General Question

Mariah's avatar

How much bleeding can hemorrhoids cause?

Asked by Mariah (19187 points ) December 24th, 2011

Awkward question time.

Was attributing some bleeding to hemorrhoids due to having some of the classic symptoms but now I’m not sure. I’m bleeding an awful lot. Can that happen with hemorrhoids, or is it just little streaks of blood like I’ve been reading? I’m scared there might be something wrong with my new plumbing.

Obviously I’m going to talk to my doctor so you don’t need to tell me to.

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42 Answers

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Bellatrix's avatar

I haven’t had haemorrhoids so I am going purely off what I have heard. I believe the blood from bleeding haemorrhoids is very bright red. I can’t answer about the quantity but if the blood you are seeing is very bright red that would be indicative of the haemorrhoids bleeding rather than something more sinister. Darker blood would suggest something else. Hope this helps a little and it is just a nasty case of piles!

SmashTheState's avatar

If a thrombosed artery from hemorrhoids bursts, it can produce a surprising amount of blood (and hurt like a motherfucker to boot). I’ve burst hemhorrhoids while having a large bowel movement which bled so hard it trickled merrily into the toilet in a stream. As @Bellatrix wrote, it’s also a bright, festive red.

marinelife's avatar

Not that much in my experience. Is the blood back or red? Red would mean fresh and ongoing.

Mariah's avatar

Thanks for your answers so far, guys. I’m not experiencing pain when I go so I don’t think I have any kind of major or burst hemorrhoid. The blood is red. I know people say don’t worry unless it’s dark, but I know better from having ulcerative colitis. When my colon used to bleed it was red, so unfortunately I’m not convinced that this blood isn’t coming from my j-pouch or small intestine. Merry Christmas, Rachel. :\

mattbrowne's avatar

A doctor should determine the grade ranging from 1 to 4. There can be a lot of bleeding for the higher grades.

Eureka's avatar

Actually, having red blood coming out would be more of a concern than brown. Red (also called frank blood) means an active bleeding site. Brown or black is old blood, meaning that whatever happened to cause it is probably over and done with.

Not having pain is not indicitive of a non – serious situation, either. My first thought at reading your details was an intestinal polyp hemorrhage. If this is the case, it is not going to stop on its own – you are going to have to seek medical attention. And, although this is probably not what you want to hear today, if you are passing a lot of blood, you need to go to the hospital.

Best of luck with this.

Mariah's avatar

@Eureka Hmm, I do know that brown or black blood can mean that it’s old blood, but I believe it also can indicate current bleeding high up in the digestive tract. Bright red usually indicates current bleeding low in the tract or externally.

There is a LOT of backstory to my digestive health. I don’t have a colon or a rectum anymore, for one thing. I had the surgery very recently so I think the bleeding is, if not hemorrhoids, related to that.

I also was just reading the literature on an antibiotic I am taking and one of the “severe side effects” is bloody stools. My doctor had told me to stop the antibiotic if I experienced any severe side effects so maybe that will do the trick.

Unless it gets worse I am just going to call the doctor on Monday. I would not trust anybody except my surgeon to go poking around my bum right now, so I do not think I want to go to the local hospital.

Lightlyseared's avatar

It is quite possible to have some amazingly heavy bleeding from hemorrhoids but it does tend to be quite rare. (there is a related disorder you see in people with advanced liver disease called rectal varicies that can cause life threatening bleeding).

If the anastomosis from your bowel surgery is near the rectum then it is possible you would get bright red blood (the further from the anus the less like blood it looks when it comes out – blood from the stomach is black when you pass it) if there was a problem there. However surgeons are usually pretty good at making sure the joins are good and if there was a problem it usually comes to light before you’re discharged from hospital after the surgery. Still, when you go to the doc I’d be surprised if they didn’t have a look with an endoscope just to be sure and if there is a problem they can treat it there and then during the endoscopy.

Anyhow hopefully it was just the meds and it’ll sort itself out.

CWOTUS's avatar

“Internal bleeding” is excreted in the form of black and tarry-looking bowel movements. You wouldn’t even recognize it as blood. Bright red blood indicates that it is occurring close to the point of excretion – from whatever source.

My own take on this is that if you have “bright red” bleeding, and the quantity of blood doesn’t alarm you, then your decision to wait until Monday seems sound. Also, to take it easy this weekend. Good luck, @Mariah.

