Bleeding Hemorrhoids Treatment: What Doctors Recommend

Medically reviewed by: Liza M. Capiendo, MD

Bleeding is a common sign of hemorrhoids. If you’ve noticed bright red blood after bowel movements, you may have underlying hemorrhoids.

Read ahead to learn everything you need to know about bleeding hemorrhoidal treatment — from why hemorrhoids bleed to whether bleeding hemorrhoids are serious and the best treatment for them.

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What are hemorrhoids?

Hemorrhoids are swollen blood vessels in the rectal area. They can be located inside (internal hemorrhoid) or outside (external hemorrhoid) of your anus and can cause pain, itching, and sometimes bleeding. Hemorrhoids are caused by straining during bowel movements, constipation, pregnancy, aging, and a low-fiber diet.

It’s important to note that hemorrhoids are a normal part of the human body, and everyone has them. So, when we use the term “hemorrhoids” it usually refers to inflamed and symptomatic internal and external hemorrhoids.

Why do hemorrhoids bleed?

Hemorrhoids usually bleed when irritated, which can happen due to straining during bowel movements or from rubbing the hemorrhoid area with toilet paper. The irritation from the rubbing can damage its lining and cause hemorrhoids to bleed.

Many other causes can also irritate hemorrhoids (and thus lead to bleeding), such as excessive wiping, sitting for long periods, constipation, and diarrhea.

Another cause of bleeding hemorrhoids is thrombosis. This is a condition in which a hemorrhoidal blood vessel bleeds and forms a clot.  Thrombosed hemorrhoids usually cause severe pain and may rupture and bleed.

How long do hemorrhoids bleed?

In most cases, patients notice bleeding hemorrhoids only after a bowel movement. This means hemorrhoids don’t usually bleed continuously but rather have short bleeding episodes during and after bowel movements.

When it comes to how long the overall symptoms of hemorrhoids last, those with mild cases usually experience relief after a few days of home treatments. However, people with severe cases may need to see an experienced doctor who can treat hemorrhoids.

This is especially true if you have grade 3 or 4 hemorrhoids. Grade 3 hemorrhoids are those that hang outside the rectum but can be pushed back inside, while grade 4 hemorrhoids are those that remain permanently outside the anal canal.

How do you get hemorrhoids to stop bleeding?

To get the hemorrhoid to stop bleeding, you must address any factors that can irritate it. This means:

  • Taking a Sitz bath, where you soak your hemorrhoids in warm water
  • Using soft and gentle wipes that don’t contain irritating fragrances or chemicals
  • Increasing the intake of water and high-fiber foods to prevent constipation 
  • Avoiding straining during bowel movements
  • Avoiding prolonged periods of sitting on the toilet
  • Maintaining an appropriate level of physical activity to avoid constipation
  • Wearing loose and soft underwear

In addition to diet and lifestyle changes, you can also try topical creams or ointments that can help reduce the swelling and irritation of hemorrhoids. These creams usually contain corticosteroids, which are highly effective at reducing inflammation.

If these treatments aren’t enough, you can talk to your doctor about more advanced treatment options, such as rubber band ligation or sclerotherapy.

What creams can be used for bleeding hemorrhoid treatment?

Creams used to treat bleeding hemorrhoids include hydrocortisone cream and lidocaine ointment. Hydrocortisone cream is a mild corticosteroid that can reduce inflammation and itching, while lidocaine ointment can help numb the area.

You can also try topical products containing witch hazel, aloe vera, or zinc oxide to reduce pain and itching. This is important because itching is another irritating factor for hemorrhoids and can worsen bleeding.

What is the best treatment for bleeding hemorrhoids?

The best treatment for bleeding hemorrhoids is to address the underlying factors that caused them in the first place.

However, lifestyle changes and topical medications are sometimes not enough. In these cases, your doctor may suggest a more invasive procedure such as rubber band ligation or sclerotherapy.

