Hemorrhoids

Enlarged rectal veins can cause bleeding, pain, itching and the sensation of a lump.

Hemorrhoids are associated with enlargement of the veins in the anal canal and rectum. They may be internal or external and can present with bleeding, itching, pain and a lump.

When to seek emergency care

If any of the following signs occur, call *3003 immediately — do not wait for a routine appointment:

  • Heavy rectal bleeding
  • Black stool
  • Severe anal pain and swelling
  • Fever
  • Unexplained weight loss and anemia

What is it?

The main danger is that a patient may assume all rectal bleeding is due to hemorrhoids and delay the diagnosis of serious bowel disease.

Symptoms

  • Blood during a bowel movement
  • Itching
  • Pain
  • A lump in the anal area
  • Mucus discharge
  • A feeling of incomplete evacuation

Causes & risk factors

  • Constipation
  • Prolonged sitting
  • Pregnancy
  • Excess weight
  • Heavy lifting
  • A low-fiber diet
  • Age

Diagnosis

Diagnosis does not rely on a single test. Symptoms, risk factors, physical examination findings and investigation results are assessed together.

  • Proctological examination
  • Anoscopy or rectoscopy
  • Blood test for anemia
  • Colonoscopy according to age and risk
  • Exclusion of other causes of bleeding

Treatment approaches

Treatment is individualized according to disease severity, the patient's overall condition, comorbidities and procedural risk.

  • Increasing fiber and fluid intake
  • Treatment of constipation
  • Topical medications
  • Band ligation and other proctological procedures
  • Surgery in severe cases

How we help

At the center, hemorrhoid symptoms are distinguished from other causes of rectal bleeding. Gastroenterological and proctological assessment is arranged when needed.

When a procedure may be needed

A procedure may be needed for recurrent bleeding, thrombosis, pain, a non-reducible lump or failure to respond to conservative treatment.

Patient checklist

  • Do not delay assessment by assuming that bleeding is caused by hemorrhoids
  • Treat constipation
  • Increase your fiber and fluid intake
  • Do not sit on the toilet for prolonged periods

FAQ

Is blood in the stool always caused by hemorrhoids?

No. Polyps, inflammation and cancer can also cause bleeding. Assessment is necessary.

Can hemorrhoids resolve without surgery?

In mild cases, dietary changes, constipation control and topical treatment may help.

Last updated:

Related department

Gastroenterology

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