Introduction
Hemorrhoids are a cushion of blood vessels that prevents gases and stool from escaping from the rectum. In hemorrhoidal disease these vessels are thickened. This can be caused by too much pressure when defecating, childbirth or a weakness of the connective tissue.
Hard stool can cause the hemorrhoids to tear open and start bleeding. Treatment is possible through medication, ointments or surgery. About 80% of adults suffer from haemorrhoids.
Cause of blood from haemorrhoids
The cause of the protrusion of the haemorrhoidal vessels themselves is often a pressure load caused by heavy pressing during defecation or during childbirth. In rare cases, portal vein hypertension due to liver disease is also a possible cause. The bulging, thickened haemorrhoids extend far into the anus opening and can be an obstacle to stool. If the stool is hard, they can be torn open and bleed. An acute increase in blood pressure, as occurs during pressing, can also lead to the hemorrhoids bursting.
What does the blood look like?
There are three colors that blood in the stool can take on. The colour of blood in the stool often provides information about the cause of the blood: however, other intestinal diseases can sometimes cause bleeding. Depending on the place of origin, the colour can also be light red, dark red or black.
- The classic haemorrhoidal disease is arterial, i.e. oxygen-rich, blood with a light red colour. – The portal vein high pressure is a so-called false hemorrhoid, as it is caused by venous congestion. This blood is rather dark red and low in oxygen. – If the source of bleeding is not in the haemorrhoids but further up the intestinal tract, the blood can also be pitch black. This is known as tarry stools.
Can the blood also come from colon cancer?
This distinction between tumor and hemorrhoidal disease cannot be made on the basis of blood color alone. Most intestinal tumours are located in the rectum or sigmoid and therefore also lead to fresh bleeding. Therefore, even in the case of known haemorrhoids, a complete colonoscopy must always be performed to detect possible malignant tumours and to initiate the appropriate therapy. The exclusion of other sources of bleeding is also only possible with a colonoscopy.
Therapy
In the case of a mild haemorrhoidal disease, conservative therapy is often sufficient. In this case, the stool is regulated by a specific diet and prolonged sitting is avoided. Drug treatment is also possible.
Local anaesthetics can reduce pain and haemostatic drugs can limit the blood in the stool. Anti-inflammatory agents such as glucocorticoids can also help those affected. These can be used in the form of ointments or suppositories.
There are also some outpatient therapy options. In sclerotherapy, the haemorrhoids are fixed and separated from the blood supply by certain drugs. It can also be achieved by local heating of the tissue with infrared light.
Thrombolization then leads to shrinkage of the hemorrhoids. Icing is also possible, but is hardly ever performed due to the side effects. In a rubber band ligation, a tight rubber band is placed around the hemorrhoids and the lack of blood supply leads to the death of the hemorrhoids.
In addition to the outpatient treatments, classical operations are also possible. Here the relapse rate is very low. These procedures are especially used in cases of severe hemorrhoidal disease.
