Hemorrhoid Symptoms and Diagnosis: Internal and External Hemorrhoids

Hemorrhoids occur when veins in the skin around the anus or in the lower rectum get swollen and inflamed. It’s not exactly clear what causes people to get hemorrhoids, but there are some common, accepted risk factors and conditions that lead to their development.

Aging can decrease muscle tone in the area, weakening the tissue and causing hemorrhoids to bulge, while obesity and pregnancy can increase the risk for hemorrhoids due to increased pressure on tissue in the area. (1)

Repeated straining to make a bowel movement, as well as constipation, are also associated with hemorrhoids.

Hemorrhoids are generally not dangerous or life-threatening, but they may be painful.

Common Hemorrhoid Symptoms to Watch For

The following signs and symptoms may indicate hemorrhoids:

• Bright red blood on toilet paper, in stool, or in the toilet bowl after a bowel movement
• Anal itching
• Pain around the anus, especially while sitting
• Pain during bowel movements
• One or more hard, painful lumps around the anus

If you have any symptoms of hemorrhoids, try to avoid excessive straining, rubbing, or cleaning around the anus.

Doing these things can make any irritation and itching worse, and can sometimes lead to bleeding.

Internal Hemorrhoids vs. External Hemorrhoids

There are two main types of hemorrhoids:

Internal Hemorrhoids These hemorrhoids develop inside the lower rectum. Internal hemorrhoids usually don’t hurt, but they often bleed painlessly, resulting in bright red blood you might notice when you go to the bathroom and wipe.

Most of the time, internal hemorrhoids are not visible to the naked eye. But in some cases, internal hemorrhoids may protrude through the anus, which is known as becoming prolapsed. When this happens, they will usually shrink back inside the rectum on their own. Protruding hemorrhoids can become irritated and itchy, and patients may find it difficult to clean themselves after a bowel movement.

Internal hemorrhoids are categorized by how prolapsed they are, which helps determine how they should be treated.

Grade 1 hemorrhoids means there is no prolapse. A prolapse that goes back in by itself is categorized as grade 2. Prolapse that needs to be pushed back in by the patient is considered grade 3. Grade 4 is when the prolapse can’t be pushed back in. (2)

External Hemorrhoids These hemorrhoids develop under the skin around the outside of the anus. They can be itchy or painful, and may feel lumpy.

External hemorrhoids are called thrombosed hemorrhoids when a blood clot develops within the hemorrhoid. The increased pressure can be very painful, especially within the first 48 hours after it develops. (1)

Thrombosed hemorrhoids tend to be bluish in color due to the clot. Sometimes the blood clot will go away on its own, but because the clot has stretched the skin, it may result in an anal skin tag — excess skin left when the blood clot in a thrombosed hemorrhoid is absorbed by the body. Skin tags do not require removal, but if it’s particularly bothersome to a patient, excision is an option. (1)

If a thrombosed hemorrhoid has been present for longer than two days, the pain has often peaked and you might try home treatments while waiting for the clot to clear up on its own. When the clot first forms, it can be very painful; if you make it to your doctor’s office during this time, an in-office surgical procedure, involving local anesthesia and excision of the hemorrhoidal tissue, may be available. (2)

RELATED: 8 Myths You’ve Been Told About Hemorrhoids

How Hemorrhoids Are Diagnosed by Your Doctor

See your doctor if you think you might have hemorrhoids, especially if you notice bleeding from your anus or rectum, or have bloody stools. Your doctor will want to rule out more serious problems that can cause bleeding from the anus or rectum, such as cancer.

Hemorrhoid symptoms may also be similar to those of other anal and rectal problems, including anal fissures, abscesses, warts, and polyps.

Your doctor will ask about your medical history and will ask you to describe your symptoms. Questions about your eating habits, toilet habits, and enema and laxative use are likely to come up. (3)

Your doctor will also perform a physical exam to look for lumps or swelling, prolapsed internal hemorrhoids, external hemorrhoids, skin irritation, skin tags, and anal fissures, which are small tears in the anus that can result in itching and bleeding. (3) This will involve a visual examination of the area.

