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Hemorrhoids (cont.)

When to seek medical care for hemorrhoids

When to call the doctor

  • Bleeding from the rectum or anus is never normal and although hemorrhoids are the most common reason to have blood in the stool, it should be discussed with your primary health-care professional. Other causes of rectal bleeding exist and can be serious. Inflammatory bowel disease and cancers of the colon can present with rectal bleeding. Blood in the stool should never be ignored.
  • Medical care should be sought urgently if a person is taking anticoagulation medications such as warfarin (Coumadin), dabigatran (Pradaxa), rivaroxiban (Xarelto), apixaban (Eliquis), clopidogrel (Plavix), prasugrel (Effient) or enoxaparin (Lovenox).
  • Individuals who have associated symptoms such as lightheadedness and weakness may have significant blood loss and may require more urgent care.
  • Hemorrhoids do not cause abdominal pain; should this pain be present with bleeding, medical care should be sought immediately.
  • Prolapsed hemorrhoids that cannot be pushed back through the anus require medical care.
  • Thrombosed external hemorrhoids may cause significant pain and medical care may be necessary to remove the clot.

Which specialties of doctors treat hemorrhoids?

Hemorrhoids are a common problem and most often may be treated by a primary care provider, internist, emergency or urgent care provider. Surgeons may need to operate to remove enlarged or inflamed hemorrhoids.

How are hemorrhoids diagnosed?

Diagnosis of hemorrhoids is usually made by history and physical examination by the health-care professional. Inspection of the anus and a digital rectal examination are often performed. Depending upon the situation, past medical history, medications and stability of the patient, treatment may follow with no further testing.

  • Internal hemorrhoids may not be diagnosed by physical exam; they may not be able to be felt, even by digital rectal exam.
  • Prolapsed internal and external hemorrhoids may be visualized when the health-care professional examines the anus.
  • A thrombosed external hemorrhoid can be diagnosed just by looking at it.

If there is concern that significant bleeding has occurred, a complete blood count (CBC) to measure blood hemoglobin and hematocrit levels, and platelet count is obtained. If the patient is on warfarin (Coumadin), a prothrombin time (PT) or INR may be done to measure the blood clotting levels.

Medically Reviewed by a Doctor on 6/6/2016
Medical Editor:

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