  • Rubber band ligation is a procedure in which the doctor wraps a rubber band around the base of hemorrhoid to cut off the blood supply. This causes hemorrhoids to shrivel up and eventually fall off.
  • Sclerotherapy is a procedure in which the doctor injects a chemical solution into a hemorrhoid, which causes sclerosis and shrinkage. 

Keep in mind that rubber band ligation and sclerotherapy can be used only for grade 1-3 internal hemorrhoids that don’t respond to other treatments. 

For grade 4 internal hemorrhoids, you’ll need a more complex surgical procedure — such as hemorrhoid stapling or a hemorrhoidectomy — to permanently stop the bleeding.

Similarly, external hemorrhoids that don’t respond to other treatments will need a surgical procedure like hemorrhoidectomy to treat. External hemorrhoids can’t be treated with office-based procedures like rubber band ligation.

Are bleeding hemorrhoids serious?

Bleeding hemorrhoids are not usually serious. This is true only if you’re experiencing painless, bright red bleeding at the end of a bowel movement.

However, if you experience bleeding between bowel movements — or dark-colored blood in stool — you may have another gut condition, such as inflammatory bowel disease

You may also have another disorder if you’re experiencing other “alarm symptoms”, such as weight loss, changes in appetite, and a reduced stool diameter.

In all of these cases, it’s important to seek urgent medical attention so your healthcare provider can exclude any other health conditions.

It’s also important to keep in mind that people with blood clotting disorders or those on blood thinning drugs may experience prolonged hemorrhoidal bleeding. 

Again, make sure to give your healthcare provider a complete history — including any drugs you’re taking — so they can address your bleeding appropriately.

Can bleeding hemorrhoids go away on their own?

Indeed, mild bleeding hemorrhoids often diminish on their own, particularly when coupled with preventive measures and lifestyle modifications. These include increasing dietary fiber, ensuring adequate hydration, and engaging in regular exercise specifically aimed at improving hemorrhoid conditions.

However, if your hemorrhoids aren’t responding to these measures and last more than a week, you should talk to your doctor. They can help determine the underlying cause of your bleeding hemorrhoids and suggest the best treatment approach for you.

How much bleeding is OK with hemorrhoids?

Bleeding from hemorrhoids is not usually serious, and a few drops are fine. But it’s still important to get checked, so your doctor can ensure your bleeding is from hemorrhoids and not from another cause.

It’s important to remember that all bleeding should be taken seriously. Even small amounts of rectal bleeding can indicate a more serious problem, such as colorectal cancer.

What happens if bleeding hemorrhoids go untreated?

In most cases, untreated bleeding hemorrhoids go away on their own if they’re mild. But sometimes, if left untreated, serious complications can arise.

For instance, if you have grade 3 or 4 internal hemorrhoids and don’t treat them, they may develop a clot and become more painful. This can lead to additional complications, such as bleeding and even infection.

You can also develop iron deficiency anemia, which is a condition where your red blood cell count is too low due to prolonged bleeding. Anemia can be serious since it can affect your energy levels and damage your heart if not treated.

It’s also important to remember that bleeding hemorrhoids can mask other, more serious conditions, such as colorectal cancer. That’s why it’s important to get any rectal bleeding checked out by a doctor, even if you think it may be from hemorrhoids.

Treatment for bleeding hemorrhoids summarized

To sum things up, the best treatment for bleeding hemorrhoids depends on the severity of your symptoms. 

Mild cases can often be managed with lifestyle changes and home remedies, such as taking Sitz baths, applying hemorrhoid creams, drinking more water, and exercising regularly.

However, if your symptoms don’t go away within a week or worsen over time, you should seek medical help to exclude any other underlying health conditions. 

Your doctor may suggest surgery or office-based procedures such as rubber band ligation or sclerotherapy.

Finally, remember that it’s important to take all rectal bleeding seriously and get checked out by a doctor, even if you think it might be from hemorrhoids. 

That way, you can get the appropriate treatment and ensure that any other underlying conditions are addressed.

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