Your doctor may also perform a rectal exam to diagnose internal hemorrhoids, check the muscle tone of your anus, and check for blood in the stool. This is done with a gloved, lubricated finger (called a digital rectal examination) and a tool called an anoscope.

An anoscope is a type of endoscope — a hollow, lighted tube that is inserted a few inches into the anus to help the doctor see any problems inside the lining of the rectum. This procedure is performed in the doctor’s office and doesn’t require anesthesia. (3)

Your doctor may also recommend additional tests to rule out other causes of bleeding, especially if you are over age 40.

These tests may include:

Colonoscopy After you’re sedated with medicine, your doctor uses a thin, flexible tube called a colonoscope to look at the inner lining of your colon.

A colonoscopy can help discover ulcers, polyps, tumors, and other areas of inflammation or bleeding.

Sigmoidoscopy This procedure is similar to a colonoscopy, but it uses a shorter tube called a sigmoidoscope to examine the lining of the rectum and the sigmoid colon (the lower part of the colon).

Barium Enema X-ray This is a special type of X-ray of the colon and rectum in which your doctor inserts a liquid solution containing barium sulfate into the rectum. The solution helps highlight specific areas in the colon for your doctor to examine in the X-ray images.

RELATED: 4 Signs Your Hemorrhoids Warrant a Doctor’s Visit

Additional reporting by Deborah Shapiro.

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What Is Rectal Bleeding? Symptoms, Causes, Diagnosis, Treatment, and Prevention

By Ashley WelchMedically Reviewed by Grant Chu, MD

Reviewed: October 20, 2022

Medically Reviewed

Rectal bleeding, which is bleeding from the rectum or anus, is a scary but surprisingly common phenomenon.

Rectal bleeding is usually assumed to refer to bleeding from your rectum, which makes up the last few inches of your large intestine. Bleeding from higher in the intestinal tract, from the stomach, duodenum, or other parts of the small intestine, may also pass through the large intestine and appear to come from the rectum, notes MedlinePlus.

Common Questions & Answers

What are the symptoms of rectal bleeding?

Serious cases of rectal bleeding may involve abdominal pain, diarrhea, fatigue, constipation, and unintentional weight loss. The blood can show up in stool or mucus in stool, or you may see it on underwear, on toilet paper, or in toilet water.

What are common causes of rectal bleeding?

Rectal bleeding is most often caused by hemorrhoids and anal fissures. Diverticulitis, a condition in which tiny bulges appear on the colon wall, and colitis, which is the inflammation of the lining of the colon, may also be causes.

How serious is rectal bleeding?

Rectal bleeding is a scary but common phenomenon. Typical causes like hemorrhoids or anal fissures aren’t life threatening, but in some cases, rectal bleeding can be a sign of colon cancer or, more rarely, anal cancer.

Is rectal bleeding bright red?

Blood from rectal bleeding ranges in color from bright red to maroon to black or tar-colored.

When should you worry about rectal bleeding?

Light rectal bleeding caused by constipation or hemorrhoids rarely needs medical attention. If the bleeding doesn’t stop after a week, check with your doctor. Bleeding due to colorectal cancer may occur in small amounts over time, so also check with your doctor if you notice this pattern.

Signs and Symptoms of Rectal Bleeding

Blood from rectal bleeding ranges in color from bright red to maroon to black or tar colored. Blood can be on or in the stool, be combined with mucus in the stool, or appear on your clothes and underwear, on toilet paper, or in the toilet water.

Symptoms that commonly occur with serious rectal bleeding include:

• Abdominal pain
• Dizziness
• Fatigue
• Diarrhea
• Constipation
• Unintentional weight loss

Causes and Risk Factors of Rectal Bleeding

The most common causes of rectal bleeding are diverticulosis, hemorrhoids, anal fissures, and colitis, according to the Cleveland Clinic.

Diverticulosis is the most frequent cause of rectal bleeding. It is the presence of tiny bulges, called diverticula, in the colon wall. Diverticula are common and typically do not cause problems, but they can sometimes protrude through the walls of the bowels, leading to bleeding or infections.

