Do Internal Hemorrhoids Bleed Only During Bowel Movements? - Surgery

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Internal hemorrhoids can indeed bleed during bowel movements, but they are not limited to bleeding only at that time. The bleeding associated with internal hemorrhoids typically occurs when the hemorrhoids become engorged with blood and are subjected to the pressure and friction of passing stool. This can lead to the rupture of small blood vessels, resulting in bright red blood on the stool or toilet paper.

However, it is also possible for internal hemorrhoids to bleed without a bowel movement. This can happen if the hemorrhoids become inflamed or irritated due to factors such as prolonged sitting, straining, or even certain dietary choices. In some cases, internal hemorrhoids may bleed intermittently, and the blood may not always be visible during bowel movements. Instead, it may appear as dark red blood in the stool or as blood in the toilet bowl after a bowel movement.

Regarding your situation, it is reassuring that you have not experienced pain during bowel movements and that your stool occult blood test came back negative. This suggests that there may not be significant bleeding occurring from the hemorrhoids or any other source. The absence of pain is also a positive sign, as pain is often associated with more severe conditions, such as thrombosed hemorrhoids or anal fissures.

As for the concern about skin irritation or "破皮症狀" (skin breakdown), it is possible that the area around the anus could experience irritation due to friction, especially if there are hemorrhoids present. This irritation can sometimes lead to minor bleeding, but it is typically less severe than the bleeding associated with more significant hemorrhoidal issues.

Regarding your concerns about the risk of infection from the instruments used during your examination, it is important to note that medical professionals follow strict sterilization protocols to minimize any risk of infection. The risk of transmission of bloodborne pathogens through properly sterilized instruments is extremely low. If you have any specific concerns about this, it is best to discuss them directly with your healthcare provider.

In summary, while internal hemorrhoids often bleed during bowel movements, they can also bleed at other times due to irritation or inflammation. The absence of pain and negative occult blood tests are encouraging signs. If you continue to have concerns or if you notice any changes in your symptoms, it is advisable to follow up with your healthcare provider for further evaluation and management. Regular monitoring and maintaining a healthy diet rich in fiber can help manage symptoms and prevent exacerbation of hemorrhoids.