Haemorrhoids: When to seek medical help?

By  , Expert Content
Aug 27, 2012

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Having haemorrhoids is a common problem in adults. Common symptoms of haemorrhoids include bleeding during bowel movements, itching, and rectal pain. Many other conditions such as anal fissures, anal fistulas, colon polyps, rectal prolapse, inflammatory bowel disease (IBD), and colon and rectal cancers can cause similar symptoms.

Call your doctor if you have one or more of the following symptoms suggestive of some serious medical condition:

  • Rectal bleeding (such as bright red streaks of blood on the toilet paper or bright red blood in the toilet bowl after passing motion).
  • Rectal bleeding not associated with attempts to pass stools.
  • Thin and narrow stools (may be no wider than a pencil).
  • Severe constipation or recurrent diarrhoea with abdominal bloating.
  • Black or tarry stool.
  • Any kind of discharge from the anus.
  • Urge to pass stool right after having a bowel movement
  • Fever with blood in stools.
  • Prolapse of tissue from the anus.
  • Lump or bulge, which may or may not be tender, develops at the anal opening.

If you have haemorrhoids, consult your doctor if:

  • rectal bleeding (such as bright red streaks of blood on the toilet paper or bright red blood in the toilet bowl after passing motion) persists for more than a few days
  • rectal pain lasts longer than 1 week after self care and home treatment.
  • you have severe pain or swelling at the anus
  • tissue comes out from inside the body and does not return to normal after 3 to 7 days of home treatment.
  • rectal bleeding becomes severe or changes colour (such as from bright red to dark red), or if stools change colour (from brown to maroon or black).

Watchful Waiting

Under 50 people with no family history of rectal and colon cancer, having occasional minimal rectal bleeding (bright red blood seen mainly on toilet paper) from haemorrhoids, may try lifestyle and diet modifications for a week or two.

But if you want to wait before consulting your doctor, make sure of the following about your bleeding:

  • occurs when you strain to pass stools
  • it is not increasing in severity.

Most cases with mild bleeding because of haemorrhoids improve in 2-3 days. You may continue lifestyle and diet modifications to prevent bleeding from starting again. Consult your doctor if:

  • bleeding continues for more than 1 week without improvement
  • bleeding starts again
  • bleeding is not related to passing stool or occurs without any reason.

A person older than 50 years of age with a family history of colon cancer, or any other risk factor for colon cancer should consult a doctor even if the cause seems obvious to be haemorrhoids.

Who to consult

Some health professionals who can be consulted to evaluate and treat haemorrhoids include:

  • family medicine doctor
  • internist
  • nurse practitioner
  • physician assistant
  • gastroenterologist
  • general surgeon.

If you need medications or surgery, you may be referred to:

  • gastroenterologist
  • general or colorectal surgeon
  • proctologist (a specialist doctor who treats problems affecting the rectum and anus).



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