Often called piles, hemorrhoids are swollen veins that appear at the bottom of the large intestine and outside the anus. They may be caused by excessive straining, such as while making a bowel movement, sitting on the toilet too long, or in women, pregnancy and giving birth. People who have persistent hemorrhoids are often constipated, are overweight or obese, or eat a very low-fiber diet.

Hemorrhoids can be itchy, painful, and annoying, but they are rarely serious and often go away on their own. In certain cases, treatment may be needed.

Anal fissures, another cause of rectal bleeding, are tiny tears in the anus and anal canal commonly caused by straining with hard stools.

Colitis is the inflammation of the lining of the tissues of the colon. This inflammation can lead to rectal bleeding. Ischemic colitis occurs when blood flow to the colon is reduced, typically as a result of narrowed or blocked arteries. With infectious colitis, the swelling of the colon is caused by bacteria, viruses, or parasites.

Less common causes of rectal bleeding include intestinal polyps, proctitis, colon cancer, inflammatory diseases of the bowel, or rapid bleeding from the stomach or upper GI tract.

Intestinal polyps are masses of tissue that protrude from the bowel wall, sometimes causing minor bleeding. Proctitis is an inflammation of the lining of the rectum. If you have proctitis, you may feel rectal pain and the continuous sensation of having to make a bowel movement.

Colorectal cancer is one of the most serious causes of rectal bleeding. Anal cancer, which is less common than colorectal cancer, can also cause rectal bleeding.

People with an inflammatory bowel disease, such as Crohn’s disease or ulcerative colitis, may also experience rectal bleeding and related symptoms, such as abdominal pain, diarrhea, constipation, ulcers, and a higher risk for colorectal cancers.

How Is Rectal Bleeding Diagnosed?

When you see a doctor for rectal bleeding, you’ll be asked a series of questions to help identify the cause. These can include when the rectal bleeding began, any foods you ate prior to the onset of symptoms, if you were constipated, and if you were straining during your bowel movement.

Your doctor will also perform a medical exam and take your medical history.

Tests that may help determine the cause of rectal bleeding include:

• Colonoscopy, in which a long, flexible tube with a tiny camera on its tip is inserted into the rectum. This allows your doctor to view the inside of the entire colon and look for any abnormalities, notes the Mayo Clinic.
• Sigmoidoscopy, in which a healthcare provider uses a sigmoidoscope, a flexible tube with a light and camera, to view the lower part of your colon and rectum. This test can help diagnose bowel disorders and cancer, per the Cleveland Clinic.
• Fecal occult blood test, which is a lab test to detect hidden, or occult, blood in stool. The test can be done in a few ways, either by the patient collecting stool samples and returning them to their doctor or a lab or by using a flushable pad or tissue that changes color when blood is present, according to the Mayo Clinic.

Duration of Rectal Bleeding

How long rectal bleeding lasts will vary based on the individual and condition causing it.

Rectal bleeding from hemorrhoids can last anywhere from a few seconds to several minutes with bowel movements. Bleeding may also occur occasionally between bowel movements. Talk to your doctor if you have rectal bleeding or if you have hemorrhoids that don’t clear up after a week, notes the Mayo Clinic.

Anal fissures typically heal within a couple of weeks, according to the National Health Service in Great Britain.

Rectal bleeding associated with polyps or colorectal cancer may occur in small amounts over time until a doctor identifies the cause and treats it.

Treatment and Medication Options for Rectal Bleeding

If you are experiencing rectal bleeding, the first thing to do is try to identify the cause. The cause will determine any treatment you may seek.

For example, losing weight, consuming more fiber-rich foods, and taking over-the-counter treatments are usually effective at managing the symptoms of hemorrhoids, according to the Mayo Clinic.

Anal fissures can usually be managed with treatment for constipation and the use of moistened wipes, which soothe the area around the anus. Anal fissures rarely require medical treatment or surgery, notes the Mayo Clinic.

More serious causes of rectal bleeding, such as bowel disease or cancer, may require more advanced treatment. People living with Crohn’s disease, for instance, may be prescribed medications like corticosteroids or immunotherapy. Those with cancer may require surgery to remove tumors, per the Cleveland Clinic.

