Hemorrhoids are a common pathology that is associated with physical inactivity, poor diet, constipation, and hereditary pathology of the venous wall. Often people do not see a doctor and treat themselves independently and irregularly.
Hemorrhoids progress, increase in size, inflammation occurs and the node becomes irreducible. After another load (straining or lifting), the hemorrhoid may burst. What to do in this case? How to give yourself first aid and what therapeutic measures should be taken in the following days? When should you contact a surgeon? Anyone with bleeding hemorrhoids needs to know this.
Causes of hemorrhoidal rupture
Both external and internal hemorrhoids can occur suddenly. It can “mature” for years, gradually enlarge, fall out of the rectum and bleed. The mucous membrane over it periodically becomes inflamed. As the lump grows, the venous wall is stretched and thinned. For a hemorrhoid to rupture, a trivial situation is enough:
- sudden load,
- straining,
- careless insertion of a plastic enema tip,
- injury from a dense piece of feces.
The rupture of hemorrhoids is preceded by bleeding, which is sometimes not noticed. An approaching complication is indicated by enlargement, pulsation of the node, repeated small thrombosis, and increased inflammation. Additional thin-walled nodules may appear, which feel softer and more mobile. New lumps may begin to bulge from the anus.
Straining occurs with constipation. They also occur with prostate adenoma in men. In severe cases, you have to strain when urinating.
Hemorrhoids
Rupture of the vascular wall can be caused by general disorders in the body, concomitant diseases or medication. Anticoagulants, aspirin, clopidogrel reduce blood clotting and platelet adhesion. If you have hemorrhoids, there is a risk of venous wall rupture and uncontrolled bleeding.
Symptoms and signs
When hemorrhoids rupture, pain occurs and bleeding begins. The node may not be painful. A tumor-like formation at the site of the bump begins to form a little later. This occurs due to tissue saturation with blood and acute reactive inflammation. These are the primary signs of rupture of external hemorrhoids.
Bleeding
If the internal node bursts, the symptoms will be different. The pain may be mild, then the moment of rupture will go unnoticed. More often, severe and sharp pain occurs, as well as bleeding. Depending on the size of the node damage, general signs of blood loss may appear:
- dizziness,
- weakness,
- noise in ears,
- flashing “flies” before the eyes.
When blood accumulates inside the ampulla of the rectum, a false urge to defecate appears. If there were feces in the intestine, they will be mixed with scarlet blood. If it was empty, blood would flow in the form of diarrhea. This is very frightening, increases heart rate and causes panic.
Fright, panic at the sight of bleeding
Important! When the cone ruptures, the blood is scarlet, liquid, without clots or signs of coagulation. This means that the source of bleeding is the anal nodes, and not the upper parts of the large intestine.
If a lump bursts when straining during the act of defecation, this moment may go completely unnoticed. Any degree of pain is perceived as normal. After leaving the toilet, you may feel like your underwear is wet, indicating continued bleeding and damage to the lump. When hemorrhoids rupture, the pain is significant - sharp, throbbing. It is necessary to take painkillers in tablets or injections.
Prevention of exacerbation of the disease
The basis for preventing strangulation of hemorrhoids and exacerbation of the disease is considered to be a strict diet.
When creating a menu, it is necessary to take into account that dishes should be easy to digest and not cause constipation and diarrhea. The patient is advised to give up smoking, alcohol abuse and heavy lifting.
A patient with hemorrhoids is required to regularly perform strengthening exercises. When working sedentarily, it is necessary to do a short warm-up every hour for 3-5 minutes to prevent stagnation of blood in the vessels.
In case of hemorrhoids, the patient is required to undergo an annual preventive examination for timely detection of worsening pathology and its treatment.
Prevention of exacerbations of hemorrhoidal disease and bleeding from hemorrhoids is based on complete abstinence from alcohol, heavy physical labor, exclusion of inactivity, adherence to the rules of intimate hygiene of the anorectal area, performing a daily set of special Kegel exercises and individual exercise therapy.
But control over the regularity of bowel movements remains a priority, since without eliminating constipation or diarrhea, there is no guarantee of the absence of injuries to the rectal mucosa.
Lyudmila Zhavoronkova
Higher medical education. 30 years of working experience in practical medicine.
