Bleeding hemorrhoids: What are the causes and how to treat them?

Hemorrhoids can happen to any of us through different stages of our lives, with evidence suggesting that approximately half of all adults over the age of 50 will at some point receive treatment for hemorrhoids^[1]; however, even though they are quite common, untreated hemorrhoids can quickly worsen and lead to more serious complications.

Hemorrhoids, also known as piles, are considered to be the most common cause of bleeding from the rectum.^[2] Here are some reasons why that might happen and 9 tips on how we can treat bleeding hemorrhoids.

Why do hemorrhoids bleed?

Hemorrhoids, also called piles, are the result of enlarged veins inside the rectum (internal hemorrhoids) and on the outside of the anus (external hemorrhoids) that have stretched out as a result of having been put under extra pressure. The most common symptom of hemorrhoids is rectal bleeding associated with bowel movements.^[3]  Essentially, when hemorrhoids are full of blood, the tiny capillaries can burst and provoke a brief period of bleeding.

As such, the most common causes of bleeding hemorrhoids are:

• Excessive straining during bowel movements or caused by firm stools or constipation.
• Irritation in the anal area when wiping: external hemorrhoids are especially sentitive and painful to touch.
• A low-fiber diet, which in turn can increase constipation, together with the likelihood of suffering from hemorrhoids. See more about what diet to follow for hemorrhoids.
• Swollen hemorrhoids. If left untreated, the hemorrhoid can continue its growth and become swollen, which increases the likelihood of the hemorrhoid eventually becoming torn or even bursting, therefore causing bleeding.^[4]
• Since pregnancy increases the pressure in the pelvic area as the baby grows, it is more likely to cause hemorrhoids that can quickly become inflamed and bleed. Explore the best tips to treat and prevent hemorrhoids during pregnancy.

Hemorrhoidal disease creates both physical and psychological discomfort and if not treated it can significantly affect the quality of life of those suffering from it due to its sensitive symptoms such as anal bleeding, an itching and uncomfortable sensation, together with what can often be constant pain.^[5]

Bleeding hemorrhoids should normally show as traces of bright red blood either in the stool, or on the toilet paper after wiping. If the color of the blood is dark red, it is important to go to the doctor as soon as possible as this could indicate a more serious problem related to the gastrointestinal tract.^[6]

How to treat bleeding hemorrhoids

By preventing hemorrhoids from swelling and becoming more sensitive, the risk of bleeding can be greatly reduced. One of the ways of dealing with bleeding hemorrhoids is to use  venotonic treatments. We recommend that you ask your doctor.

If bleeding lasts more than a few minutes, or if it becomes recurrent, it is highly recommended to visit a specialist. Bleeding internal hemorrhoids may require more invasive treatments such as injection sclerotherapy, rubber band ligation, or infrared photocoagulation.^[7] Therefore, acting quickly and taking preventative measures before hemorrhoids reach these more serious stages is of key importance.

Tips to prevent bleeding hemorrhoids

While suffering from hemorrhoids might prove to be unavoidable due to the widespread nature of the disease, there are a handful of tips that can help you prevent the worsening of hemorrhoids so they do not end up bleeding. These tips involve both dietary and lifestyle changes,^[8] which mean being extra attentive and careful in order to allow the hemorrhoids to gradually be cured in their own time.

1. Showering often in order to ensure personal hygiene in the rectal area.
2. Soaking in a sitz bath. A warm, shallow bath that only covers the hips and buttocks.^[9]
3. Wiping with witch hazel in order to avoid using dry, rough toilet paper after bowel movements, instead opt for wet wipes or baby wipes to avoid further irritation. ^[10]
4. Adding more fiber to the diet to ensure that the stool is softer and there won’t be as much straining. ^{[11] [12]}
5. Avoiding doing any strenuous exercise that could put unnecessary pressure on the rectal area. Read here to find out more about the risks of certain exercises when having hemorrhoids. 
6. Staying away from sitting too long on the toilet, as this habit can add more pressure to the rectum and the anus.
7. Opting for cotton underwear. This allows the skin to breathe better, and prevents the formation of moisture in the area.^[13]
8. Drinking lots of water, which is a great way to combat and avoid constipation.
9. Get familiar with oral flavonoid venoactive treatments. If symptoms persist or your condition does not improve, it is highly recommended to visit your doctor who will advise you further on medications. Make sure to ask them about oral flavonoid venoactive treatments, which can treat the inflamed veins and can reduce symptoms and discomfort while also improving the blood flow and overall tone of the veins themselves.⁷ These venoactive drugs can also be used as a preventative measure to reduce the chances of hemorrhoids returning as an uninvited guest at a later date.

Check out these answers to the most commonly asked questions about hemorrhoids.