Prevention of Rectal Bleeding

The best way to prevent rectal bleeding is to prevent its chief causes.

To prevent hemorrhoids, it’s important to keep your stools soft so they can pass easily. To do this, drink plenty of fluids and eat a diet high in fiber. Go to the bathroom as soon as you feel the urge and avoid straining when passing stools. Also, limit your time sitting on the toilet.

Anal fissures can be prevented by avoiding irritating the rectum and wiping the area with soft tissues, a moistened cloth, or cotton pad. Don’t use rough or scented toilet paper.

People at an increased risk for colorectal cancer should undergo regular screenings, primarily colonoscopy. Colorectal cancer screenings can detect precancerous polyps in the colon or rectum so that they can be removed before they turn into cancer. Screenings can also identify colorectal cancer early, when treatment is more likely to be successful.

According to the Centers for Disease Control and Prevention (CDC), about 90 percent of new cases of colorectal cancer occur in people over age 50. Therefore, the U.S. Preventive Services Task Force recommends that adults age 45 to 75 be screened for colorectal cancer. How often you undergo screening is determined by your risk and should be discussed with your doctor. Adults age 76 to 85 should talk to their physician about whether they should continue to be screened, the CDC says.

Lifestyle changes can also help reduce the risk of colorectal cancer, including quitting smoking, maintaining a healthy weight, getting regular physical activity, and limiting red meat consumption and alcohol use, according to the American Cancer Society (ACS).

According to the 2020–2025 U.S. Dietary Guidelines for Americans, if alcohol is consumed, it should be done in moderation, meaning up to one drink per day for women and up to two drinks per day for men.

Complications of Rectal Bleeding

Light rectal bleeding or spotting due to constipation or hemorrhoids in people under 40 rarely needs medical attention. However, if your rectal bleeding is continuous or heavy, it could lead to shock, a life-threatening condition in which the body is not getting enough blood flow. If not treated, this can result in organ damage. According to the Mayo Clinic, you should seek medical attention immediately if you are experiencing rectal bleeding and any of the signs of shock, including:

• Faintness
• Nausea
• Rapid, shallow breathing
• Blurred vision
• Dizziness or lightheadedness
• Confusion
• Clammy, pale skin
• Low urine output

Untreated polyps in the colon or rectum that cause rectal bleeding can lead to colorectal cancer.

Research and Statistics: How Many People Have Rectal Bleeding?

While no statistics exist stating exactly how many people are affected by rectal bleeding at any given time, research suggests that it’s a common enough occurrence.

A study published in the British Journal of General Practice found that the consultation rate for rectal bleeding in patients over age 34 was 15 per 1,000 per year.

According to the National Institute of Diabetes and Digestive and Kidney Diseases, hemorrhoids, a major cause of rectal bleeding, affect about 1 in 20 adults in the United States. About half of adults over age 50 have hemorrhoids.

About 1 in 10 people are affected by anal fissures at some point in their lives.

According to the ACS, excluding skin cancers, colorectal cancer is the third most common cancer diagnosis in the United States. In 2020, the ACS estimates that there were 104,610 new cases of colon cancer and 43,340 new cases of rectal cancer.

Black Americans and Rectal Bleeding

While there are no statistics on rectal bleeding in different ethnic groups, colorectal cancer disproportionately affects the Black American community. According to the ACS, Black Americans are 20 percent more likely to receive a colorectal cancer diagnosis and are 40 percent more likely to die from it than people in other groups.

While the reasons for this disparity are complex, they reflect racial differences in risk factors, access to healthcare, and socioeconomic status. Black Americans have higher rates of obesity, with non-Hispanic Black Americans about 1. 3 times more likely to be obese compared with non-Hispanic white Americans, the U.S. Department of Health and Human Services Office of Minority Health reports.

Black Americans also experience greater obstacles to cancer prevention, detection, treatment, and survival. Such obstacles include lower paying jobs, lack of health insurance, lack of access to healthy and affordable foods, and low-quality housing and education.

Related Conditions and Causes of Rectal Bleeding

Colorectal cancer is one of the most serious causes of rectal bleeding. It is the third leading cause of cancer-related death in men and women, although death rates are dropping, thanks to earlier detection.

