Rectal Bleeding: Is It Hemorrhoids or Something Else? - Surgery

Dr. Lin Hongmao reply Surgery

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Dear OL: Thank you for your question.
Based on your description, it seems like you may be experiencing issues related to internal hemorrhoids.
I have some information about hemorrhoids for your reference.
1.
What are hemorrhoids? In simple terms, hemorrhoids are an enlargement of the vascular tissue in and around the anus.
This tissue is present from birth but can gradually enlarge due to various reasons, and with the degeneration of supporting tissue, it can protrude outward during bowel movements, forming what is known as hemorrhoids.
Hemorrhoids can be classified into internal and external types, with the dividing line being the dentate line of the anal canal.
2.
Why do hemorrhoids occur? Generally, veins have valves that promote blood flow and prevent backflow.
However, the veins in the rectum and anus lack valves, making it easier for blood to pool and causing the vessels to enlarge, leading to hemorrhoids.
Several factors can contribute to the development of hemorrhoids, including: anal inflammation, pregnancy, constipation, diarrhea, prolonged standing or sitting, abdominal tumors, rectal tumors, and chronic cough.
3.
What are the symptoms of hemorrhoids? Most individuals with hemorrhoids do not experience symptoms or discomfort.
The most common symptoms include:
1.
Bleeding: A small amount of bright red blood during bowel movements.
2.
Prolapse or rectal prolapse: First degree involves bleeding without prolapse; second degree involves prolapse after bowel movements that can retract spontaneously; third degree requires manual retraction; fourth degree is permanent prolapse that cannot be retracted.
3.
Anal pain: Pain may occur if there is prolapse, twisting, inflammation, or ulceration.
4.
Other: Burning sensation in the anus, urgency, and formation of abscesses.
4.
Treatment: Most hemorrhoids are asymptomatic and do not require treatment.
Those with mild symptoms may only need conservative management, while severe cases may require surgical intervention.
1.
Conservative therapy: Avoid alcohol, spicy foods, staying up late, prolonged sitting, and standing.
Increase intake of fruits and vegetables for fiber to soften stools, apply topical ointments, and use warm sitz baths.
2.
Rubber band ligation: Some internal hemorrhoids can be treated in an outpatient setting by a physician without hospitalization.
Patients may experience discomfort for a few days and minor bleeding afterward.
3.
Sclerotherapy: A mildly caustic agent is injected directly into the base of the internal hemorrhoid by a physician to induce scarring or fibrosis, alleviating symptoms.
However, this method is not suitable if there is inflammation or abscess formation.
4.
Surgical treatment: If hemorrhoids are severely prolapsed, bleeding, inflamed, painful, or associated with thrombosis or abscess, surgical intervention is necessary.
The procedure is performed under local anesthesia, and only the vascular tissue is removed without damaging the sphincter, so patients will not experience urinary or fecal incontinence afterward.
This is the most fundamental treatment method.
5.
Important note: It is crucial to emphasize that [rectal bleeding is not always due to hemorrhoids].
Conditions such as colorectal cancer, rectal cancer, or polyps can often be mistaken for hemorrhoids, leading to delays in diagnosis.
Therefore, if you experience rectal bleeding, please seek medical attention immediately.
You may try conservative therapy first, but if bleeding recurs, it is advisable to visit a hospital for further examination for peace of mind.
Wishing you good health and all the best!

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Reply Date: 2004/08/18