Why Do Hemorrhoids Bleed?

Bleeding is simultaneously one of the most common and most frightening symptoms of hemorrhoids. You're going about your daily life, usually feeling no major discomfort, and then suddenly it looks like you're losing massive amounts of blood!

Why do hemorrhoids do this? What causes them to bleed so frequently and so profusely?

First, remember that they are probably not bleeding as profusely as it would first appear. Blood from the mucosal tissue lined anal canal gets diluted in the large amounts of mucus that irritation produces. Mucus is generally clear, while of course blood is not. Therefore a relatively small amount of blood can get quite large in volume when mixed with mucus while retaining it's bright, oh so alarming color. In addition, any bleeding that occurs in the bowl of a toilet is going to quickly get diluted by the toilet water, and again, it can look like a lot more than it really is.

But, you may ask, why do they bleed in the first place?

A hemorrhoids is, by definition, a swelling in a vein and the tissue surrounding that swelling. As a vein swells, the vein wall gets thinner, much like an inflated balloon. If something hard or harsh, for example a constipated stool, scrapes against it, that vein is quite likely to give way. In addition, smaller blood vessels close to the surface of the tissue are also under pressure and frequently behave the same way. To continue with the balloon analogy, straining can cause the blood vessels of the area to "pop" under increased hydraulic blood pressure. Of course, because even the smallest hemorrhoid projects above the area of the surrounding tissue, it's going to be under the most pressure from any straining or hard stools.

Is hemorrhoidal bleeding a major cause for concern?

If you are experiencing anal bleeding for the first time, yes. There are a multitude of potential causes for anal bleeding, including some quite serious health conditions such as colon cancer, and a doctor needs to rule out those causes. Hemorrhoidal bleeding should always be relatively bright red in color and fresh. If you are experiencing anal bleeding and the blood is dark brown, black, or scablike, it is even more serious and should be seen by a doctor right away. Even fresh, bright red bleeding can be a symptom of something other than hemorrhoids, such as anal fissures, fistulas, or warts, so it's a good idea to get a correct diagnosis. In addition, bleeding hemorrhoids can be a target for infection, especially due to location, so that's something to keep an eye on. If you ever find yourself with an unexplained fever, chills, or other signs of infection, go see a doctor immediately. However, if other causes have been ruled out and your hemorrhoids are not infected, bleeding is a fairly common symptom, especially of internal hemorrhoids.

If you suffer from chronic bleeding due to hemorrhoids, there are several things that can help.

If you bleed from an external hemorrhoid, getting a hemorrhoid cream that includes a topical vasoconstrictor and either calamine or zinc oxide can help stop the bleeding. Internal hemorrhoids may be helped by a prescription for a vasoconstrictor to be taken by mouth. Using the normal recommended methods of treating hemorrhoids in general will also help reduce and eventually eliminate hemorrhoidal bleeding.