Heavy Rectal Bleeding from Hemorrhoids: When to Seek Surgery

Profuse bleeding from hemorrhoids?

Hello doctor, I have hemorrhoids, but previously I only experienced bleeding when using the restroom.
Recently, for the past month, I've been bleeding without any apparent reason, and sometimes I even notice blood when urinating.
The amount is significant, comparable to menstrual bleeding.
What could this condition be? Also, since I plan to have a child, would you recommend having surgery to remove the hemorrhoids first? Thank you.

Ivy, 30~39 year old female. Ask Date: 2015/11/13

Dr. Yu Mingchang reply Surgery

Hello; please consult with the colorectal department to assess the severity of your hemorrhoids.
The Changhua Hospital of the Ministry of Health and Welfare cares about you.

Reply Date: 2015/11/13

More Info

Heavy rectal bleeding, especially when it occurs unexpectedly or in large amounts, can be concerning and warrants careful evaluation. In your case, the fact that you have a history of hemorrhoids but are now experiencing significant bleeding, even during urination, raises several important considerations.

First, it is crucial to differentiate between bleeding caused by hemorrhoids and other potential sources of rectal bleeding. While hemorrhoids can cause bleeding, especially during bowel movements, the sudden onset of heavy bleeding without a clear trigger could indicate other issues, such as anal fissures, rectal prolapse, or even more serious conditions like colorectal polyps or malignancies. The fact that you mentioned bleeding during urination is particularly concerning, as this may suggest a urinary tract issue or a more complex problem that could involve both the gastrointestinal and urinary systems.

Given the severity of your symptoms, it is advisable to seek medical attention promptly. A healthcare professional will likely perform a thorough examination, which may include a digital rectal exam, anoscopy, or colonoscopy, to identify the source of the bleeding. Blood tests may also be necessary to assess your overall health and hemoglobin levels, especially if you are experiencing significant blood loss.

Regarding your question about surgery for hemorrhoids, the decision to proceed with surgical intervention should be based on several factors, including the severity of your symptoms, the frequency of bleeding, and your overall health. If your hemorrhoids are causing significant discomfort, recurrent bleeding, or if conservative treatments (such as dietary changes, topical treatments, or minimally invasive procedures) have failed, surgery may be a viable option.
It's also important to consider your plans for pregnancy. If you are planning to conceive, you should discuss this with your healthcare provider. Some treatments for hemorrhoids can be performed safely during pregnancy, while others may be better suited for after childbirth. Your doctor can help you weigh the risks and benefits of surgery against your desire to become pregnant.

In summary, heavy rectal bleeding, particularly when it is unexpected and significant, should not be ignored. It is essential to seek medical evaluation to determine the cause and appropriate treatment. If surgery is indicated, your healthcare provider will guide you on the best timing and approach, considering your future plans for pregnancy. Always prioritize your health and well-being, and do not hesitate to reach out for professional medical advice.

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