When cancer develops in a polyp, it can grow into the wall of the colon or rectum over time. From there, the cancer can grow into blood vessels or lymph nodes and can spread to nearby lymph nodes or different parts of the body. Screening for polyps is key to preventing colorectal cancer or catching it early so it can be treated, notes the ACS.

Anal cancer is an uncommon type of cancer occurring in the anal canal that can cause rectal bleeding. According to the ACS, there were an estimated 8,590 new cases of anal cancer in 2020 and 1,350 deaths.

 Most people with anal cancer are treated with chemotherapy and radiation. This type of cancer rarely spreads to different parts of the body. As such, many patients with anal cancer can be cured, notes the Mayo Clinic.

Resources We Love

Favorite Organizations for Essential Information on Rectal Bleeding

American Society for Gastrointestinal Endoscopy

Founded nearly eight decades ago, this professional organization of physicians is dedicated to advancing patient care and digestive health. Get all the info you need on common causes of rectal bleeding, including hemorrhoids, anal fissures, polyps, and colon and anal cancer.

American Cancer Society

ACS is a nationwide organization dedicated to advocating for people with cancer and eliminating cancer as a major health problem. It is the ultimate source of information if you or a loved one is worried about colorectal cancer, has recently been diagnosed, is going through treatment for colorectal cancer, or is trying to stay well after treatment.

Cleveland Clinic

The Cleveland Clinic offers an array of information on possible causes of rectal bleeding, care and treatment, and when to call a doctor.

Editorial Sources and Fact-Checking

• Gastrointestinal Bleeding. MedlinePlus. May 4, 2016.
• Rectal Bleeding. Cleveland Clinic. August 13, 2020.
• Colonoscopy. Mayo Clinic. May 18, 2022.
• Flexible Sigmoidoscopy. Cleveland Clinic. October 19, 2020.
• Fecal Occult Blood Test. Mayo Clinic. May 4, 2022.
• Hemorrhoids: Symptoms and Causes. Mayo Clinic. May 12, 2021.
• Anal Fissure. National Health Service. November 9, 2021.
• Hemorrhoids: Diagnosis and Treatment. Mayo Clinic. May 12, 2021.
• Anal Fissure: Diagnosis and Treatment. Mayo Clinic. November 17, 2020.
• Anal Fissures. Cleveland Clinic. February 22, 2019.
• What Should I Know About Screening? Centers for Disease Control and Prevention. February 17, 2022.
• Colorectal Cancer Risk Factors. American Cancer Society. June 29, 2020.
• Dietary Guidelines for Alcohol. Centers for Disease Control and Prevention. April 19, 2022.
• Rectal Bleeding. Mayo Clinic. January 6, 2022.
• Ellis BG, Thompson MR, Factors Identifying Higher Risk Rectal Bleeding in General Practice. British Journal of General Practice. December 2005.
• Definition and Facts of Hemorrhoids. National Institute of Diabetes and Digestive and Kidney Diseases. October 2016.
• Key Statistics for Colorectal Cancer. American Cancer Society. October 31, 2022.
• Colorectal Cancer Rates Higher in African Americans, Rising in Younger People. American Cancer Society. September 3, 2020.
• Obesity and African Americans. U.S. Department of Health and Human Services Office of Minority Health. March 26, 2020.
• What Is Colorectal Cancer? American Cancer Society. June 29, 2020.
• Key Statistics for Anal Cancer. American Cancer Society. January 12, 2022.
• Anal Cancer Symptoms and Causes. Mayo Clinic. August 12, 2021.

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What does a proctologist treat and how to prepare for an examination? Indications for visiting a doctor at the MEDSI Clinic

A proctologist is a specialist who treats diseases of the rectum, large intestine and anus. You should contact this doctor immediately after the first signs of the disease are detected. MEDSI clinics employ experienced specialists who provide support to patients with a variety of proctological problems.

Proctologist specialization

A proctologist treats infectious, parasitic, congenital, inflammatory and oncological diseases of the intestine, colon and surrounding tissues. The specialist examines patients and collects anamnesis. You can also get medical advice from a professional.

