Hemorrhoids, commonly known as piles, are swollen and inflamed veins located around the anus or in the lower rectum. This common condition affects approximately 1 in 20 Americans, with about half of adults over 50 experiencing them. While generally not dangerous, a ruptured hemorrhoid, especially one that bleeds, warrants attention.
Understanding a Ruptured Hemorrhoid
Hemorrhoids are enlarged blood vessels that form either internally, within the lining of the anus and lower rectum, or externally, under the skin around the anus. Internal hemorrhoids typically do not cause pain unless they prolapse or become irritated, but they can bleed. External hemorrhoids, located outside the anus, can be itchy, painful, and may also bleed.
A hemorrhoid “ruptures” when it tears or breaks open, typically leading to bleeding. This often occurs with a thrombosed external hemorrhoid, where a blood clot forms inside the vein, causing significant pressure and swelling. If this pressure becomes too high, the hemorrhoid can burst through the skin, releasing the clot and blood. While internal hemorrhoids less commonly “burst,” they can bleed suddenly, often presenting as bright red blood in the toilet or on toilet paper.
Potential Risks and Complications
The primary concern with a ruptured hemorrhoid is bleeding. While often brief, bleeding can sometimes be significant and persistent. Chronic or excessive blood loss from hemorrhoids can lead to iron deficiency anemia, with symptoms such as tiredness, shortness of breath, and chest pain developing in severe cases.
Another risk following a rupture is infection. A burst hemorrhoid creates an open wound, making the area susceptible to bacterial contamination. If bacteria enter the wound, it can lead to infection, potentially requiring antibiotics or specialized wound care. Signs of an infected hemorrhoid include increased pain, redness around the anus, and sometimes pus or discharge.
Severe pain and discomfort are also common complications, particularly if a thrombosed hemorrhoid ruptures. The sudden release of pressure from the blood clot can provide some relief, but the area remains tender and inflamed. In some instances, a prolapsed internal hemorrhoid may become strangulated if its blood supply is cut off by the anal muscles, leading to intense pain and potentially requiring surgical intervention.
When Medical Attention is Necessary
While many ruptured hemorrhoids can be managed with home care, certain symptoms indicate a need for professional medical evaluation. Persistent or heavy bleeding is a primary reason to seek medical attention, including a large amount of blood (e.g., toilet water turning red) or blood clots. Rectal bleeding can also indicate more serious conditions, such as colorectal cancer.
Severe or continuous pain that does not improve with home remedies warrants a doctor’s visit, especially if it significantly affects daily activities like sitting or walking. Signs of infection, such as fever, increasing redness, swelling, or pus/discharge around the anal area, require immediate medical attention to prevent further complications.
Other concerning symptoms include dizziness, lightheadedness, or faintness, which may suggest significant blood loss and potential anemia. If hemorrhoid symptoms, including bleeding or discomfort, do not improve after a week of consistent home care, consult a healthcare provider. A painful bluish lump on the anus, indicative of a thrombosed hemorrhoid, should also prompt a doctor’s visit.
Care and Treatment Options
Initial management for a ruptured hemorrhoid often involves home care. Soaking in a warm bath, also known as a sitz bath, for 10 to 20 minutes several times a day can help alleviate pain and discomfort. Over-the-counter creams, ointments, or pads containing ingredients like witch hazel or hydrocortisone can provide temporary relief from pain and itching.
Dietary adjustments promote softer bowel movements, which reduces straining. Increasing fiber intake through high-fiber foods like fruits, vegetables, and whole grains, or by using fiber supplements, is beneficial. Drinking plenty of water daily also contributes to softer stool consistency.
For cases that do not respond to home treatments, or for more severe hemorrhoids, medical interventions are available. Rubber band ligation, a common procedure for internal hemorrhoids, involves placing a small band at the base of the hemorrhoid to cut off its blood supply, causing it to shrink and fall off within about a week. Sclerotherapy involves injecting a chemical solution into the hemorrhoid to cause it to shrink and scar. For larger or persistent hemorrhoids, surgical removal, known as a hemorrhoidectomy, may be considered.