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911DOC
911DOC, Board Certified Dr.
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Experience:  Emergency Medicine Physician
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Hemorrhoids flare up since Sunday. Worse one yet in 20 years.

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Hemorrhoids flare up since Sunday. Worse one yet in 20 years. I have both internal and external hemorrhoids. I'm a 57 yr old female who has switched from a junk food diet to a more plant based diet since 6/10/13. And, now I have this glare up! Things were getting better today until bleeding started with a BM about sn hour ago. I was planning to continue self treating (tucks, prep H) for a couple more days, but now not sure. Bleeding is bright red. I plan to have a colonoscopy in the next few months and am looking for an gastroenterologist. Would now be a good time for a consult? What do you advise? Thanks.
Hello from JA


I am Dr. Thomas, board certified in internal medicine and I can help you with this and any follow up questions. I cover a lot of ground and might give you an answer or ask for information, but use reply to communicate with me for questions or added details.

You were due a colonoscopy at age 50.
If you have not had this is is way overdue.
I would move up the GI consult and colonoscopy, as this would reveal all problems.

If you continue to bleed or worsen in the mean time, see your regular doctor.

OK. If you have further questions or details, use reply to expert.
Otherwise please choose a positive rating . But, still come back if you need to…think of something later, etc. Bonuses are appreciated.
Customer: replied 3 years ago.

I had a colonoscopy at 48 so I'm right on schedule. So, you're saying that any bleeding from the hemorrhoids warrants a doctor visit now?

the site says you opted out of this question.

do you desire to continue with Dr Thomas?

best
Customer: replied 3 years ago.

No, I would prefer a more complete answer by another doctor which I understand is my option. Thanks for your consideration.

Very well.

Happy to help.

The fact of the matter is that this IS likely hemorrhoidal bleeding, but, with the persistent and 'worst ever' rectal bleeding you have experienced to date this is not something to wait on.

The reason is that while it is LIKELY to be hemorrhoidal, it COULD be for other reasons... some of them are dangerous.

Diverticulosis is a likely and relatively benign cause. HERE IS A GOOD LINK ON THIS PROBLEM.

Unfortunately, cancer is also on the list. As a physician we can not afford to assume that bleeding from the rectum is due to hemorrhoids even when hemorrhoids are clearly visible. This is why colonoscopy is necessary, and why it should be done at age 50 in women, and perhaps sooner if there is a family history of colon cancer.

One final thing. The proper name for your current condition is 'rectal bleeding' or 'lower GI bleeding'. HERE IS A LINK WHICH DETAILS THIS PROBLEM.

As you can see from the list there are no shortage of causes. Pay particular attention to the 'when to see a doctor' section at the bottom.

Since your bleeding is heavier than normal and persistent, I think you should see your doctor at the earliest opportunity. If you can not get into see your doctor with 24 hours I would not hesitate to go to the ER or to an urgent care.

If you become dizzy on standing or develop other symptoms like weakness, rapid heart rate, or shallow breathing, you should call 911 as this might mean you have lost a significant amount of blood.

This kind of bleeding CAN be an emergency. As it stands based on your story you have an 'urgent' problem that could become dangerous quite quickly.

Please get yourself seen by your physician or at an ER or Urgent Care tonight if possible, tomorrow if you fell well and have read and understand the precautions listed in the Mayo Clinic article.

Thank you so much for your question. It was a pleasure talking with you. If this answer has been helpful to you please consider leaving positive feedback. Should you require my assistance in the future simply start your question with ‘for 911doc’, and I am usually on the site most days.
Best
911DOC, Board Certified Dr.
Category: Medical
Satisfied Customers: 5094
Experience: Emergency Medicine Physician
911DOC and 4 other Medical Specialists are ready to help you
Customer: replied 3 years ago.

Thanks, 911DOC, for taking the time to provide excellent information. I doubt if the bleeding is coming anywhere other than the hemorrhoids, but I understand your concern. I'll call my family doc tomorrow. Thanks again.

you are most welcome.

ask for me anytime. always happy to help.

best

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