Doctors have a therapeutic or surgical profile. Doctors of the first type carry out only conservative therapy, the second – surgical interventions.

What diseases does the doctor treat in women?

A proctologist treats:

• Hemorrhoids. This disease occurs due to varicose veins in the rectum and leads to the development of hemorrhoids that protrude from the anus, causing discomfort, bleeding and pain
• Anal fissures. This pathology occurs as a result of damage to the walls of the rectum
• Polyps in the colon. This pathology belongs to the category of benign formations and is hereditary in nature
• Paraproctitis. These diseases lead to inflammation of the perirectal tissues and the formation of fistulas
• Worm infestations
• Cancers

Women should consult a doctor when the first signs of any of the listed pathologies are detected.

These include:

• Constipation or fecal incontinence
• Pain in the anus
• Anal bleeding
• Discharge from anus mucus and pus
• Bloating

What diseases does it treat in men?

In men, proctologists treat the same diseases as in women.

You should consult a specialist for hemorrhoids, anal fissures, polyps, proctitis and paraproctitis. It is important to understand that only with timely diagnosis, diagnosis and treatment, one can count on the rapid elimination of not only the symptoms of diseases, but also their causes. Turning to a doctor in the early stages of the development of pathology, the patient receives adequate conservative therapy, which avoids the need for surgical intervention.

How to prepare for the examination?

Preparing for a proctologist examination is quite simple. You don’t have to go on a special diet or do cleansing enemas.

Follow these guidelines:

• It is recommended to have a bowel movement before going to the doctor. If necessary, you can take a laxative. This will allow the specialist to make a preliminary diagnosis
• One day before the appointment with the proctologist, you should exclude from the diet products that stimulate increased gas formation
• Immediately before going to the doctor, perform standard hygiene procedures (washing with soap)
• Try to calm down and not worry. There is nothing terrible and shameful in the examination by a proctologist. Doctor doing his job

How is the inspection?

An examination by a proctologist takes place in several stages:

• History taking and listening to patient complaints
• Primary examination. It is carried out by palpation. The organs are palpated by the doctor through the abdominal wall and through the anus. Such an examination allows you to assess the condition of the anal canal and closely located parts of the intestine. Diagnosis by palpation makes it possible to detect pathological formations and damage to the walls
• Anoscopy. To conduct this examination, an anoscope is used – a special device in the form of a hollow tube with a light tip and an adapter, which allows you to perform a visual examination of the walls of the rectum. For diagnosis, the patient lies on his side and pulls his legs to his stomach. The device is inserted into the anus and allows the doctor to see all the changes. In addition, during anoscopy, biopsy material is taken
• Sigmoidoscopy. This examination is carried out using a sigmoidoscope. Diagnosis is aimed at assessing the rectum and sigmoid colon, as well as the condition of the mucous membranes at a depth of up to 40 cm. The sigmoidoscope is a fiber optic tube with a lighting device. For diagnosis, the patient is asked to kneel and elbows. This ensures that the tool penetrates to the desired depth
• Colonoscopy. Such an examination belongs to the category of endoscopic and is one of the most informative. With such a diagnosis, tumors, ulcerative colitis and Crohn’s disease can be detected. The procedure can be not only diagnostic, but also therapeutic. Colonoscopy is also prescribed to stop bleeding, remove small benign tumors and remove foreign bodies from the rectum. Colonoscopy can be performed under anesthesia
• Laboratory studies. Patients often donate blood and feces

If dangerous pathologies are suspected, the following is additionally prescribed:

• Computed tomography
• Intestinal ozonation
• ultrasound
• Colon hydrotherapy

Proctologist examination of children

If your child complains of pain during bowel movements, experiences other problems of a proctological nature, you should immediately register him with a doctor. As a rule, the diagnosis of diseases in children is carried out using the palpation technique. Instrumental methods are not used because of the too small size of the rectum. Additionally, the doctor prescribes ultrasound, CT and other examinations that are non-invasive.

Who treats colitis – proctologist or gastroenterologist?

