- About hemorrhoids
- Self-care
- Medical treatment
- Takeaway
Even without treatment, the symptoms of small hemorrhoids might clear up in just a few days. Chronic hemorrhoids, however, can last weeks with regular symptom flare-ups.
Keep reading to learn how to treat hemorrhoids that won’t go away and when to see a doctor.
Hemorrhoids are swollen veins around your lower rectum and anus. These veins can swell to the point that they bulge and become irritated. There are two main types of hemorrhoids:
- Internal hemorrhoids. These occur in the small arterial branches inside the rectum. They’re typically not felt or seen, but they may bleed.
- External hemorrhoids. These occur in the veins under the skin outside of the anal opening. Like internal hemorrhoids, external hemorrhoids can bleed, but because there are more nerves in the area, they tend to create discomfort.
Conditions commonly associated with chronic hemorrhoids include the following:
- A prolapsed hemorrhoid is an internal hemorrhoid that gets bigger and bulges outside the anal sphincter.
- A strangulated hemorrhoid is a prolapsed hemorrhoid with the blood supply cut off by the muscles around your anus.
- A thrombosed hemorrhoid is a clot (thrombus) that forms after blood pools in an external hemorrhoid.
If you have hemorrhoids, you’re not alone. The National Institute of Diabetes and Digestive and Kidney Diseases estimates hemorrhoids affect about 5 percent of Americans and about 50 percent of adults over 50 years old.
If you have hemorrhoids that just won’t go away or keep reappearing, see your doctor.
Following diagnosis, your doctor might recommend treating chronic hemorrhoids with lifestyle changes, including:
- incorporating more high-fiber foods in your diet
- increasing your daily consumption of water and other nonalcoholic beverages
- limiting your time sitting on the toilet
- avoiding straining during bowel movements
- avoiding heavy lifting
Your doctor may also recommend some more involved or more medicinal steps to incorporate in self-treatment, such as using:
If self-care isn’t effective in relieving your symptoms, your doctor may recommend one of a variety of procedures.
In-office procedures
Your doctor may suggest:
- Rubber band ligation. Also called hemorrhoid banding, this procedure is used for prolapsing or bleeding hemorrhoids. Your doctor places a special rubber band around the base of the hemorrhoid to cut off its blood supply. In about a week, the banded section will shrivel and fall off.
- Electrocoagulation. Your doctor uses a special tool to deliver an electric current that shrinks a hemorrhoid by cutting off its blood supply. It’s commonly used for internal hemorrhoids.
- Infrared photocoagulation. Your doctor uses a tool that delivers infrared light to shrink a hemorrhoid by cutting off its blood supply. It’s typically used for internal hemorrhoids.
- Sclerotherapy. Your doctor injects a solution that shrinks a hemorrhoid by cutting off its blood supply. It’s typically used for internal hemorrhoids.
Hospital procedures
Your doctor may suggest:
- Hemorrhoidopexy. A surgeon uses a special stapling tool to remove internal hemorrhoid tissue, pulling a prolapsed hemorrhoid back into your anus. This procedure is also called hemorrhoid stapling.
- Hemorrhoidectomy. A surgeon surgically removes prolapsed hemorrhoids or large external hemorrhoids.
If you have hemorrhoids that won’t go away, see your doctor. They can recommend a variety of treatments, ranging from diet and lifestyle changes to procedures.
It’s important you see your doctor if:
- You’re experiencing discomfort in your anal area or have bleeding during bowel movements.
- You have hemorrhoids that don’t improve after a week of self-care.
- You have a lot of rectal bleeding and feel dizzy or lightheaded.
Don’t assume that rectal bleeding is hemorrhoids. It can also be a symptom of other diseases, including anal cancer and colorectal cancer.
Last medically reviewed on October 7, 2019
Hemorrhoids are swollen veins within and around the anal canal. The veins around the anus tend to stretch under the increased pressure and may be swollen. If you have experienced an acute anal pain with per rectal bleeding related to the bowel movements, it is highly recommended to seek for an urgent medical attention. This could be the signs and symptoms of ruptured hemorrhoids.
Get to know ruptured hemorrhoids
If a blood clot forms inside the hemorrhoids, it can become thrombosed and eventually burst, once the internal pressure increases (during the excessive straining from either constipation or diarrhea).
