Hemorrhoids are a very common anal-rectal condition that is defined as the symptomatic enlargement and distal displacement of the normal anal bolster. Hemorrhoids cause itching and pain and these are also one the most common cause of bright red bleeding with defecation. To mark the difference between the two types of Hemorrhoids (External and Internal) – External hemorrhoids are associated with severe pain from the inflammation and edema caused by thrombosis (the clotting of blood within the hemorrhoid) which may lead to ischemia of the area and eventual necrosis. On the other hand, Internal hemorrhoids are not usually painful until they bleed or prolapsed (enlarged internal hemorrhoids that actually protrude through the anus) at which the size of the hemorrhoid will increase.
In this article you will know why hemorrhoids bleed and what to do when they bleed?
Before we proceed to that, in order to know why the hemorrhoids bleed, let us first talk about the factors associated with the occurrence of hemorrhoids and understand the disturbance of function that this condition has caused to the affected area. Some publications say that the cause of hemorrhoids is not known. However, there are a number of conditions that can result to hemorrhoids. A few of them are as follows: straining too hard during defecation (commonly found when constipated), episiotomy after child birth, and also genetic disorders that involves weakening of the muscles around the anal orifice.
For many years it was believed that the cause of hemorrhoids is due to the varicosities. In this theory, it was postulated that hemorrhoids were caused by varicose veins in the anal canal. But this idea is now obsolete because hemorrhoids and ano-rectal swollen/knotted veins are proven to be of different distinctive entities. There was also a study conducted between patients with portal hypertension and swollen veins and it was found out that these patients do not have an increased incidence of hemorrhoids.
The most common symptom of hemorrhoids is rectal bleeding associated with bowel movement. Hemorrhoids are actually swollen blood vessels in the lower rectum; hence this answers the first question on “why hemorrhoids bleed and what to do when they bleed?” The second question on the other hand will be discussed in the later part of this article.
To explain further, the reason why hemorrhoids bleed is due to the rich vascular supply of the anus. Because of its highly sensitive location there is a tendency for this area to engorge and have prolapsed. In hemorrhoids, there is abnormal swelling of the anal cushions that causes the dilatation and inflammation of the arteriovenous plexuses (these are veins and arteries in that area). This will then lead to stretching of the ligament muscles and eventual slippage of rectal tissue through the anal canal. The engorged anal mucosa will become very much sensitive, therefore it will be is easily traumatized, resulting to rectal bleeding and the color of the blood when it bleeds is typically bright red due to high blood oxygen content within the arterial and venous junctions.
Let us now proceed to what to do when hemorrhoids bleed.
In case bleeding occurs on hemorrhoids, it is highly advised to undergo diagnostic examinations such as anoscopy or another option is a flexible sigmoidoscopy. These procedures shall be aimed to evaluate any bright-red rectal bleeding. In these cases, Colonoscopy can also be considered in the evaluation of any rectal bleeding that is not typical of hemorrhoids such as in the presence of strong risk factors for colonic malignancy or in the setting of rectal bleeding with a negative anorectal examination. This is important to rule out other factors that might be associated with the bleeding in the ano-rectal part of your body. It is important to recognize the formation of hemorrhoids in the anus can also be a predisposing factor to another condition. Diagnostic examination will help evaluate the condition further. Know what exactly is the problem can prevent any further damage that can occur.
For first aid treatments in case of active bleeding should be done, like cold compress to the affected area to stop the bleeding. Be sure that you do not apply the ice directly on the skin. If you do not have a cold pack, wrap ice in a thin sheath of cloth. It is important to remember that in a case of active bleeding, avoid using treatment regimens that has moist heat because it encourages vessel dilation and bleeding. This implies that you should not do Hot Sitz bath when there is bleeding on the hemorrhoid tissues.
Excessive bleeding might occur for large hemorrhoids that burst. In such cases, it is necessary to seek medical attention immediately especially if the bleeding does not stop. Immediately dress the bleeding properly and press it against the hemorrhoid area to stop the bleeding. Once this is done, proceed to the nearest medical facility to proper treatment.
Remember that these hemorrhoids may be having thrombosis (where there is formation or presence of one or more blood clots) – which may partially or completely block an artery or vein. In such cases surgical intervention is highly advised so as to remove the clotted blood. Other treatment options are Sclerotherapy, Rubber Band Ligation and Cryosurgery. In the United States, rubber band ligation (compared with injection sclerotherapy) is the preferred option.
The importance of a high-fiber diet, increased fluid intake, mild exercise, and regular bowel movements must be emphasized in order to avoid or even just lessen the occurrence of hemorrhoids. In case of any bleeding, remember not to panic, do first aid necessary to stop the bleeding and then seek consultation to a medical professional. Home remedies may also be available for treatment of hemorrhoids. These treatments should be done diligently on a regular basis; otherwise the treatment started will not be effective. In the event that symptoms continue to persist even with following the correct procedure in treatment, the first action is to proceed to a doctor to have the hemorrhoids diagnostically evaluated.
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