Hemorrhoids are swollen veins located in the rectum or around the anus. They develop due to increased pressure in the lower rectum, often from straining during bowel movements, pregnancy, or prolonged sitting. While many people experience hemorrhoids, understanding when symptoms warrant professional medical attention is important. This article outlines signs indicating when a doctor’s visit is warranted.
Understanding Common Hemorrhoid Symptoms
Common hemorrhoid symptoms are typically mild to moderate. Discomfort around the anus is frequent, often accompanied by itching. Mild bleeding, usually appearing as bright red blood on toilet paper or in the toilet bowl after a bowel movement, is also common, and swelling around the anal opening may occur.
Hemorrhoids can be internal, forming inside the rectum, or external, developing under the skin around the anus. Internal hemorrhoids often cause painless bleeding during defecation or may prolapse, meaning they protrude outside the anus. External hemorrhoids tend to be more painful and itchy, especially if a blood clot forms within them, leading to a thrombosed hemorrhoid. These common symptoms often respond well to home care.
Signs That Warrant a Doctor’s Visit
Certain symptoms warrant a doctor’s visit. Any significant amount of blood, dark blood, or blood mixed with stool should prompt a medical evaluation, as this can signal more serious underlying conditions. Severe pain that is debilitating or does not improve with typical home care also requires attention, possibly suggesting a thrombosed external hemorrhoid or another issue.
If hemorrhoid symptoms persist for more than a week or two, or worsen despite home remedies and lifestyle changes, medical consultation is advisable. A prolapsed hemorrhoid that cannot be gently pushed back inside the anus, often called an incarcerated hemorrhoid, can be very painful and may require immediate medical intervention to prevent complications.
Signs of infection, such as fever, chills, pus, or increasing redness and swelling around the anal area, require prompt medical attention for potential antibiotic treatment. Unexplained changes in bowel habits, including a sudden change in stool consistency or frequency, should always be discussed with a healthcare provider to rule out other conditions. If you are taking blood-thinning medications and experience hemorrhoid bleeding, consult a doctor immediately, as blood thinners can worsen bleeding.
Medical Assessment and Treatment Approaches
When visiting a doctor for hemorrhoid concerns, a medical assessment typically begins with a physical examination of the anal area. The doctor may perform a digital rectal examination (DRE) to feel for abnormalities inside the rectum. In some cases, an anoscopy, which involves inserting a short, lighted tube into the anus to view the lower rectum, may be performed to visualize internal hemorrhoids.
Initial treatment recommendations often focus on lifestyle modifications to alleviate symptoms and prevent recurrence. These include increasing dietary fiber intake through fruits, vegetables, and whole grains, and ensuring adequate hydration to soften stools. Over-the-counter creams, ointments, or medicated wipes containing hydrocortisone or witch hazel can help reduce itching and inflammation. Oral pain relievers may also be recommended for discomfort. For persistent or more severe cases, doctors may suggest minimally invasive office procedures.
Rubber band ligation, a common procedure, involves placing a small rubber band around the base of an internal hemorrhoid, cutting off its blood supply, causing it to wither and fall off within a week. Sclerotherapy involves injecting a chemical solution into the hemorrhoid to shrink it. Infrared coagulation uses infrared light to coagulate the blood within the hemorrhoid, causing it to shrivel. Surgical intervention, such as a hemorrhoidectomy, which involves surgically removing large or recurrent hemorrhoids, is considered for very severe or unresponsive cases.