Signs and symptoms of ruptured hemorrhoids
Warning signs and symptoms indicating ruptured hemorrhoids include:
- Palpable painful lump at the anal opening
- Persistent per rectal bleeding
- Severe pain, irritation and swelling around the anus
Severity of ruptured hemorrhoids
If the hemorrhoid bursts, an emergency care must be sought. The serious complication that’s caused by excess blood loss are dizziness, faintness or even hypotension/shock. However, per rectal bleeding can also be a particular sign of other disease conditions, such as colorectal and anal canal cancer. Owning to the fact that these conditions mutually share the certain presentations, careful physical examination and subsequent appropriate diagnostic tests conducted by expert specialists are highly recommended.
Management of ruptured hemorrhoids
Once the hemorrhoid bursts, an immediate care should be provided as to follow the steps:
- Gentle compression using clean soft cloths or sanitary napkins to stop the bleeding.
- Apply cold compression or cold sitz bath to reduce the inflammation and to stop the bleeding.
If per rectal bleeding persists and the following symptoms develop: palpitation, dizziness, faintness and cold hands and/or feet, an immediate medical attention must be obtained.
Treatment of ruptured hemorrhoids
Ruptured hemorrhoid with excessive per rectal bleeding usually happens from the external hemorrhoid. The primary treatment option is to have the hemorrhoid removed, known as hemorrhoidectomy. It is considered as the most effective approach for this issue with rapid recovery and quickly return to daily activities. Depending on the severity, surgery can be arranged as a “Day – Surgery” procedure or outpatient procedure without hospitalization.
Prevention of ruptured hemorrhoids
- Avoid the excessive strain during the motion.
- Avoid prolonged sitting in the toilet.
- Drink plenty of water of at least 8-10 glasses per day.
- Consume high-fiber diet; fruits, vegetables and whole grains.
- Seek for medical attention whenever needed.
A ruptured hemorrhoid may lead to severe blood loss, resulting in serious complications which require an emergency. Accurate and timely diagnosis to role out other conditions is the key enabling an effective treatment. Due to advances in the surgical techniques and technologies, the new treatments have continuously emerged, allowing the patients to achieve the best possible treatment outcomes with minimal discomfort, less post-operative complications, rapid recovery, quickly return to the normal daily activities and less recurrences.
"If you have already been diagnosed with hemorrhoids and your symptoms are not improving with fiber supplements, an increase in water intake, over-the-counter pain relievers, or a warm bath, then schedule an appointment," Dr. Charabaty-Pishvaian says.
In most cases, you can see a general practitioner or your family physician about your hemorrhoid symptoms. If complications arise, you may be referred to a specialist, such as a gastroenterologist or a proctologist.
Different Types of Hemorrhoids
There are two types of hemorrhoids: external and internal. External hemorrhoids arise from the anal canal, while internal hemorrhoids arise from the rectum, immediately above the anal canal. According to Cuckoo Choudhary, MD, associate professor of gastroenterology at Thomas Jefferson University in Philadelphia, one type is not worse than the other, but both can cause problems. "It all depends on the size and degree of the hemorrhoid," Dr. Choudhary says. "Untreated internal hemorrhoids can cause bleeding. External hemorrhoids can cause thrombosis [blood clotting], which gives way to severe pain from hemorrhoidal strangulation."
If you know you have hemorrhoids and you have acute and severe anal pain, it could be a sign of thrombosed hemorrhoids.
Know When to See Your Doctor
Though the annoyance of hemorrhoids can be reason enough to call your doctor, use this checklist to know when a visit is a must:
- If you're experiencing any type of rectal bleeding
- If the hemorrhoids are causing you pain or discomfort
- If the problems persist despite trying over-the-counter hemorrhoid creams or other remedies
- If you're passing stools that look maroon in color or tarry in color, a sign of bleeding
If you experience a large amount of rectal bleeding that is accompanied by dizziness or faintness, be sure to seek emergency medical care immediately.
Though hemorrhoids are thought of as a minor health problem, you shouldn't let that notion keep you from getting them examined. The ultimate goal is hemorrhoid relief, and for many people, that means an office visit.
Read more: Hemorrhoids: What to Know