Patients are usually shocked by anal bleeding, and anal bleeding is not always due to hemorrhoids. When you visit the hospital, the color and appearance of the blood from anal bleeding will be asked first. If the blood color is black, it means the bleeding from the upper gastrointestinal tract, such as the stomach and esophagus. If the blood color is reddish, it means it is from the large intestine. Depending on the case, appropriate tests and treatment will be given. In most cases, the blood from anal bleeding is bright red (fresh blood). This is bleeding from the anus, the rectum close to the anus, sigmoid colon or such, which may be due to cancer around the anus, and tests for cancer must be performed as soon as possible. Although rare, there are some patients presenting with severe bleeding due to ruptured internal hemorrhoids. In such cases, immediate surgical procedures must be performed on that day and, thus, it is essential for such patients to visit a hospital as soon as they become aware of the problem.
Patients with "anal bleeding" and/or "anal prolapse" should consult a physician. A sensation of inadequate defecation due to hemorrhoids (piles) or anal prolapse may be resolved by OTC drugs. However, if such a sensation or anal prolapse recurs soon after discontinuation of OTC drug use, it can be understood that the condition cannot be resolved by OTC drugs and must be treated at a hospital.
OTC drugs may be effective against mild anal fissure, during which time anal fissure may repeatedly recur before complete wound healing, resulting in chronic anal fissure. Chronic anal fissure may cause persistent pain. In severe cases, pain will persist for the rest of the day after defecation. Patients suffering from such pain should consult a physician. Although rare, chronic anal fissure may become severe and ulcerated, and the deep wound may be invaded by bacteria which will cause an abscess to form. Due caution should be exercised for chronic anal fissure.
If anal bleeding cannot be stopped by OTC drugs for hemorrhoids, it is recommended to visit a hospital for identification of the cause of bleeding. Colorectal cancer may be the cause, so patients should not assume that bleeding is from hemorrhoids. "There is no delay in the treatment of hemorrhoids, but there is a delay in the treatment of colorectal cancer." if a patient does not visit a hospital in time. There are many patients with hemorrhoids who were found to have advanced colorectal cancer. This was investigated at our hospital and was published in a paper. Such patients tend to leave anal bleeding untreated assuming that the bleeding is from hemorrhoids. So it is also important for patients to receive an endoscopy after reaching the age of 40 years. Patients receiving routine medical examinations will not have to be afraid of bleeding.
Anal fistula may also be a cause of cancer, but simple anal fistula rarely leads to cancer. However, since complex anal fistula may develop into cancer, early treatment with surgery is recommended.
Anal bleeding and pain are symptoms for which patients must visit a hospital. Not all anal pain and bleeding are due to hemorrhoids. Rectal cancer can be a cause of anal pain, so caution must be exercised. When examining patients, proctologists pay much attention to the absence or presence of cancer.
In many patients, dark red bleeding, not bright red bleeding, is found during digital examination. Other than colorectal cancer, there are other possible diseases such as enterocolitis, Crohn's disease, and ulcerative colitis. If any such diseases are suspected, only an enema is performed immediately and a short colonoscopy is introduced for observation. In many cases, ischemic enterocolitis or intestinal diverticular bleeding is the cause of such dark red bleeding. Bleeding due to these conditions is often mistaken as bleeding from hemorrhoids. As mentioned above, there may be a number of causes. In case of bleeding occurring, the patient must visit a hospital, without delay.
Bleeding during defecation often occurs due to various causes while bleeding not associated with bowel movements can be caused by diseases such as colorectal cancer which is life-threatening. Therefore, differentiation between hemorrhoids (piles) and colorectal cancer must be made. In such a case, consult a specialist immediately. If unbearable pain is caused by hemorrhoids, an incision must be performed for pus drainage or removal of blood clots. In such a case, consult a specialist. Prolapsed hemorrhoids without bleeding and pain are unlikely to require immediate treatment. However, if prolapsed internal hemorrhoids, which can be cured by early treatment with one injection (sclerotherapy), are left untreated, prolapse will not be cured by injection sclerotherapy, and invasive procedures that cause pain (surgical incision) will be the sole treatment option. There are advantages that patients who visit a hospital early can choose various treatment methods.
Not necessarily "bleeding from the anus = hemorrhoids"!? It may be colon cancer or polyps.
I got blood from my anus! First aid available at home and types of dangerous bleeding
Question to a doctor “Symptoms frequently observed in patients at the initial visit”
Question to a doctor “Procedural flow of and cost for initial visit”