More about the author
Last updated: January 24, 2020
Diagnosis of pathology
It is easy to understand that the hemorrhoidal node has burst. The diagnosis suggests that the cause of bleeding is a venous lump. Bleeding after straining is typical for hemorrhoids.
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The absence of fever, purulent discharge, pain in other organs and other negative symptoms speak in favor of rectal bleeding. The doctor diagnoses a complication of hemorrhoids after a digital examination. When examined with an endoscope, the diagnosis of a ruptured hemorrhoid becomes final.
How dangerous is the condition?
Venous accumulation in the rectum is accompanied by pain in the anus. Therefore, when a hemorrhoid cone bursts, the patient feels relief after it comes out. The blood clot leaks out as heavy bleeding. This is the main danger when hemorrhoids break out.
The occurrence of a dangerous stage is accompanied by the following symptoms:
- increased body temperature;
- fever;
- pain in the anus;
- swelling of the tissues of the anus;
- the appearance of purulent discharge.
Sometimes patients pierce the node themselves. This can lead to unpleasant consequences for the patient's health. This often causes complications and necrotic processes. In addition, the patient may experience blood poisoning.
First aid for a ruptured hemorrhoid?
You need to know how to help yourself at home and stop the bleeding. First you need to calm down. Then remember the algorithm:
- lie down in a comfortable position,
- treat the wound with hydrogen peroxide,
- apply a cold compress to the anus area,
- insert a hemostatic suppository.
Attention! You can't be afraid or panic. One does not die from such bleeding. You need to calm down and begin therapeutic actions to prevent the knot from breaking through further.
A comfortable position during bleeding requires the obligatory elevation of the pelvic area. You should place a pillow under your buttocks and lie on your back or side. You can take a couple of valerian tablets to relieve tension.
Comfortable position
A compress means gauze soaked in cold water. As it warms up, it should be wetted again. It is recommended to place a tampon in the anus area. The gasket will not work because it does not apply mechanical pressure to the burst veins.
If you feel that the bleeding has stopped, you should not get up and go about your business. The initial cessation of blood flow is associated with the formation of a primary thrombus. It is unstable, weak, and only closes the defect, allowing time to wait for the formation of a stable fibrin clot. The primary thrombus easily breaks off at the slightest movement and bleeding resumes.
Primary thrombus
Inflammatory swelling is caused by swelling around the wound, so you can apply anti-inflammatory creams to the area. You need to make applications with healing ointments and balms (“Rescuer”, “Bepanten”).
Suppositories with a hemostatic effect contain phenylephrine. There are suppositories with Ginkgo Biloba, troxerutin (Troxevasin), and shark liver oil (Relief). For hemorrhoids that bleed frequently, it is helpful to keep them at home. You can apply a hemostatic sponge. To know what to do if hemorrhoids burst and are bleeding, you should prepare for the consequences in advance and familiarize yourself with the topic. The best solution is timely treatment.
If the bleeding does not stop, you need to call an ambulance. If the pain does not go away, you may need to administer narcotic analgesics, so you need to assess your condition and consult a doctor in time.
First aid for bleeding
Self-treatment in the following days
It is necessary to prepare decoctions and infusions of hemostatic herbs. You need to drink them for at least five days from the moment the lump ruptures to consolidate the effect and prevent further bleeding. The following herbs are purchased at the pharmacy:
- mountain arnica,
- sandy immortelle,
- knotweed (bird, pepper),
- St. John's wort,
- horse chestnut,
- stinging nettle,
- burnet,
- shepherd's purse,
- big plantain,
- swamp cudweed,
- yarrow,
- horsetail,
- Salvia officinalis.
You can make a collection or brew each separately. These decoctions are drunk and cool baths can be made from them, especially in cases of internal rupture. For the decoction, take one teaspoon of dry medicinal raw material per 0.5 liter of boiling water. The herb should be boiled over low heat, cooled, and strained. For external use, place in the freezer and freeze into cubes.
Compress for bleeding
On the day of bleeding - bed rest. Over the next five days, you need to avoid exertion and carrying heavy things. Training is cancelled, except for swimming and yoga. The wound on the lump is fresh and fragile. The new load will provoke the next bleeding, which will be stronger than the previous one.
