Hemorrhoids: Symptoms, Causes, and Recovery Time

Hemorrhoid flare-up

Hello Dr.
Ke: On the first day, my stool was shaped like whipped cream.
On the second day, there was a significant amount of blood in the toilet after bowel movement.
The third day was similar, and on the fourth day, it improved a bit with only one instance of bleeding after two bowel movements.
On the fifth day, there was blood in the stool and also at the anal opening.
I have been experiencing significant itching both inside and outside the anus every day.
I am currently using the medication prescribed by the previous colorectal specialist.
Could you please let me know if this is an exacerbation of internal hemorrhoids? If it is indeed an exacerbation of internal hemorrhoids, how long might it take for the bleeding to improve? Thank you for taking the time to respond, Dr.
Ke.
PS: I had a mixed hemorrhoid surgery six months ago, and the internal hemorrhoids have recurred without further treatment.
I underwent a double-contrast barium enema three years ago.

Da Xiong, 40~49 year old female. Ask Date: 2013/03/29

Dr. Ke Fangxu reply Surgery

Based on your description, it is likely that you are experiencing symptoms of hemorrhoids.
Generally, conservative treatment should show results within a week.
During this period, it is advisable to avoid spicy and irritating foods, increase your intake of vegetables and fruits, avoid staying up late, and take warm sitz baths, which can also be helpful.

Reply Date: 2013/03/29

More Info

Hemorrhoids, commonly referred to as piles, are swollen veins in the lower rectum and anus that can cause discomfort, bleeding, and itching. They can be classified into two main types: internal hemorrhoids, which occur inside the rectum, and external hemorrhoids, which develop under the skin around the anus. Your symptoms, including the presence of blood during bowel movements, the shape of your stools, and the itching around the anal area, suggest that you may be experiencing an episode of internal hemorrhoids.

Symptoms of Hemorrhoids
The symptoms of hemorrhoids can vary depending on their type and severity. Common symptoms include:
- Bleeding: Bright red blood on toilet paper or in the toilet bowl after a bowel movement.

- Pain and Discomfort: Pain during bowel movements or discomfort in the anal region.

- Itching: Itching or irritation around the anus.

- Swelling: Swelling around the anus, which may be more pronounced with external hemorrhoids.

- Prolapse: In severe cases, internal hemorrhoids may protrude outside the anus.

Causes of Hemorrhoids
Hemorrhoids can develop due to a variety of factors, including:
- Straining during bowel movements: This is often due to constipation or diarrhea.

- Pregnancy: Increased pressure on the pelvic blood vessels can lead to hemorrhoids.

- Obesity: Excess weight can put additional pressure on the veins in the rectal area.

- Sedentary lifestyle: Lack of physical activity can contribute to constipation and hemorrhoid development.

- Age: As people age, the tissues that support the veins in the rectum and anus can weaken.

Recovery Time
The recovery time for hemorrhoids can vary significantly based on the severity of the condition and the treatment approach. In many cases, mild hemorrhoids can improve within a few days to a week with conservative treatment, which may include:
- Dietary changes: Increasing fiber intake to soften stools and reduce straining.

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

- Topical treatments: Over-the-counter creams or ointments to relieve itching and discomfort.

- Warm baths: Soaking in warm water can help alleviate pain and swelling.

If your symptoms persist or worsen, it may be necessary to consult a healthcare provider for further evaluation. In some cases, more invasive treatments such as rubber band ligation, sclerotherapy, or surgical options may be required, especially if there is significant bleeding or if the hemorrhoids are causing severe discomfort.

Special Considerations
Given your history of mixed hemorrhoid surgery and the recurrence of internal hemorrhoids, it is essential to monitor your symptoms closely. If you experience significant bleeding, severe pain, or if the itching and discomfort do not improve with home treatment, you should seek medical attention. Additionally, if you have not had a follow-up examination since your last surgery, it may be prudent to schedule one to assess the current state of your hemorrhoids and discuss potential treatment options.

Conclusion
In summary, your symptoms are consistent with an episode of internal hemorrhoids, and while many cases can improve with conservative management, it is crucial to monitor your condition closely. If your symptoms do not improve or if you have concerns about your health, please consult a healthcare professional for personalized advice and treatment options.

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