Hemorrhoidal bleeding is a common and often alarming symptom that affects many adults at some point in their lives. While seeing blood during bowel movements can be concerning, hemorrhoids are a frequent and usually treatable cause. Understanding what hemorrhoidal bleeding is, why it happens, and how it’s treated can help patients seek timely and effective care.
What Is Hemorrhoidal Bleeding?
Hemorrhoidal bleeding occurs when swollen veins in the rectum or anus—known as hemorrhoids—become irritated or damaged. These veins can enlarge due to increased pressure and may bleed, especially during bowel movements.
Bleeding associated with hemorrhoids is typically bright red and may appear on toilet paper, in the toilet bowl, or on the surface of stool. While hemorrhoids are not life-threatening, ongoing bleeding can cause discomfort, anxiety, and in some cases anemia if left untreated.
What Causes Hemorrhoids and Hemorrhoidal Bleeding?
Hemorrhoids develop when excessive pressure is placed on the veins in the lower rectum or anus. Common contributing factors include:
- Chronic constipation or diarrhea
- Straining during bowel movements
- Prolonged sitting, especially on the toilet
- Pregnancy and childbirth
- Obesity
- A low-fiber diet
- Aging, which weakens supporting tissues
Over time, repeated strain and pressure can cause hemorrhoids to enlarge and become more prone to bleeding.
Types of Hemorrhoids
Hemorrhoids are classified based on their location:
- Internal Hemorrhoids: Located inside the rectum and often painless, but may cause bleeding
- External Hemorrhoids: Form under the skin around the anus and may cause pain, itching, or swelling
- Prolapsed Hemorrhoids: Internal hemorrhoids that protrude outside the anus
Bleeding is most commonly associated with internal hemorrhoids.
Symptoms of Hemorrhoidal Bleeding
In addition to rectal bleeding, hemorrhoids may cause a variety of symptoms, including:
- Bright red blood during or after bowel movements
- Anal itching or irritation
- Pain or discomfort, especially with external hemorrhoids
- Swelling or lumps near the anus
- A feeling of incomplete bowel evacuation
Because rectal bleeding can also signal other gastrointestinal conditions, it’s important to seek medical evaluation rather than self-diagnose.
How Is Hemorrhoidal Bleeding Diagnosed?
Diagnosis typically begins with a physical exam and review of symptoms. Depending on the presentation, a healthcare provider may perform:
- A digital rectal exam
- An anoscopy or sigmoidoscopy
- Imaging or additional testing if another cause of bleeding is suspected
Proper diagnosis ensures that bleeding is truly due to hemorrhoids and not another condition requiring different treatment.
Treatment Options for Hemorrhoidal Bleeding
Treatment depends on symptom severity, frequency of bleeding, and response to conservative care.
Conservative and Non-Surgical Treatments
Many patients find relief through lifestyle and medical management, including:
- Increasing dietary fiber and fluid intake
- Stool softeners
- Topical creams or suppositories
- Warm sitz baths
- Avoiding straining and prolonged toilet sitting
While these measures can help manage mild symptoms, they may not be effective for persistent or severe bleeding.
Surgical Treatment Options
Traditional surgical approaches, such as hemorrhoidectomy, physically remove hemorrhoidal tissue. While effective, surgery may involve significant pain, longer recovery, and higher risk of complications.
What Is Hemorrhoidal Artery Embolization (HAE)?
Hemorrhoidal Artery Embolization (HAE) is a minimally invasive, non-surgical procedure designed to treat hemorrhoidal bleeding at its source. Performed by interventional radiologists, HAE targets the arteries supplying blood to hemorrhoids.
Using image guidance, a small catheter is placed into the hemorrhoidal arteries. Tiny coils or particles are then delivered to reduce blood flow, causing the hemorrhoids to shrink over time and significantly decreasing bleeding.
HAE does not involve cutting or removing tissue, making it a gentler alternative to surgery.
Benefits of Hemorrhoidal Artery Embolization
HAE offers several advantages over traditional surgical treatment, including:
- Minimally invasive with no incisions
- No stitches and only a small bandage
- Low risk of complications
- Reduced pain compared to surgery
- Short recovery time
- Outpatient procedure
- Effective relief from hemorrhoid-related bleeding
Many patients are able to return to normal activities within just a few days.
What to Expect During the HAE Procedure
The HAE process typically includes:
- Consultation: Evaluation by an interventional radiologist to confirm candidacy
- Preparation: Instructions regarding medications or dietary adjustments
- Procedure: Performed under local anesthesia, lasting about 30–60 minutes
- Recovery: Same-day discharge with post-procedure care instructions
Follow-up visits help ensure healing and symptom improvement.
When Should You Seek Medical Care?
If you experience persistent rectal bleeding, worsening pain, or symptoms that interfere with daily life, it’s important to seek medical evaluation. Hemorrhoidal bleeding may feel embarrassing to discuss, but effective and discreet treatment options are available.
Finding Relief Without Surgery
Advancements in minimally invasive care have made it possible to treat hemorrhoidal bleeding without the pain and downtime of surgery. At Vascular Tree in Cary, NC, our experienced interventional radiology team offers hemorrhoidal artery embolization as a safe and effective alternative for eligible patients.
If hemorrhoid symptoms are affecting your comfort or quality of life, scheduling a consultation can help you explore whether HAE is the right option for you.
