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Dr. Sohaib
Dr. Sohaib, Doctor
Category: Medical
Satisfied Customers: 5337
Experience:  MBBS, FCPS Experienced in all Medical Specialities
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Last October I had rectal bleeding after passing some large

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Last October I had rectal bleeding after passing some large stools, and my PC doctor put me on suppositories as well as a high fiber diet and stool softeners. It got better, but now the issue has returned. I will say that I was feeling better, so I stopped eating as much fiber/taking supplements and stool softener. My stools seem normal sized to me and normal colored, but I am having some pain after passing them and every once in a while there will be a small amount of bright red blood on the TP or in the commode coating the stool. I'm just concerned because I'm having pain now and I've read where internal hemorrhoids don't necessarily cause pain. I had a cold a few weeks ago and every time I coughed I felt a sharp pain in my rectal area. It does hurt to sit on my bum sometimes as well, and my job has me sitting a lot. I've tried to get up more and definitely drink more water. Just concerned it could be something worse than hemorrhoids. I had a colonoscopy several years ago due to bowel issues, and nothing was found except internal hemorrhoids. Thanks in advance for your help!

Hello and thank you for the question.
I am Dr. Sohaib, a practicing Internal Medicine Consultant with over 13 years of experience and I will do my best to help you today.
Let me review your question for a minute and I will get back to you.

Customer: replied 7 months ago.
Thank you!

No that's not true that internal hemorrhoids don't cause pain.

They can cause significant pain depending upon their size, and whether if they are infected or not.

Sometimes, it is just an inflammation of the mucosa (covering) of the hemorrhoid secondary to irritation/rubbing of stools, which continues every time you pass stools. In this situation, using laxatives is helpful (fibers/movicol etc.) which makes the stools very soft and allow healing of the inflamed hemorrhoid.

As of now, if despite using fibers and stool softeners, you continue to have pain and intermittent bleed, this is an indication to have a physical exam and anuscopy done, as there may be formation of new hemorrhoids, or there might be increase in size or pre-existing hemorrhoids, or there can be infection also.

Drink plenty of water (1.5 to 2 liters per day); and use stool softeners. Both are necessary to produce regular, soft stools, which reduce straining at defecation and hence promote healing.

Customer: replied 7 months ago.
Ok. Thank you. I forgot to mention (I apologize) that I feel like there's a bit of discharge as well. It's not a lot - and I only noticed it for the first time on Monday. It seems to be clear and again, there's very little. I'm going to see my PC provider tomorrow as well.

Topical ointments that include analgesics, such as mixed hydrocortisone/lidocaine, can also be used for time being to control pain.

Discharge means the chances of infection are more.

Good luck and my sincere wishes for your good health.

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Customer: replied 7 months ago.
Ok. I will increase my water intake and start stool softeners again as well (as well as increased fiber intake). Would my PC provider be able to tell if there was an infection?

Yes, he can do some basic tests like CBC/CRP and also a clinical exam will tell if you need antibiotics or not.

Get well soon !

Customer: replied 7 months ago.
Ok. Thank you very much for your help!

You are always Welcome.

Thanks for visiting JA!

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