Hemorrhoids are swollen veins in the anus and lower rectum, similar to varicose veins. They are vascular structures that assist with stool control. When these veins become inflamed or swollen, they can lead to uncomfortable symptoms, including bleeding. Hemorrhoids can occur internally, within the rectum, and externally, around the anus.
Understanding Hemorrhoidal Bleeding
Blood from hemorrhoids is typically bright red. This distinctive color indicates fresh blood from the lower gastrointestinal tract, specifically the anus or rectum. The bright red appearance means the blood has not been exposed to digestive enzymes, which would otherwise cause it to darken.
This bleeding often occurs during or after a bowel movement, particularly with straining or the passage of hard stools, which can damage the delicate surface of the swollen veins. Bright red blood may be noticed on toilet paper after wiping, as streaks on the stool, or as drops in the toilet bowl. Bleeding from internal hemorrhoids is usually painless because the rectum has fewer pain-sensing nerves. External hemorrhoids can also bleed, though their bleeding may sometimes appear darker, and they are typically more painful due to sensitive nerve endings in the anal area.
Distinguishing Hemorrhoidal Blood from Other Bleeding
Distinguishing hemorrhoidal blood from other types of rectal or gastrointestinal bleeding is important. Blood that is dark red or maroon, often mixed within the stool, usually signals bleeding from higher up in the colon or small intestine. The darker color results from the blood being partially digested as it travels through a longer segment of the digestive tract.
Stools that appear black and tarry, known as melena, indicate bleeding from the upper gastrointestinal tract (esophagus, stomach, or small intestine). Digestive chemicals interact with the blood, turning it black and giving it a sticky, tar-like consistency. Blood clots can also appear with rectal bleeding and might suggest a different source or more significant bleeding than typically seen with uncomplicated hemorrhoids.
When to Consult a Doctor
Any new or concerning rectal bleeding should prompt a consultation with a healthcare professional, as it can indicate conditions more serious than hemorrhoids. Seek medical attention if bleeding is heavy, persistent, or frequent between bowel movements. Symptoms such as dizziness, lightheadedness, or faintness accompanying rectal bleeding require immediate medical evaluation, as these can be signs of significant blood loss.
Medical advice is important if you experience severe anal pain, particularly with a bluish lump, which could indicate a thrombosed hemorrhoid. Changes in bowel habits (e.g., persistent diarrhea or constipation), unintentional weight loss, or abdominal pain alongside bleeding are additional reasons to see a doctor. If your stools are dark red, maroon, or black and tarry, seek medical care.