Is It Hemorrhoids? Symptoms and When to Seek Help

Unsure if it is hemorrhoids?

Hello, doctor.
I apologize for the lengthy description of my issue.
Over the past few years, I have been very meticulous about cleaning myself after using the restroom.
Additionally, I sometimes experience constipation and anal fissures (the bidet causes stinging pain), which has led to frequent instances of bright red blood on toilet paper.
I initially thought this was just due to excessive cleaning and the anal fissures.
However, after being reminded by those around me that there should be no blood in stool, I started researching online and became increasingly alarmed by the information I found.
I gradually changed my excessive cleaning habits, and the instances of blood have decreased.

For the past two months, my bowel movements have been relatively normal—yellow-brown and about the thickness of a ten-cent coin.
However, while traveling abroad last week, I noticed bright red blood at the end of my stool, and there was blood on the toilet paper after wiping.
The blood appeared a few seconds after I finished my bowel movement; if I wipe immediately after, there is no blood.
I purchased a hemorrhoid suppository and have been using it for five days, and currently, there is no blood in my stool.

However, I have noticed that I need to exert some effort to pass gas, and I'm unsure if this is due to my anxiety or the use of the hemorrhoid suppository.
When I pass gas, a little air escapes from my anus, and I involuntarily tighten up.
The same happens when I have a bowel movement; I’m not sure if I’m straining too much.
Sometimes, my stool appears flattened as if it has been pinched, but it varies—most of the time, I still have relatively thicker stools.
I also find it a bit uncomfortable sitting on a chair; I often feel soreness in the area between my buttocks and lower back after sitting for a while.

Aside from these issues, I do not feel any discomfort, and I have no diarrhea or abdominal pain.
I consulted a gastroenterologist at a nearby hospital, who believes it is likely related to hemorrhoids.
However, since no examination was conducted, they couldn't be certain, so they arranged for a colonoscopy, which is scheduled for two months from now.
Currently, I feel quite anxious and paranoid about my condition.
Based on the information I have provided, do you think this is more likely a phenomenon caused by hemorrhoids?

WW, 30~39 year old female. Ask Date: 2024/06/25

Dr. Zhang Shuhao reply Surgery

Based on the symptoms you described, such as bright red blood during bowel movements, pain from anal fissures, bleeding caused by excessive cleaning, and changes in the shape of gas and stool, it is likely related to hemorrhoids and anal fissures.
These symptoms are primarily caused by local irritation and injury, especially since the symptoms have improved after changing your cleaning habits.
While the current symptoms seem to be associated with hemorrhoids, it is appropriate to undergo a colonoscopy to rule out other potential issues.
This will ensure that there are no other underlying gastrointestinal diseases or abnormalities.
In the meantime, you can take the following measures to alleviate discomfort: 1.
Keep the anal area clean: Gently wash with warm water and avoid vigorous wiping.
2.
Avoid prolonged sitting: Get up and move around regularly, and use a cushion to reduce pressure.
3.
Maintain regular bowel movements: Drink plenty of water, increase dietary fiber intake, and avoid constipation.
4.
Use hemorrhoid medications: Such as suppositories or ointments, but follow your doctor's instructions.
If symptoms worsen or new abnormalities occur, it is advisable to seek medical attention promptly.

Reply Date: 2024/06/25

More Info

Based on the symptoms you've described, it does seem likely that you are experiencing issues related to hemorrhoids, particularly given the presence of bright red blood on the toilet paper after wiping and the discomfort associated with bowel movements. Hemorrhoids are swollen veins in the lower rectum and anus that can cause pain, itching, and bleeding, especially during bowel movements.
Your history of constipation and anal fissures (which can occur from straining during bowel movements) can contribute to the development of hemorrhoids. The fact that you have noticed blood after bowel movements, particularly at the end, aligns with common symptoms of hemorrhoids. The blood is typically bright red, indicating that it is coming from the lower gastrointestinal tract, which is consistent with hemorrhoids rather than more serious conditions that might cause darker blood.

The use of a hemorrhoid suppository has likely helped alleviate some of your symptoms, as these medications can reduce inflammation and discomfort associated with hemorrhoids. However, the fact that you are experiencing difficulty passing gas and feeling the need to strain could indicate that you are still dealing with some level of irritation or swelling in the anal area.

It's important to note that while hemorrhoids are common and often manageable, any rectal bleeding should be evaluated by a healthcare professional to rule out other potential causes. You mentioned that a gastroenterologist has already suggested that your symptoms lean towards hemorrhoids, but they also recommended a colonoscopy for a more thorough examination. This is a prudent step, as it will help ensure that there are no other underlying issues, such as polyps or other gastrointestinal conditions.

In the meantime, here are some recommendations to help manage your symptoms and promote better bowel health:
1. Dietary Changes: Increase your fiber intake by consuming more fruits, vegetables, whole grains, and legumes. This can help soften your stool and reduce straining during bowel movements.

2. Hydration: Drink plenty of water throughout the day. Staying hydrated can help prevent constipation.

3. Regular Bowel Habits: Try to establish a regular schedule for bowel movements. Do not ignore the urge to go, and avoid straining.

4. Gentle Cleaning: While it's important to maintain hygiene, be gentle when cleaning the anal area. Consider using moist wipes instead of dry toilet paper to reduce irritation.

5. Warm Baths: Soaking in a warm bath can help relieve discomfort and reduce swelling.

6. Avoid Prolonged Sitting: If you find sitting uncomfortable, try to change positions frequently or use a cushion to relieve pressure on the anal area.

7. Follow-Up Care: Keep your appointment for the colonoscopy, as it is essential for a comprehensive evaluation of your symptoms.

If your symptoms worsen or if you experience additional symptoms such as severe pain, significant changes in bowel habits, or any other concerning signs, do not hesitate to seek medical attention sooner. Your health and peace of mind are important, and addressing these symptoms proactively is the best approach.

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