Mariah's avatar

@Lightlyseared, thank you for chiming in. I had my rectum removed in the surgery and had an ileoanal anastomosis. Shortly after the surgery I had failure to thrive and was rehospitalized, the surgeon suspected an abscess so he went back in with an endoscope. It turned out everything was connected just fine. That was in May, so I would think it could only be more healed by now. Yes….hopefully just the meds. Other possibilities to consider are pouchitis and cuffitis but I sure as hell don’t want to be started down those roads already.

@CWOTUS I have lots of experience with internal bleeding – it can definitely be bright red if it is in the rectum or descending colon. At this point I no longer have either of those organs so I am a bit concerned it might be coming from my j-pouch, which is what I have instead of a colon now.

Mariah's avatar

@CWOTUS, either you edited or I overlooked your second paragraph the first time; thanks for your well-wishes. Happy holidays.

gorillapaws's avatar

I’m from the “better to be safe than dead” school of thought when it comes to bloody stools. I don’t think it would be weird to have someone page him just to quickly figure out how serious he thinks it is. My father is a surgeon, and he routinely got calls on the weekend for much stupider questions than that.

Mariah's avatar

Yeah I guess I’m pretty desensitized; I know I can go on this way for weeks without dying so I’m just not that worried about waiting till Monday.

Rarebear's avatar

Mariah with your condition you should be scoped. They can cause a lot of bleeding though.

Mariah's avatar

Thanks for chiming in @Rarebear. I’m planning on it. Hopefully it won’t mean another trip to Cleveland.

JLeslie's avatar

@Mariah, I don’t know exactly how your lower digestive sustem is connescted now and excretes waste. Meaning, I simply am unclear about how the surgeries have put you back together, but I can tell you my own experience and maybe it relates. I have days in a row when I have bowel movement causes the toilet water to be red with a lot of blood in it, as opposed to just having some blood on the tissue when I wipe. It usually happens when I have been constipated, or if I have eaten a lot of nuts, especially almonds, and raw carrots, or other very hard vegetables. I usually take care to eat easy to digest foods for a few days and I heal. I don’t have any hemmaroids, I have had three colonoscopies in 12 years, and there does not seem to be anything specifically internally that would cause the bleeding when I am scoped. I have had two small polyps, that is why I have been scoped so often.

I do have irritation and inflammation, long story, but it is basically under control, yet sometimes I still get these bleeding spells.

Be sure not to take any aspirin, or meds that can thin blood.

Hopefully it will subside on it’s own. I know I don’t need to point out to you you might want to contact your doctor if it does not get better.

Mariah's avatar

@JLeslie My colon and rectum were removed, except the rectal cuff is still intact. Unfortunately some diseased cells remain in the rectal cuff so it is possible to have problems with it, but that’s relatively rare. The surgeon used the tissues of my ileum to form a reservoir, and it is connected to my anus.

Odd about your bleeding problem. Sorry you have to deal with that. As far as I can tell, this isn’t related to anything I’ve been eating. My diet hasn’t changed over the last week compared to before. I tend to avoid roughage out of habit. And constipation is so not a problem when you don’t have a colon. :o)

Thanks for your help.

Rarebear's avatar

Cleveland? It should just be a simple sigmoidoscopy. Anybody with the equipment could do it. It’ll take 10 minutes.

JLeslie's avatar

@Mariah The heavy bleeding does not happen often. It might happen once, and then not again for three years. Or, sometimes it happens twice in three months, and then not again for a couple of years. It is so hard for that area to heal, since it is constantly disturbed. When it does happens to me it usually only lasts a 2–3 days at that severity, then the bleeding is lighter for a couple days and finally healed.

Mariah's avatar

@Rarebear Oh that is good to hear. My surgeon is in Cleveland (6 hours away) and I wasn’t in any hurry to jump in the car. There is a local colorectal surgeon who said he would see me for complications. I just hope whatever he finds isn’t complicated enough to warrant going back to Cleveland, but I guess you do what you gotta do.

Mariah's avatar

Getting a little in-office scope today and possibly a pouchogram; if they don’t find the problem we’ll schedule a full pouchoscopy. Glad to be getting this taken care of; I’m in a time crunch with school approaching.

