Bleeding During Bowel Movements: Next Steps for Hemorrhoid Relief

Bleeding during bowel movements?

Hello, I experience bleeding during bowel movements (every time, without pain).
In June, I had a colonoscopy, which revealed a small hemorrhoid located less than two centimeters inside the anal canal.
I was advised to apply an ointment, but my condition has not improved.
In early August, I consulted a different doctor who performed a digital examination and confirmed the presence of an internal hemorrhoid located about two centimeters inside the anal canal.
The doctor also recommended using the ointment, but to this day, the bleeding has not improved.
Could you please advise me on the next steps I should take? Additionally, what is the correct way to apply the ointment? Thank you.

Niming, 10~19 year old female. Ask Date: 2022/08/21

Dr. Zhang Shuhao reply Surgery

First, take warm sitz baths regularly, increase your intake of water and fruits and vegetables to prevent constipation, and avoid spicy and irritating foods.
Refrain from smoking, drinking alcohol, and staying up late.
Start by changing your lifestyle habits.
When applying ointment, use a fingertip to take a small amount and gently apply it about half to one finger's depth into the anus; there is no need to use a plastic applicator.

Reply Date: 2022/08/21

More Info

Bleeding during bowel movements can be a concerning symptom, and it’s good that you have already sought medical attention. Based on your description, it seems that you have been diagnosed with an internal hemorrhoid, which is a common cause of painless rectal bleeding. However, since you are still experiencing bleeding despite treatment, it may be time to consider additional steps.

Next Steps for Hemorrhoid Relief
1. Re-evaluation by a Specialist: If you have not already done so, consider seeing a gastroenterologist or a colorectal surgeon. They can provide a more thorough examination and may perform additional tests, such as a flexible sigmoidoscopy, to ensure there are no other underlying issues contributing to the bleeding.

2. Medication Review: Discuss with your doctor the effectiveness of the current topical treatments you are using. Sometimes, the strength or type of medication may need to be adjusted. Over-the-counter options include hydrocortisone creams or witch hazel pads, which can help reduce inflammation and discomfort.

3. Lifestyle Modifications: Incorporate dietary changes to help alleviate constipation, which can exacerbate hemorrhoid symptoms. Increasing fiber intake through fruits, vegetables, and whole grains can help soften stools. Additionally, staying well-hydrated is crucial. Aim for at least 8-10 glasses of water a day.

4. Sitz Baths: Taking warm sitz baths for about 15-20 minutes several times a day can help soothe the area and promote healing. This can be particularly beneficial after bowel movements.

5. Topical Application: When applying ointments or creams, ensure you are using the correct technique. Apply a small amount of the medication to your fingertip and gently insert it into the rectum, covering the hemorrhoid area. Make sure to wash your hands before and after applying the medication to prevent infection.

6. Consider Minimally Invasive Procedures: If conservative treatments fail, there are several minimally invasive procedures available for treating hemorrhoids, such as rubber band ligation, sclerotherapy, or infrared coagulation. These options can be discussed with your healthcare provider.

7. Surgical Options: In more severe cases, surgical intervention may be necessary. Hemorrhoidectomy is a procedure that removes the hemorrhoids and can provide long-term relief.

Monitoring and Follow-Up
It’s essential to monitor your symptoms closely. If you notice any changes, such as increased bleeding, pain, or changes in bowel habits, contact your healthcare provider immediately. Persistent bleeding can sometimes indicate other conditions, such as anal fissures or even more serious gastrointestinal issues, so it’s crucial to keep an open line of communication with your healthcare team.

Conclusion
In summary, while hemorrhoids are a common cause of painless rectal bleeding, persistent symptoms warrant further investigation and possibly a change in treatment strategy. By consulting with a specialist, reviewing your current medications, making lifestyle changes, and considering additional treatment options, you can work towards finding relief from your symptoms. Always remember to follow your healthcare provider’s advice and keep them informed of any changes in your condition.

Similar Q&A

Understanding Rectal Bleeding: When to Seek Medical Attention

Hello Dr. Ke, I am a worker who has been living a long-term night shift lifestyle. Recently, I have noticed that after bowel movements, the amount of blood when wiping with toilet paper has been increasing. About half a month ago, there was just a small amount of red, but recentl...

Dr. Ke Fangxu reply Surgery
This situation likely indicates a higher possibility of hemorrhoidal bleeding. As long as there is no further bleeding, it should not be a concern. It is recommended to avoid constipation during this period and to shorten the time spent on bowel movements. Spicy and irritating fo...

Understanding Rectal Bleeding: Causes and Concerns After Bowel Movements

It has been three to four days since I started experiencing significant rectal bleeding during bowel movements. The toilet bowl is often stained with blood, and I need to use tissue two or three times before the bleeding stops. The blood is mostly bright red (there is both stool ...

Understanding and Treating Rectal Bleeding and Pain During Bowel Movements

Hello Doctor: In the past two days, I have noticed some reddish, blood-like substance when wiping after using the restroom, and it also hurts after I finish. However, the amount is only a little. My stool is yellowish with a slight orange tint. I've experienced this before, ...

Dr. Ke Fangxu reply Surgery
This situation likely indicates a higher possibility of hemorrhoidal bleeding. As long as there is no further bleeding, it should not be a major concern. It is recommended to avoid constipation during this period and to shorten the time spent on bowel movements. Warm sitz baths m...

Understanding Rectal Bleeding: Causes and Concerns for Hemorrhoid Sufferers

Hello Doctor, I have been experiencing symptoms of both internal and external hemorrhoids for a long time, with episodes occurring infrequently. Recently, I have noticed bleeding during bowel movements, where blood drips for about 10 seconds after I finish. Sometimes there is a s...