bleeding: Bright red blood on toilet paper or in the toilet bowl after a bowel movement.

- Pain or discomfort: Especially during bowel movements or when sitting.

- Swelling: Around the anus, which may be tender to the touch.

- Itching: In the anal region, which can be quite bothersome.

Proper Care and Management
1. Dietary Changes: Increasing fiber intake can help soften stools and reduce straining. Foods rich in fiber include fruits, vegetables, whole grains, and legumes. Staying hydrated is also crucial.

2. Avoid Straining: When using the bathroom, try to relax and avoid straining. If you feel the need to push, it may be beneficial to wait until you feel a stronger urge.

3. Proper Hygiene: After bowel movements, gentle cleaning is essential. Using a bidet or moist wipes can be gentler than toilet paper. If using toilet paper, pat gently rather than wiping harshly.

4. Warm Baths: Soaking in a warm bath for 10-15 minutes can help relieve discomfort and reduce swelling.

5. Over-the-Counter Treatments: Creams or ointments containing hydrocortisone or witch hazel can help alleviate itching and discomfort.

6. Avoid Prolonged Sitting: If you have a sedentary job, take breaks to stand and move around to relieve pressure on the rectal area.

Addressing Your Concerns
Regarding your specific situation, it is possible that your habit of repeatedly wiping with toilet paper could lead to irritation or even minor abrasions around the anal area, which might cause bleeding. If you are experiencing slight bleeding after excessive wiping, it may be a result of this irritation rather than a more serious issue.

Using a bidet or a gentle rinse with water after bowel movements, followed by a light pat with toilet paper, is generally a good practice. If there is any bleeding, it should be noticeable, and you should not need to test for it repeatedly. If you notice blood that is persistent or accompanied by significant pain, it is advisable to consult a healthcare professional for further evaluation.

In summary, while hemorrhoids can be uncomfortable and concerning, they are often manageable with lifestyle changes and proper care. If symptoms persist or worsen, seeking medical advice is always a prudent step.

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