Dealing with Severe Hemorrhoids: When to Seek Medical Help

Hemorrhoids

Hello Doctor: My hemorrhoids have recurred, and this time they are very swollen, bleeding, and I cannot push them back inside the anus.
What should I do? Should I see a doctor? Thank you.

Xiao Yu, 20~29 year old female. Ask Date: 2009/10/24

Dr. You Ligang reply Gastroenterology and Hepatology

Hello, you should see a doctor and consider medication.
If you frequently experience abdominal issues, it indicates that dietary or lifestyle changes may not be sufficient for improvement, and you might need assistance from a surgeon.
Wishing you good health.
Sincerely, Dr.
You Li-Kuang, Taoyuan Hospital, Department of Health.

Reply Date: 2009/10/24

More Info

Severe hemorrhoids can be quite uncomfortable and distressing, especially when they become large, bleed, and cannot be pushed back into the rectum. It is essential to understand when to seek medical help for this condition.
Firstly, hemorrhoids are swollen veins in the lower rectum and anus, similar to varicose veins. They can be classified into two types: internal and external. Internal hemorrhoids are located inside the rectum and usually do not cause pain, while external hemorrhoids are located under the skin around the anus and can be painful, especially when they become thrombosed (filled with blood clots).

In your case, the symptoms you describe—large hemorrhoids that bleed and cannot be pushed back—indicate that you should seek medical attention promptly. Here are several reasons why it is crucial to consult a healthcare professional:
1. Severe Symptoms: If your hemorrhoids are causing significant pain, bleeding, or discomfort, it is essential to see a doctor. While mild hemorrhoids can often be managed with home treatments, severe cases may require medical intervention.

2. Bleeding: Any rectal bleeding should be evaluated by a healthcare provider. While hemorrhoids can cause bleeding, it is essential to rule out other potential causes, such as anal fissures, diverticular disease, or even colorectal cancer, especially if the bleeding is significant or persistent.

3. Inability to Reduce: If you cannot push the hemorrhoid back inside, it may indicate that it is thrombosed or incarcerated. This condition can lead to increased pain and complications, such as infection or necrosis (tissue death), requiring surgical intervention.

4. Persistent Symptoms: If your symptoms do not improve with home treatments, such as over-the-counter creams, sitz baths, or dietary changes (increasing fiber intake), it is time to seek professional help. A healthcare provider can offer more effective treatments, including prescription medications or procedures.

5. Potential Treatments: Depending on the severity of your hemorrhoids, treatment options may include rubber band ligation, sclerotherapy, infrared coagulation, or surgical removal (hemorrhoidectomy). Your doctor will assess your condition and recommend the most appropriate treatment based on your symptoms and overall health.

In summary, given the severity of your symptoms—large, bleeding hemorrhoids that cannot be pushed back—you should definitely see a healthcare provider. They can perform a thorough examination, provide a proper diagnosis, and discuss the best treatment options for your situation. Early intervention can help alleviate your symptoms and prevent potential complications.
Additionally, while waiting for your appointment, consider some self-care measures to help manage your symptoms. These include:
- Warm Sitz Baths: Soaking in warm water for 10-15 minutes several times a day can help reduce swelling and relieve discomfort.

- High-Fiber Diet: Increasing your fiber intake through fruits, vegetables, and whole grains can help soften stools and reduce straining during bowel movements.

- Hydration: Drink plenty of fluids to help prevent constipation.

- Over-the-Counter Treatments: Topical creams or ointments may provide temporary relief from pain and itching.

Remember, while these measures can help manage symptoms, they are not substitutes for professional medical advice and treatment.

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