Hemorrhoids are swollen veins that develop in the lower rectum or around the anus, affecting many adults. While often a source of discomfort, including pain, itching, and bleeding, hemorrhoids are generally not a serious health threat. Many instances can be managed with home remedies and lifestyle adjustments. However, certain symptoms indicate a need for professional medical evaluation to ensure proper diagnosis.
Common Symptoms of Hemorrhoids
A frequent sign is bright red blood appearing on toilet paper after a bowel movement, in the toilet bowl, or on the surface of the stool. This bleeding causes no pain.
Other common symptoms include itching or irritation around the anal area, general discomfort, or a mild ache. Swelling or lumps around the anus can also occur, especially with external hemorrhoids, located outside the anus. These symptoms often improve within a week with home treatments.
Warning Signs for Medical Attention
While many hemorrhoid symptoms resolve on their own, certain indicators suggest consulting a healthcare provider. Persistent or worsening pain that interferes with daily activities warrants medical attention. If home treatments, such as increased fiber intake, warm baths, or over-the-counter creams, do not provide relief after about a week, a doctor’s visit is advisable.
Significant or increasing rectal bleeding, particularly if it is more than just a few drops or if the blood appears dark, should prompt a medical evaluation. It is important to rule out other, more serious conditions that can cause rectal bleeding, such as inflammatory bowel disease or colorectal cancer. A prolapsed hemorrhoid, an internal hemorrhoid bulging outside the anus and not easily pushed back, requires professional assessment. Any new or unusual lumps, swelling, or pain in the anal area should be checked by a doctor.
Complications Requiring Urgent Care
Some hemorrhoid symptoms necessitate immediate medical attention. Severe, continuous rectal bleeding, particularly if it is heavy enough to turn the toilet water red or if large blood clots are present, is an urgent sign. This is important if accompanied by symptoms such as dizziness, faintness, or weakness, which could indicate significant blood loss leading to anemia.
Excruciating pain that makes it difficult to sit, walk, or perform routine activities may signal a thrombosed hemorrhoid. This occurs when a blood clot forms within an external hemorrhoid, creating a hard, painful lump that appears bluish or purple. While not dangerous, a thrombosed hemorrhoid can cause intense discomfort and may require prompt medical intervention for pain relief. Signs of infection, such as fever, chills, increased redness, warmth, pus drainage, or worsening pain around the anal area, demand immediate medical evaluation.
What to Expect at the Doctor’s Office
During a visit for hemorrhoid concerns, the doctor will begin by taking a detailed medical history, inquiring about symptoms, bowel habits, and past treatments. A physical examination will follow, which includes a visual inspection of the anal area to identify external hemorrhoids or prolapsed internal ones. To assess internal hemorrhoids, the doctor may perform a digital rectal exam, inserting a gloved, lubricated finger to feel for abnormalities.
Further diagnostic procedures might include an anoscopy, which uses a small, lighted tube to view the lining of the anus and lower rectum. For a more comprehensive view, a sigmoidoscopy, using a longer, flexible scope, might be performed to examine the lower part of the colon. Initial treatment recommendations involve lifestyle changes such as increasing dietary fiber and water intake to soften stools and reduce straining, along with warm sitz baths and over-the-counter pain relievers or topical creams. For persistent issues, the doctor may discuss in-office procedures like rubber band ligation or sclerotherapy to address the hemorrhoids.