While many hemorrhoid cases can be effectively managed at home with over-the-counter treatments and lifestyle changes, there are situations when professional medical attention is necessary. Knowing when to seek help can prevent complications and ensure you receive appropriate treatment for your condition.
This guide helps you understand the warning signs that indicate it's time to see a doctor, what to expect during a medical consultation, and the treatment options your healthcare provider may recommend.
Warning Signs That Require Medical Attention
If you experience any of the following symptoms, schedule an appointment with your GP or seek medical care:
Persistent or Heavy Bleeding
While small amounts of bright red blood on toilet paper or in the toilet bowl are common with hemorrhoids, you should see a doctor if:
- Bleeding continues for more than a week despite home treatment
- You notice large amounts of blood
- Blood is dark red or mixed with stool (this may indicate a different condition)
- You feel dizzy, lightheaded, or weak from blood loss
Rectal bleeding is not always caused by hemorrhoids. Other conditions, including colorectal cancer, inflammatory bowel disease, and anal fissures, can also cause bleeding. If you're over 40, have a family history of colorectal cancer, or notice any change in your bleeding pattern, always consult a healthcare professional.
Severe Pain
Hemorrhoids typically cause discomfort rather than severe pain. Seek medical attention if:
- Pain is severe, constant, or worsening
- Pain makes it difficult to sit, walk, or perform daily activities
- Over-the-counter pain relievers provide no relief
- You notice a hard, extremely painful lump near your anus (may indicate a thrombosed hemorrhoid)
Thrombosed Hemorrhoids
A thrombosed hemorrhoid occurs when a blood clot forms inside an external hemorrhoid. This condition causes:
- Sudden, severe pain
- A firm, bluish-coloured lump near the anus
- Significant swelling
Thrombosed hemorrhoids often require medical treatment, especially within the first 72 hours when clot removal can provide significant relief.
Prolapsed Hemorrhoids That Won't Retract
Internal hemorrhoids can prolapse (protrude through the anus). While mild prolapse often returns on its own, see a doctor if:
- The hemorrhoid cannot be gently pushed back inside
- The prolapsed tissue becomes painful or swollen
- You experience difficulty with bowel movements
Signs of Infection
Though rare, hemorrhoids can become infected. Seek immediate medical attention if you notice:
- Fever
- Increasing redness spreading around the affected area
- Pus or foul-smelling discharge
- Worsening pain accompanied by warmth at the site
- Bleeding that lasts more than one week
- Large amounts of blood or dark blood
- Severe or worsening pain
- A hard, bluish lump (thrombosed hemorrhoid)
- Fever or signs of infection
- Symptoms that don't improve with home treatment
- Any rectal bleeding if over 40 or with family history of colon cancer
Other Reasons to Consult a Healthcare Provider
Beyond emergency symptoms, consider seeing a doctor in these situations:
No Improvement After 1-2 Weeks
If you've been consistently using home treatments and over-the-counter products for 1-2 weeks without significant improvement, a healthcare provider can recommend stronger treatments or investigate whether another condition is causing your symptoms.
Recurring Hemorrhoids
If hemorrhoids keep coming back despite preventive measures, a doctor can help identify underlying causes and discuss longer-term solutions, including procedures that provide more permanent relief.
First-Time Symptoms Over Age 40
If you're over 40 and experiencing rectal symptoms for the first time, it's wise to have them evaluated. While hemorrhoids are the most common cause, your doctor may recommend tests to rule out other conditions.
Changes in Bowel Habits
If you notice changes in your bowel habits along with hemorrhoid symptoms, including persistent diarrhoea, constipation, narrower stools, or feeling that your bowel doesn't empty completely, consult a healthcare provider.
What to Expect During Your Appointment
Understanding what happens during a medical examination can help ease any anxiety about seeking help:
Medical History
Your doctor will ask about your symptoms, how long you've had them, what treatments you've tried, and your overall health history. Be prepared to discuss your bowel habits, diet, and any medications you take.
Physical Examination
For external hemorrhoids, a visual examination is usually sufficient. For internal hemorrhoids, your doctor may perform:
- Digital rectal exam: The doctor inserts a gloved, lubricated finger into the rectum to feel for abnormalities
- Anoscopy: A small, lighted tube is inserted a short distance into the rectum to view internal hemorrhoids
While these examinations may feel awkward, they're generally quick and cause minimal discomfort.
Additional Tests
In some cases, your doctor may recommend further testing:
- Sigmoidoscopy: Examination of the lower colon
- Colonoscopy: Full examination of the colon, typically recommended if you're over 50 or have risk factors for colorectal cancer
Medical Treatment Options
If home treatment isn't effective, your doctor may recommend one of these procedures:
Rubber Band Ligation
A small rubber band is placed around the base of an internal hemorrhoid to cut off its blood supply. The hemorrhoid shrinks and falls off within about a week. This is one of the most common and effective treatments for internal hemorrhoids.
Sclerotherapy
A chemical solution is injected into the hemorrhoid tissue, causing it to shrink. This procedure is typically used for smaller hemorrhoids.
Infrared Coagulation
Infrared light is used to create scar tissue, cutting off blood supply to the hemorrhoid. This is an option for smaller internal hemorrhoids.
Hemorrhoidectomy
Surgical removal of hemorrhoids may be recommended for large, prolapsed, or recurrent hemorrhoids that don't respond to other treatments. While more invasive, this procedure offers the most complete removal.
Stapled Hemorrhoidopexy
A surgical stapler repositions prolapsed hemorrhoid tissue and cuts off blood supply. This procedure typically has a faster recovery than traditional hemorrhoidectomy.
The good news is that the vast majority of hemorrhoid cases respond well to treatment, whether through home remedies, over-the-counter products, or medical procedures. Don't let embarrassment prevent you from seeking help when needed.
Preparing for Your Doctor Visit
Make the most of your appointment by:
- Writing down your symptoms and how long you've had them
- Listing all medications, supplements, and treatments you've tried
- Noting any questions you want to ask
- Being honest about your symptoms, even if they feel embarrassing
Remember, doctors see hemorrhoid patients regularly. There's no need to feel embarrassed about seeking help for this common condition.
While waiting for your appointment, you can explore our product comparison guide to find suitable over-the-counter treatments that may provide some relief.