Are Bleeding Hemorrhoids Dangerous?

If you have hemorrhoids, you’re not alone — millions of adults in the United States deal with these inflamed anal or rectal veins at any given time and one in two Americans over the age of 50 experience persistent hemorrhoids that linger.      

Given that most hemorrhoids improve with lifestyle adjustments and a consistent at-home care routine, it can be concerning when symptoms flare or worsen. Hemorrhoids can cause:

• Persistent anal itching  
• Hard, tender lumps near your anus
• Anal pain when you’re sitting 
• Bleeding with a bowel movement

If you’re worried about bleeding hemorrhoids, board-certified gastroenterologist Ilyas Memon, MD, and our expert team at Texas Digestive Disease Consultants can help. With three offices in The Woodlands, Magnolia, and Willis, Texas, we can get to the bottom of your symptoms and provide the care you need to get better fast. 

Here, we take a closer look at hemorrhoid formation, types, and symptoms — including when rectal bleeding is normal and when it should prompt you to seek expert care. 

How do hemorrhoids develop?

Hemorrhoids, also known as piles, are swollen, inflamed veins that occur around the anus or within the lower part of the rectum. They’re sometimes called “varicose veins” of the anus and rectum because — just like varicose leg veins — they develop when increased pressure on a vessel causes it to stretch, bulge, swell, twist, and contort.    

 You’re more likely to get hemorrhoids if:

• You have regular bouts of bowel-straining constipation
• You don’t get enough roughage (dietary fiber) each day
• Your fluid intake is insufficient; you’re often dehydrated
• You do a lot of heavy lifting (i.e., at the gym, on the job)

Other leading hemorrhoid risk factors include pregnancy, obesity, and older age. These factors set the stage for hemorrhoids by weakening and destabilizing the tissues that support the blood vessels in your rectum and anus.

Internal vs. external hemorrhoids

The two types of hemorrhoids — external and internal — are classified by their location. Let’s take a closer look at each type.   

External hemorrhoids

These irritating swollen veins appear just beneath the skin around your anus. They tend to be itchy and uncomfortable, and the overlying skin is usually sensitive and tender. 

 An external hemorrhoid may bleed or become more painful if it grows larger, forms a blood clot (thrombosis), is damaged by the passage of a hard stool, or the overlying, irritated skin breaks open from constant scratching.

Internal hemorrhoids

Internal hemorrhoids are swollen, enlarged veins that develop within the inner lining of your anus or lower rectum. You can’t see or feel an internal hemorrhoid most of the time, but bowel movement strain may cause painless rectal bleeding and momentary protrusion. 

An internal hemorrhoid can become very painful if it prolapses, or pushes outward through your anal opening and doesn’t retract back inside. 

When hemorrhoids start to bleed

When you have hemorrhoids, rectal bleeding is usually a sign of irritation or damage to the wall of the inflamed vessel. Whether your irritated hemorrhoids are external or internal, you may see bright red blood in your stool, on toilet paper, or in the toilet bowl after a bowel movement. 

 Mild rectal bleeding during bowel movements is a common occurrence for people with hemorrhoids, but it’s also one that typically resolves quickly — especially with a little self-care. 

 Taking a sitz bath, using moist wipes instead of toilet paper, trying an over-the-counter product for hemorrhoid relief (topical cream or suppository), and avoiding sitting on the toilet for long periods can help in the short run; drinking more fluids, getting more dietary fiber, and staying physically active can foster long-term hemorrhoid improvement.    

Help for bleeding hemorrhoids 

If you experience mild bleeding during bowel movements that doesn’t resolve after a week of at-home hemorrhoid care, it’s time to schedule an appointment with Dr. Memon.  

Persistent or severe rectal bleeding is more likely to be a sign of a hemorrhoid complication or something else — like ulcerative colitis or colorectal cancer — that requires expert evaluation and care. For example, if a hemorrhoid forms a blood clot, the painfully thrombosed vein may rupture, release the clot, and bleed quite heavily. 

 A thrombosed hemorrhoid requires treatment, ideally before it bleeds, but especially if it has ruptured and caused significant bleeding. Seek prompt care for bleeding hemorrhoids if you:

• Have rectal bleeding between bowel movements
• Frequently find blood on the back of your underwear 
• Notice a lot of blood in the toilet after each use
• Find a new lump near your anus that looks blue
• Develop anal pain, especially if the onset is sudden 

The bottom line? Any hemorrhoid-related rectal bleeding that’s severe, persistent, occurs with pain, or simply leaves you feeling concerned is reason to see our team ASAP — and we’re here to help. Call or click online to schedule an appointment at Texas Digestive Disease Consultants in The Woodlands, Magnolia, and Willis, Texas, today.