Hemorrhoids may bleed when hard stool damages their surface. Treatment can include at-home practices, over-the-counter products, and more rarely, medical procedures.

Hemorrhoids, also called piles, are enlarged veins in the rectum and anus.

There are two types of hemorrhoids:

  • Internal hemorrhoids: These develop in the rectum.
  • External hemorrhoids: These develop around the anal opening, beneath the skin.

For some people, hemorrhoids don’t cause symptoms. But for others, hemorrhoids may cause itching, burning, bleeding, and discomfort, especially when you’re sitting down.

Hemorrhoids may also cause bleeding that could range from mild to severe. Hemorrhoids are the most common cause of rectal bleeding in the United States.

Keep reading to learn more about why this happens and what you can do to relieve pain and discomfort.

Both internal and external hemorrhoids may cause bleeding, which usually looks bright red on toilet paper.

Some causes of hemorrhoid bleeding may include:

In most cases, hemorrhoids may be treated at home. However, it’s important to speak with a healthcare professional if you experience severe rectal bleeding or hemorrhoid symptoms that last longer than 1 week.

A bleeding hemorrhoid is usually a sign of irritation or damage to the wall of the hemorrhoid. It typically resolves on its own, but some home remedies could help relieve inflammation and soothe discomfort.

Some home remedies include:

Speak with a healthcare professional if you experience rectal bleeding.

Some medical conditions, including cancer and inflammatory bowel disease (IBD), may have similar symptoms as hemorrhoids. For this reason, it’s important to receive a proper diagnosis from a doctor.

If home treatments don’t provide relief, a healthcare professional may recommend noninvasive medical treatments or surgical treatments to help.

Noninvasive medical treatments

Some noninvasive medical treatments for internal hemorrhoids may include:

These can usually be done in the doctor’s office and don’t require general anesthesia.

Surgery

A doctor may recommend surgery for bleeding hemorrhoids, external hemorrhoids, or if you have a prolapsed hemorrhoid. A prolapse is when you have a bulge outward from the anus.

They will recommend the best procedure for you based on the type and severity of your hemorrhoids. Before surgery, a doctor may prescribe suppositories to be used once or twice per day.

Surgical options for bleeding hemorrhoids may include:

  • hemorrhoidectomy
  • hemorrhoidopexy, which is when a prolapsed hemorrhoid is stapled back into your rectum
  • haemorrhoidal artery ligation, which is when blood supply to the hemorrhoid is cut off using stitches

These approaches often involve general or regional anesthesia, as well as a potential stay overnight in the hospital.

Learn more about surgery for hemorrhoids.

Speak with a healthcare professional if you experience rectal bleeding or any of the following symptoms:

A doctor will likely start by confirming that hemorrhoids are the source of the blood you’ve noticed. This may include:

  • physical exam of the area for external hemorrhoids
  • finger exam, which involves inserting a gloved finger into the area to check for internal hemorrhoids
  • anoscopy to check for signs of other conditions that could be causing the bleeding

You can book an appointment with a primary care doctor in your area using our Healthline FindCare tool.

However, while primary care doctors can usually provide treatment for hemorrhoids, you may need to visit a gastroenterologist or proctologist if you have severe hemorrhoids or experience any complications.

When should I go to the ER for a bleeding hemorrhoid?

Call 911 or get immediate medical attention if you:

  • experience heavy rectal bleeding that doesn’t stop
  • notice a lot of blood or blood clots in the toilet water
  • experience severe pain

Hemorrhoid prevention often involves a combination of diet and lifestyle changes. In addition to staying physically active, eating a balanced diet, and drinking plenty of water, here are five ways to prevent hemorrhoids.

Maintain good personal hygiene

Keeping your rectal area clean is essential to preventing hemorrhoids, especially after a bowel movement.

Shower often and consider using a squirt bottle with warm water and moist toilet paper to gently wipe your anus. A bidet is another helpful option.

Avoid food triggers

Low fiber foods could trigger hemorrhoids. These may include:

  • dairy products (milk, cheese, and ice cream)
  • white bread and bagels
  • meat
  • processed foods like fast food and frozen meals

Spicy foods may also trigger hemorrhoids.

An elimination diet is a helpful option for learning your food triggers. You can also keep a journal to record the foods you eat and how your body reacts to them.

Wear cotton underwear

This will keep the area dry and help prevent moisture from forming.

Avoid lifting heavy objects

Lifting things like heavy boxes or groceries puts unnecessary pressure on the anal canal.

Make the toilet an entertainment-free zone

Spending too much time on the toilet, whether by using your phone or reading, places pressure on your rectum and anus. You should not spend more than 15 minutes on the toilet. Set a timer for yourself if you’re easily distracted.

Are bleeding hemorrhoids serious?

In most cases, bleeding hemorrhoids are a sign of irritation and will get better on their own. However, bleeding hemorrhoids may also be a sign of something more serious, such as cancer or IBD.

How to treat hemorrhoids that bleed?

Treatment for bleeding hemorrhoids may include home remedies like bathing with essential oils, wiping with a damp cloth, and drinking plenty of fluids to avoid constipation. Some OTC and prescription topical creams are available. If these treatments don’t work, you may require medical intervention, such as surgery.

What are grade 4 hemorrhoids?

Grade 4 hemorrhoids are when you cannot push a hemorrhoid in, or, if you push it in, the hemorrhoid spontaneously prolapses. Grade 4 hemorrhoids can be very painful.

Hemorrhoids can bleed when they become damaged or irritated. Usually, this bleeding and irritation can resolve with home treatment.

Speak with a healthcare professional if you experience rectal bleeding. They could provide a proper diagnosis and treatment plan for you.