4 Signs Your Hemorrhoids Warrant a Doctor's Visit

Hemorrhoids, which are also known as piles, are swollen and inflamed veins inside the rectum or under the skin around the anus. They can be painful and uncomfortable and are generally caused by straining during bowel movements, pregnancy or obesity. Hemorrhoids are very common among people aged 45 to 75 and affect more than 10 million people annually.

Types of Hemorrhoids

Hemorrhoids which can be one of the most common causes of rectal bleeding are of two types.

External Hemorrhoids

They are under the skin around the anus. Symptoms of external hemorrhoids are pain, bleeding, itching and swelling. These hemorrhoids can also cause thrombosis, also known as blood clotting, and may give way to severe pain from hemorrhoidal strangulation.

Internal Hemorrhoids

They are inside the rectum and hence, you cannot usually see or feel them. Symptoms of internal hemorrhoids are blood on toilet paper after you wipe or in the toilet bowl. You may feel pain when you poop as tissues outside the anal opening bulge during internal hemorrhoids. They are moist bumps that are pinker than the surrounding area and generally go back inside on their own.

Causes of Hemorrhoids

Hemorrhoids can be caused when pressure is built in your lower rectum which affects the blood flow and makes the veins present in the area swell. There could be any of the below-mentioned reasons which can build pressure in the lower rectum.

  • Obesity

  • Growing of uterus during pregnancy

  • Consuming food that might be low in fiber

  • Indulging in anal sex frequently

  • Excessive pushing during bowel movements

  • Straining while doing physical activities

Apart from these, people who stand or sit for long periods are at high risk of developing hemorrhoids. Moreover, if your parents had hemorrhoids, you are likely to get them. Hemorrhoids may be a result of untreated constipation or diarrhea and coughing, sneezing or vomiting could worsen the discomfort for the affected adults.

When to See a Doctor?

Hemorrhoid symptoms like itching or pain can be treated at home with over-the-counter (OTC) remedies. However, there might be times when a trip to the doctor may be essential. The visit might be for a more specific prescribed medication or a hemorrhoid surgery, depending upon the severity of the hemorrhoids. The severe complications of hemorrhoids are uncommon but, it’s imperative to know when you should see a doctor.

Here are the four signs that indicate your hemorrhoids require medical intervention.

Bleeding during Bowel Movements

Bleeding associated with internal hemorrhoids is usually bright red. It may cause mild pain, occur with bowel movements and may be moderate in amount. Any type of rectal bleeding is dangerous and if you experience it, you must see a doctor immediately.

A Noticeable Bulge at the anus

Internal hemorrhoids fall outside of the anal opening during a bowel movement. At first, the tissue may retract without any medical intervention or the bulge can be easily pushed back inside. But prolapse can get worse over time and can ultimately cause irritation, itching, bleeding and pain. Early treatment may help to prevent the prolapse in internal hemorrhoids from aggravation.

Problem with Passing Stools

If you are passing stools that appear maroon or tarry in colour and experience bleeding while passing stools, it may be due to hemorrhoids. Prolapsing internal hemorrhoids can cause the sensation that your stool is stuck in the anus. You may also note a mucous discharge and experience trouble cleaning yourself following a bowel movement. These symptoms can be treated with prescribed medications and hence, one must consult a doctor immediately.

Discomfort in the Anal Region

Hemorrhoids may cause you pain or discomfort due to itching and irritation in the anal region. One must not delay visiting a doctor and wait till the pain gets severe enough to disrupt your daily life.

Diagnosis of Hemorrhoids

For the correct diagnosis, the doctor will ask about your symptoms and medical history. In external hemorrhoids, the doctor may do either a physical exam or digital rectal exam or both as a necessity.

In a physical exam, the doctor will examine the anus and rectum to check for swelling, irritation, lumps or any other issues. In a digital rectal exam, the doctor will apply lubrication and insert a finger inside your rectum to check the muscle tone and lumps and to feel the tenderness.

In internal hemorrhoids, tests like anoscopy, sigmoidoscopy or colonoscopy may be carried out by the doctor for a detailed examination. In an anoscopy, a thorough examination of the anal canal is conducted with the help of a plastic tube called an anoscope.

During a sigmoidoscopy, the lower colon is checked with a tube called a sigmoidoscope and in a colonoscopy; an examination of the large intestine is conducted with a flexible tube called a colonoscope. In sigmoidoscopy and colonoscopy, some tissue samples might be collected for further testing and deciding the right treatment.

Treatment of Hemorrhoids

The doctor's treatment plan depends on the severity of the hemorrhoid symptoms. Simple lifestyle changes like adding fibre to your daily diet and drinking more water may relieve mild hemorrhoid symptoms within a week. Also, avoiding straining during bowel movements and using ice packs can ease pain and swelling. However, in some cases, doctors may recommend some over-the-counter creams and prescribed medications to ease pain, itching and swelling.

Unfortunately, if you have large hemorrhoids and home remedies or other non-surgical treatments have not helped, you might need surgery.

Infrared coagulation (IRC) is a highly effective method which uses infrared light to painlessly coagulate the blood vessels. When the blood flow is blocked, the enlarged tissues shrink and hemorrhoidal symptoms resolve. One of the nonsurgical methods which block blood flow and causes hemorrhoids to disappear is rubber band ligation. However, it may cause bleeding and is comparatively more painful than IRC.

Prevention of Hemorrhoids

You can try these preventive measures to lower the chances of getting hemorrhoids.

  • Consume Fibre − Aim for consuming 20 to 35 grams of dietary fibre a day. This helps food to pass through your system easily. Rich sources of fibre include vegetables, fruits, whole grains, beans, nuts and legumes. Some over-the-counter supplements can also help soften stool. Consult a healthcare provider before consuming any supplements.

  • Drink Water − Drinking an adequate amount of water can avoid constipation and hard stools. It will also lessen the strain during bowel movements and help stools to pass through easily.

  • Exercise Regularly − Engaging in physical activity for at least 30 minutes a day keeps your blood and bowels moving. You also need to keep a healthy weight to avoid the risk of getting hemorrhoids.

  • Don't Hold Your Pee or Stools − Don't wait for too long and use the toilet as soon as you feel the urge.


Although hemorrhoids are considered a minor health problem, you shouldn’t hesitate from getting them examined. If you experience rectal bleeding that is accompanied by dizziness, don’t delay in seeking emergency medical care. The final goal of every affected individual is hemorrhoid relief, and for some people, that may refer to a doctor’s visit.

Updated on: 23-Jan-2023


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