Rarebear's avatar

Perfect. That ought to make the diagnosis.

Mariah's avatar

Okay, no in office scope unfortunately; I gave a stool sample because he’s concerned about possible C Diff because of the antibiotics I’m on; if that’s negative I’ll have a pouchoscopy on next Tuesday or Wednesday. He also thought maybe pouchitis, but I don’t think so, I think I’d be feeling worse than this. The other possibility is some irritation at the anastomosis, which he’d be able to cauterize during the pouchoscopy. That is what I think this probably is. It’ll just be good to get some peace of mind on this.

JLeslie's avatar

@Mariah Were you taking any probiotics while taking the antibiotics? Are your stools looser than your usual?

Mariah's avatar

I take acidophilus and eat yogurt every day, and there aren’t any changes besides the bleeding…so I really don’t think it’s C Diff or pouchitis.

JLeslie's avatar

I don’t think it is C. Dificile either.

Mariah's avatar

C diff test came back negative. Pouchoscopy on Tuesday.

Rarebear's avatar

Can you ask them to give you a picture?

Mariah's avatar

I don’t know, maybe! The plan is for me to be awake during it so I may be able to see.

JLeslie's avatar

What do they do for pouchitis? Is there a med specific for that?

JLeslie's avatar

@Rarebear So the treatment is basically the same for pouchitis and c.dificile, and I wonder if they find nothing if they still will throw some flagyl at her just to see if it helps? If they are going to do that I don’t think she should endure any procedure at all. At least not now. Or, if they are going to just give her suppositories for inflammation, seems like they can do that also without scoping her.

@Mariah Has the bleeding abated at all?

Mariah's avatar

@JLeslie They treat pouchitis with flagyl usually; unfortunately flagyl makes me very nauseated, I would try to get cipro instead, it can work too. The trouble with trying to avoid the pouchoscopy is I don’t really have time to try various things to see if they work; I go back to school in under 2 weeks. I’m fine with the pouchoscopy; without a colon you don’t even have to prep!

I actually haven’t had any visible bleeding since Christmas Eve. But apparently there were blood cells in the sample I gave yesterday. It seems to be getting better; I just want to know what’s going on before I head back to school.

JLeslie's avatar

@Mariah It just seems like c. Dificile or camplobacter (which is what I assume they are fighting with cipro) would show in the stool sample. But, then I am the queen of having a chronic bacterial infection and cultures showing nothing. Long story, not stool cultures, different area of the body. If it is getting better, I lean towards doing nothing. But, of course I am not a doctor, and this is the internet. But, I think doctors are wrong all the time. I am currently really pissed off with how doctors are treating my aunt, so it’s a bad day for me to discuss it.

JLeslie's avatar

Actually, after reading the link again that @Rarebear provided it looks like they have no idea what bacteria they are treating. Camplo would probably make you feel sick, so that guess I made is probably wrong.

Mariah's avatar

Yeah, I definitely don’t think it’s C diff or pouchitis. Both would have other symptoms besides bleeding, and I’m having no other symptoms. I’m guessing the very sensitive blood vessels around the anastomosis are irritated and are causing the bleeding, which would probably only be seen with a scope, so I’m happy to be getting scoped soon. I just want to know what’s up so I can stop fretting. And you’re right, as far as I know, nobody knows exactly what bacteria cause pouchitis, but it does respond to flagyl and cipro.

Sorry your aunt is having trouble. :( [HUGS] Best of luck to her.

JLeslie's avatar

@Mariah Oh, well if you are happy about the scope, then I am glad you will be having it done. Whatever will make you feel better about the situation. Let us know everything is ok; I’m sure it will be.

Mariah's avatar

Just had my pouchoscopy. The doctor found a small irritated place at the anastomosis. He didn’t cauterize, but he noticed that it looked much less red after being rinsed with saline. He gave me a saline enema and some mesalamine suppositories to use for a little while. He also talked on the phone to the surgeon who said to stop friggin’ worrying. I’m still healing and apparently it’s normal. I feel kind of silly now, but I just really wanted to know what was up before leaving to college.

Rarebear's avatar

“stop friggin’ worrying.” Love it.

Mariah's avatar

Lmao, not a direct quote, but I’ll bet he was thinking it. Thanks for all your help, Rarebear.

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