When to See a Doctor for Hemorrhoids: 7 Red Flags You Shouldn’t Ignore

Most hemorrhoids can be treated at home — but some symptoms require medical attention.

Ignoring them can lead to complications like anemia, infection, or missing a more serious diagnosis (like colorectal cancer).

Here are the 7 red flags that mean it’s time to call a doctor.

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🚩 1. Heavy or Persistent Bleeding

• Soaking through toilet paper
• Blood in stool (not just on surface)
• Bleeding lasts >7 days

⚠️ Why it matters: Can lead to anemia. May indicate fissure, polyp, or cancer.

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🚩 2. Severe Pain That Doesn’t Improve

• Pain prevents sitting, walking, sleeping
• Not relieved by ice, sitz baths, or OTC meds
• Worse over time

⚠️ Why it matters: May be thrombosed hemorrhoid needing drainage.

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🚩 3. Hard, Bluish Lump Near Anus

• Sudden appearance
• Extreme tenderness
• May feel “hot” or swollen

⚠️ Why it matters: Classic sign of thrombosed external hemorrhoid — often needs in-office drainage.

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🚩 4. Prolapsed Tissue That Won’t Go Back In

• Tissue bulges out and stays out
• You can’t push it back manually
• Feels “stuck” or strangulated

⚠️ Why it matters: Grade IV internal hemorrhoid — requires surgical evaluation.

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🚩 5. Symptoms + Age >45

• Any rectal bleeding after 45
• Change in bowel habits
• Unexplained weight loss

⚠️ Why it matters: Risk of colorectal cancer increases with age. Never assume it’s “just hemorrhoids.”

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🚩 6. Symptoms Return Frequently

• Hemorrhoids keep coming back every few weeks
• No improvement with diet/lifestyle changes

⚠️ Why it matters: May need procedure (banding, sclerotherapy) for long-term relief.

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🚩 7. Signs of Infection

• Fever or chills
• Pus or foul-smelling discharge
• Red, hot, swollen skin around anus

⚠️ Why it matters: May be abscess or fistula — needs antibiotics or drainage.

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What to Expect at the Doctor

1. History: Questions about symptoms, diet, bowel habits
2. Visual Exam: Looking at anal area
3. Digital Exam: Gloved finger to feel for internal hemorrhoids
4. Anoscopy: Short tube to view inside rectum (painless)
5. Referral: To proctologist or colorectal surgeon if needed

✅ Pro tip: Write down your symptoms, dates, and what you’ve tried — helps your doctor make a faster diagnosis.

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FAQs

Can I go to my primary care doctor or do I need a specialist?

Start with primary care — they can diagnose and treat most cases. If you need procedures, they’ll refer you to a proctologist.

Will the exam be painful?

Visual and digital exams are usually painless. Anoscopy may feel pressure but not pain. Tell your doctor if you’re anxious — they can go slower.

What if I’m embarrassed?

Doctors see this every day — no judgment. Your health is more important than embarrassment. Many clinics offer same-gender providers if that helps.

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