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Internal hemorrhoids vs. rectal flare

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Ulcerative Colitis
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ilovefood
Regular Member
Joined : Dec 2010
Posts : 111
Posted 10/29/2020 11:07 AM (GMT -7)
Hi all, I am trying to figure out which of the above I am dealing with. Symptoms are some blood (twice in past week on nonconsecutive days) and rectal soreness (mostly when sitting). So I think and am really hoping it’s hemorrhoids. My BMs have if anything been somewhat firmer recently, I only have one a day, and I have no other UC symptoms like urgency or cramping. But then again, I don’t think I had those at the start of previous flares either.

I went in to my practice today hoping they could do a flex sig, but evidently they now send you to the endoscopy center for those as well. (***?). Doctor was unavailable, nurse practitioner felt up there and said she thought hemmies but couldn’t be sure. (Makes me think of my first diagnosis now nearly 30 years ago— my dad’s old crusty GP stuck a finger up there, took it out and stated, flatly and immediately, “This is not hemorrhoids. This is colitis.” Guess the NP did not have the experience to do that!) Anyway, waiting on blood tests for inflammation and may try to drive back for the flex sig. Anyone have any experience with telling when it’s a flare and when it’s a bad hemmie?
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quincy
Elite Member
Joined : May 2003
Posts : 32472
Posted 10/29/2020 8:50 PM (GMT -7)
Some blood sporadically compared to friable tissue while in a flare...flare bleeding would be consistent.

I would more assume a hemmie.

Were you not prescribed hemmie meds and do you have UC rectal meds?

q
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iPoop
Forum Moderator
Joined : Aug 2012
Posts : 16177
Posted 10/30/2020 6:49 AM (GMT -7)
Ah yes, the age old quandary: is it a flare or just a hemorrhoid? Many puzzle over this nearly to the point of madness.

You can test for a flare with an Inflammation test like Calprotectin stool test or C-Reactive Protein blood test. Or you can get endoscopy.

Alternatively, test for hemorrhoids. Go to your pharmacist, ask for over-the-counter preparation H (or generic store brand equivalent), and try it for a couple weeks to see if the blood and sitting pain clears up. I've got some with a nozzle that goes up the bumm, squeeze to apply some ointment there. Use it when my hemorrhoids act up.
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ilovefood
Regular Member
Joined : Dec 2010
Posts : 111
Posted 11/2/2020 11:48 AM (GMT -7)
Good news, everyone! (And many thanks for the replies.) My doc wanted to do the sigmoidoscopy (quite a blast from the past!) and the colon itself actually looked great. (Yay!). It was hemmies!

So, here to say you can definitely have some on-again, off-again blood and pretty bad rectal pain and it may just be an internal hemmie. Always good to check, though!

Phew.
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quincy
Elite Member
Joined : May 2003
Posts : 32472
Posted 11/2/2020 10:41 PM (GMT -7)
Good news...and what did the doc rx for the hemmies?

q
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garyi
Veteran Member
Joined : Jun 2017
Posts : 2055
Posted 11/3/2020 8:19 AM (GMT -7)

ilovefood said...
Good news, everyone! (And many thanks for the replies.) My doc wanted to do the sigmoidoscopy (quite a blast from the past!) and the colon itself actually looked great. (Yay!). It was hemmies!

So, here to say you can definitely have some on-again, off-again blood and pretty bad rectal pain and it may just be an internal hemmie. Always good to check, though!

Phew.

Congrats!

Only with UC can having an internal hemmie be 'good news.'
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ilovefood
Regular Member
Joined : Dec 2010
Posts : 111
Posted 11/3/2020 8:54 AM (GMT -7)
It’s actually been feeling better for several days now. So no meds— he thinks it might have had a fissure but is now healed up.

Hey, I’m close to turning 54 and if hemorrhoids are the worst of my problems, I’ll take it!
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