Proctologists are involved in the treatment of colitis, as well as other diseases of the lower digestive tract. They carry out both an initial examination and consultations, as well as a complete diagnosis, and further therapy. If necessary, an additional examination by a gastroenterologist is prescribed. If the situation is complex and confusing, doctors consult and decide on the treatment of pathology together.

Benefits of visiting a proctologist at MEDSI

• Use of the latest European diagnostic and treatment protocols
• Minimization of psychological uncertainty, feelings of fear and anxiety in patients
• Experienced doctors with many years of experience. Our proctologists in Moscow regularly improve their skills, undergo internships in the world’s leading clinics
• Using a range of modern diagnostic methods: laboratory tests, endoscopy of the anal canal and rectum. MRI of the pelvic and abdominal organs
• The use of minimally invasive endoscopic and surgical intervention techniques for the treatment of diseases of the large intestine, anal canal and perineum: sclerotherapy, infrared photocoagulation, node removal, laser operations
• Lack of queues and the possibility of making an appointment with a doctor at a convenient time

To make an appointment with a proctologist, just call: +7 ((495) 152-47-53.

Do not delay treatment, contact a doctor right now:

• Proctologist appointment

If you have hemorrhoids which doctor will help you?

/ Home / Articles / First aid for hemorrhoids

Hemorrhoids are a fairly common disease among adult men and women, especially sedentary work contributes to it. The problem is so delicate that many are embarrassed to go to the clinic with it, to find out which doctor you need to book a consultation with. However, this is wrong behavior: if hemorrhoids are not treated, they become chronic. The exacerbation of the disease is caused by the transfer of heavy objects, the period of pregnancy, and malnutrition. If you do not treat hemorrhoids, then you will have to eliminate the problem with the help of surgical operations. Therefore, we recommend that at the initial manifestations of hemorrhoids, contact a specialist – a proctologist or coloproctologist.

Which doctor treats hemorrhoids?

Hemorrhoids is a pathology of the lowest part of digestion – the rectum. Proctologists are engaged in the diagnosis and treatment of this part of the body. According to the modern classification of specialties – coloproctologist. These specialists deal with all problems that are associated with the colon, anus and perineum. Hemorrhoids are diagnosed by an increase in nodes, they will be detected by a gynecologist who performs a routine examination of women and a urologist when examining men. Also, the young men can be informed about the first signs of the disease by a surgeon who examines them as part of a medical examination at the military registration and enlistment office. If symptoms are detected, then the patient is referred to a narrower specialist – a coloproctologist, they explain that a professional approach is important in treating the disease.

Most district-level hospitals have a proctologist on staff. If not, then you can make an appointment with a surgeon, since proctology is one of the areas of surgery, so such a doctor has a sufficient knowledge base and practice in this area. The surgeon in the district hospital (polyclinic) conducts an outpatient appointment free of charge. In addition, you can contact a private medical clinic, there are enough coloproctologists in such institutions. To get to a good specialist, you should ask if the clinic has a license, find out the doctor’s experience and category, read reviews about him. When making an appointment, it is necessary to clarify what is included in the examination, the doctor may additionally prescribe an instrumental examination (sigmoidoscopy, anoscopy), which are paid separately. It is important to clarify this not only in terms of finances, but also for proper preparation for the study.

In the case when there is bleeding from the anus, the pain is very strong, then you need to call an ambulance. Such a complication can be caused by infringement of the node or thrombosis. If medical care is not provided in time, this will lead to necrosis (tissue necrosis).

Proctologists and Coloproctologists

The exact name of medical specialties is approved by the List of the Ministry of Health. In state institutions, when applying for a job, they strictly monitor that the name of the specialty exactly matches the law. Previously, doctors who treated hemorrhoids were called “proctologists”. Since 2014 they have been referred to as “coloproctologists”. This is due to the fact that the field of study of pathology was slightly “expanded” – to the entire large intestine.

Depending on the place of work and the characteristics of the medical profile, coloproctologists can be:

1. Therapists. In this case, the coloproctologist is engaged in therapeutic (drug) treatment of the disease, as well as the treatment of Crohn’s disease, colitis, elimination of infections and parasites that have settled in the intestines.
2. Surgeons. Coloproctologists of this direction practice minimally invasive methods of treating hemorrhoids, and also perform operations to remove tumors, hemorrhoidal cones, polyps using special endoscopic devices.

