Why do Haemorrhoids bleed and how can I stop it?



Also known as piles, haemorrhoids occur when veins in your rectum or anus become inflamed and swell as result of increased pressure being exerted on them, usually when someone has constipation or diarrhoea. Sufferers can develop either internal (within the rectum) or external haemorrhoids (under the skin around the anus). All types of haemorrhoids are itchy and can become painful – they can also begin to bleed over time if left untreated. They are, however, not life-threatening and usually clear up on their own.


Bleeding haemorrhoids

Both internal and external haemorrhoids can start bleeding if the outer skin of the haemorrhoid lump becomes damaged due to excessive straining during a bowel movement. Thrombosed haemorrhoids can also rupture if they become too full. All haemorrhoid bleeding produces blood that appears bright red on a wipe or toilet paper, and can be quite alarming.

Haemorrhoids normally only bleed after they’ve been damaged or severely irritated, and will usually heal on their own. If, however, the bleeding continues for several days or has no obvious source, you should speak to your doctor immediately as a number of other more serious conditions can exhibit the same symptoms as haemorrhoids.

As previously mentioned, internal and external haemorrhoids can progress into thrombosed haemorrhoids, which occur when a blood clot appears within the vein, causing a lot of pain. If a thrombosed haemorrhoid becomes too full of blood it can burst, and will bleed profusely for a short time. The haemorrhoid will be very painful prior to bursting, but will settle down shortly after it has ruptured and produce a sensation of relief instead for the sufferer.

If bleeding continues for longer and is accompanied by ongoing pain, you may have a bleeding haemorrhoid instead of a burst thrombosed haemorrhoid. Bleeding can endure for up to several minutes but shouldn’t last longer than ten minutes. Further bowel movements may lead to more bleeding.


How to treat bleeding haemorrhoids at home

The first step in all home treatments for haemorrhoids is to cleanse the affected region. This can be achieved in a few simple ways.

First off, when cleaning the anal area after bleeding or a bowel movement, pat rather than wipe the region as too much abrasion can cause further irritation. A moistened paper towel or unscented cleansing wipe can be used when cleaning – don’t use anything perfumed or scented as this can also cause increased irritation to the sensitive skin in the anal region.

Next, try soaking the area in warm (not hot) water to gain some much-needed relief and further cleanse the region. You can do this in a normal bathtub or by using a sitz bath,  a basin which is placed over the toilet seat. Epsom salts can be added to the water to increase the comfort factor.

If you’re experiencing a lot of painful swelling as a result of haemorrhoids (whether they’ve bled or not), you can reduce it by using either a warm or cold compress, or by using them one after the other. Do this by wrapping an ice-pack in a towel or by soaking a towel in hot water and applying it to the anal region. You can do this several times each day but for no longer than 15-20 minutes at a time. Reducing swelling can help make thrombosed haemorrhoids less likely to burst and aid in the healing process.

As in all cases with haemorrhoids, don’t spend excessive time straining on the toilet as this will only put fresh pressure on the veins and potentially cause another rupture or yet more bleeding. Treat your haemorrhoid-affected area as you would any part of your body that’s recently been damaged.

It’s also a good idea to avoid spending too much time sitting, so as to avoid putting added pressure on your haemorrhoids. Stay active as much as possible. If you work at a desk, get up and take a quick walk every so often to give your anal area a chance to rest. This also helps reduce your chances of becoming constipated.

Constipation is, after all, one of the key reasons for haemorrhoids to develop (and stick around) in your rectum or anus. Consume plenty of fibre-rich foods and drink plenty of water to keep your stool soft and easily-passable. The softer your stool is, the less chance there’ll be of your haemorrhoids becoming damaged and bleeding again. Hard stool can be a real setback in your recovery.


When to see the doctor

If you’re still finding blood during or after a bowel movement and home treatments aren’t working, you should go see your doctor as soon as possible. Blood in the stool can be a symptom of more serious conditions, especially if it continues unabated.

In order to determine the source of the bleeding, your doctor will inspect the area and may examine the rectum for internal haemorrhoids.  He or she may also suggest trying a colonoscopy if the source of the bleeding isn’t obvious. Always inform your doctor if, in addition to bleeding, you notice that your stool changes colour, your experience weight loss or anal pain, you feel dizzy or lightheaded, you are nauseous, your bowel movements change drastically, or you have abdominal pain.


What the doctor may recommend

Your doctor may suggest a number of other procedures to help treat your haemorrhoids if they’ve been bleeding. These include sclerotherapy, rubber band ligation, electrocoagulation, or bipolar, laser or infrared coagulation, or the latest treatment known as The Rafaelo Procedure, which is offered as a day case, usually under local anaesthetic, after which you should be able to return to work within a day.

In more extreme cases, your doctor may suggest that you undergo a more advanced treatment for your haemorrhoids, such as surgery, especially if they bleed excessively or you develop a prolapsed haemorrhoid (when the haemorrhoid hangs down out of your anus). The type of surgical procedures your doctor could recommend include a haemorrhoidectomy (surgical removal of a prolapsed internal haemorrhoid or a complex external haemorrhoid), a DG-HAL (Doppler guided haemorrhoid artery ligation), or a haemorrhoidopexy, during which a surgeon uses surgical staples to reattach a prolapsed haemorrhoid back to the inside of the rectum.

These more invasive procedures are generally undertaken under general anaesthesia and often involve significant downtime, usually around 3 weeks, for the pain to subside before you can return to work.

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