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Hemorrhoid Warning Signs: When to See a Doctor

ByComfort Below Editorial Team

Most hemorrhoids can be managed at home, and many people never see a doctor about them. But some symptoms that look like “just hemorrhoids” need a professional look, either because the hemorrhoid itself needs treatment or because something else is going on. Knowing the difference saves a lot of worry, and occasionally a lot more than that.

Get urgent help now if you have

  • Heavy rectal bleeding, or bleeding with dizziness, fainting, a racing heart or shortness of breath.
  • Black, tarry stools or large amounts of dark blood.
  • Severe pain with fever, chills, or spreading redness and swelling around the anus.
  • A hemorrhoid that has prolapsed, can’t be pushed back, and is turning dark and increasingly painful.

In the US call 911 or go to the emergency department; in the UK call 999 or 111.

Book an appointment soon if

  • You have rectal bleeding that has never been checked, even if it’s small and bright red.
  • You’re over 45, or have a family history of bowel cancer, and notice bleeding.
  • Your bowel habits have changed for more than a few weeks, such as looser stools, more frequent trips or a feeling of not emptying.
  • You’ve lost weight without trying, or feel unusually tired.
  • A painful hard lump appeared suddenly; see our guide to thrombosed hemorrhoids.
  • Symptoms haven’t improved after a week of home care, or keep coming back.
  • A hemorrhoid prolapses and needs pushing back regularly.

Why bleeding should always be checked once

Hemorrhoids are by far the most common cause of bright red blood on the toilet paper. But bowel cancer, polyps, fissures and inflammatory bowel disease can cause bleeding too, and they can’t be ruled out by looking at the blood. A quick examination, and sometimes a colonoscopy, gives a clear answer. Most people are relieved to hear it’s hemorrhoids after all. For what different amounts and colors of blood can mean, and what to do while you wait for an appointment, see bleeding hemorrhoids: what’s normal and when it’s an emergency.

What the appointment involves

Your doctor will ask about your symptoms and bowel habits, look at the area, and often do a gentle examination with a gloved finger. They may use a short scope to see internal hemorrhoids. It’s brief, and doctors do it routinely. Depending on your age and symptoms, you may be referred for further tests.

If you want a ready-made way to prepare, the Medical Appointment Prep System is a $27, 37-page fillable PDF e-book that, per its sales page, includes a one-page visit agenda, a 14-day symptom diary, a medication sheet and a post-visit worksheet, with a 60-day refund. We have not read it, so this is the vendor’s description rather than our review, and a plain notes page works too. Affiliate link: we may earn a commission at no extra cost to you.

For persistent or larger hemorrhoids, options include rubber band ligation, sclerotherapy, coagulation and surgery. Our guides to rubber band ligation and hemorrhoid surgery explain what each involves.

Frequently Asked Questions

What kind of doctor treats hemorrhoids?

Start with your primary care doctor or GP. They can refer you to a colorectal surgeon or gastroenterologist if needed.

Is bright red blood always hemorrhoids?

Often, but not always. That’s why any new rectal bleeding deserves one proper check.

How can I tell a hemorrhoid from something serious?

You can’t reliably tell at home. The warning signs above are the reasons to get examined.

What to Read Next

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Sources and further reading

General background on hemorrhoids from public health sources:

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