To prevent straining, you should take a laxative. The medicine should liquefy the stool and make it easier to pass. It is better to choose drugs from the groups of prebiotics and oils.
Important! After bleeding, you should follow a special diet for a week. Kefir and pureed vegetable soups are recommended. This will allow you to naturally regulate the passage of food and avoid constipation.
Prebiotics are substances that accompany the vital activity of normal intestinal microflora. They are food components that are not absorbed or digested. Their role is associated with fermentation by the microflora of the human large intestine. Substances of this class stimulate lactobacilli, which then cause increased peristalsis and normal stool.
Laxative oils act by coating the intestinal mucosa and feces. They give a “sliding effect”. Such a drug is Castor oil. The dose should be selected, starting with the minimum: one to two teaspoons at night. When taking, a gag reflex may occur, so it is recommended to drink through a straw. The stool should appear in the morning without pain or cramping.
Before defecation, you need to insert a suppository with an antispasmodic (Betiol, Anuzol, Belladonna Suppositories) 15 minutes before defecation. These drugs act on the muscular lining of the intestine. They do not relieve spasm from the vessels themselves, so bleeding does not increase.
After stool, approximately 30 minutes later, suppositories with an astringent, venotonic, and vascular-strengthening effect are used (Ginkor Procto, suppositories with solcoseryl, sea buckthorn). They promote healing of the wound surface. They also remove the effects of bleeding. Taking suppositories with anesthetics helps with bleeding. They “freeze” the mucous membrane and cause persistent vasospasm. This relieves pain impulses.
To resolve blood clots and hematoma after bleeding, drugs with heparin should be used. They can be used only after the bleeding has completely stopped.
It happens that when a lump ruptures, in addition to bleeding, pus comes out of the lump. This means that an abscess has opened. Here you should add antibiotic therapy and washing the wound with an antiseptic solution. Be sure to see a proctologist.
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Which doctor to contact, possible complications of untimely treatment
If hemorrhoids burst for any reason, you need an urgent consultation with a proctologist (coloproctologist). In his absence, you need to contact a surgeon. When bleeding hemorrhoids go untreated, serious complications develop:
- thrombosis and strangulation of nodes with necrosis and sepsis;
- severe pain syndrome;
- anemia;
- weeping with the development of dermatitis and eczema of the perianal area, rectal fissures;
- the addition of a secondary infection with suppuration, paraproctitis, abscess formation, fistulas of the anus and rectum;
- in rare cases, malignancy of the node.
When is surgery necessary?
Minor bleeding will stop on its own if you use the correct algorithm of actions. Hemorrhoids can burst without preconditions.
You definitely need to see a doctor. Often those whose bleeding does not stop on its own end up on the operating table. Then they operate according to vital indications. It's always worse than planned. Because the disease does not take into account the patient’s plans, does not allow examination, preparation for surgery, or collection of material resources.
In case of massive bleeding, the surgeon, under local anesthesia, sutures the edges of the veins. It can also excise adjacent tissue, fix a node, and stop bleeding. The operation is an emergency, the goal is to save life. Therefore, it is necessary to properly treat the disease from the very beginning.
Hemorrhoids can burst during pregnancy. The uterus with the fetus puts pressure on the venous plexus, causing it to become congested. Carrying a child is often accompanied by constipation. Constipation and congestion are risk factors for lump rupture and dangerous complications. For pregnant women, this situation is worse, because the woman’s body during this period has a natural physiological tendency to reduce coagulability, which is necessary for normal gestation. The use of hemostatic drugs during pregnancy is associated with risks for the child.
Hemorrhoids during pregnancy
For frequently and profusely bleeding hemorrhoids, it is important to consult a proctologist. You need to undergo all necessary examinations. At the same time, decide on the issue of planned surgical intervention.
What not to do if hemorrhoids appear
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Do you want to get rid of hemorrhoids faster? Pay attention to the list of what should not be done if the disease manifests itself or is chronic:
- lift weights;
- engage in motorcycling, cycling, horse riding;
- supercool;
- wear tight underwear and tight clothes that put pressure on the pelvic organs;
- sit on soft pillows and other surfaces;
- eat irregularly, preferring spicy, fatty foods;
- do sudden physical exercises involving holding your breath.