A coloproctologist-therapist for the treatment of hemorrhoids prescribes medications, prescribes drugs for oral and topical use, paints a diet that must be followed. Doctors of this specialization usually work in polyclinics, conduct outpatient appointments.

A coloproctologist-surgeon is a doctor who is consulted in cases where treatment with various home methods has not yielded results, hemorrhoids have entered an advanced stage, complications have appeared (a crack in the intestinal wall), bleeding begins, prolapse or infringement of hemorrhoids occurs. All this requires surgical intervention.

Both types of coloproctologists have enough knowledge and experience to diagnose hemorrhoids, determine the stage of the disease, and choose an effective treatment method. At the appointment, the doctor finds out how long ago the signs of the disease appeared, what provoked it and led to an exacerbation. At the consultation, the specialist necessarily examines the anus, performs palpation of the lower rectum, performs anoscopy, sigmoidoscopy. If there is a need, then such studies as irrigoscopy or colonoscopy are additionally assigned.

Based on the study, complaints and analyzes, an individual treatment regimen for the patient is selected, taking into account the age and presence of other diseases. The therapeutic process and its effectiveness are monitored. For stages I-III of the disease, treatment is carried out with the help of minisurgery (sclerotherapy for external hemorrhoids, the imposition of latex rings, ligation of blood vessels). Also, laser irradiation, cryotherapy, thermal coagulation can be used for treatment. After the procedures, the proctologist must prescribe a therapy that will prevent the development of exacerbations and maintain a positive result of treatment. To do this, the doctor explains to the patient the features of nutrition, hygiene, regimen.

Duties of a coloproctologist

A coloproctologist-surgeon not only treats hemorrhoids, but deals with the elimination of intestinal pathologies due to injuries, congenital diseases.

The doctor provides emergency or planned care in the presence of:

• hemorrhoids with complications;
• rectal fissures;
• intestinal polyps;
• paraproctitis;
• cysts and tumors.

The task of the doctor is to choose an effective method of treatment, taking into account the results of the diagnosis and the general health of the patient. The choice of the method of surgical intervention is based on the ratio of the level of risk and the prediction of the development of the disease. The coloproctologist explains to the patient the methods of preparing for surgery, removes structures, eliminates cracks, and restores the functionality of the intestine. After the operation, a diet, dressings, local procedures, and medications are prescribed.

The duties of a doctor of this specialization, in addition to receiving patients, include maintaining documentation, analyzing the effectiveness of their work, and improving their qualifications every 5 years. During retraining courses, the doctor gains knowledge about new therapeutic achievements and drugs, the possibilities of innovative diagnostic equipment.

Preparation for inspection

It is better to plan a trip to the coloproctologist on your day off, because you need to carefully prepare for the examination. Before taking it is desirable to perform a bowel cleansing.

A day before visiting a doctor, you need to exclude from the diet food that provokes gas formation:

• milk;
• legumes;
• all types of cabbage;
• fatty fish and meat dishes;
• sweet products;
• sparkling water, strong coffee and tea;
• pickles;
• any alcohol, including beer.

You should refrain from smoking. The night before, you need to do 2 cleansing enemas, in the morning one more. If the classic version of the enema is poorly tolerated, then rectal suppositories based on glycerin, Microlax microclysters, are suitable. They provide bowel cleansing in 20 minutes. You should go to the doctor on an empty stomach in case he prescribes a blood test.

How painful is the examination?

The doctor performs an examination taking into account the patient’s condition, his excitement. Therefore, he talks to the patient and tries to conduct the examination slowly and carefully. The palpation procedure is quite unpleasant, but for the most part it does not cause pain. If there is a hemorrhoidal blackened node outside, then the examination is not performed, its removal is immediately assigned.

Why is it important to see a doctor?

Hemorrhoids is a disease that causes discomfort and complicates life and work of a person due to such signs:

• pain during defecation;
• bleeding;
• itching, erosion, irritation, weeping around the anus;
• sensation as if there is something foreign in the anal canal.