I have had LIS surgery two months ago.  Now I think I have a hemmorhoid.  Each time I have a BM there is a moderate amount of pain during the BM and what I observe as quite a bit of blood in the toilet water following the BM.  I've called with my CRS but only get to speak with the physician assistant.  I've been religiously following the diet suggestions, taking stool softeners, my BMs are Bristol State 4 each time.  But the amount of blood I see in the toilet water following each BM disturbs me.  Since I'm now on vacation 1500 miles away from my regular doctor, I've asked what is the one warning sign that would cause me to go to the emergency room, and the response from the CRS physician assistant was "when you can't stand the pain".  Should I just deal with the loss of blood during each BM or is this something to really worry about.  I have good days and uncomfortable days with regard to the pain.  It is always there and if it gets too uncomfortable I usually take two Tylenol to help.  The pain is not unbearable but always there.   Just asking for a bit of advice from the group.
   
    Karin Anne

When I had bad internal hemmorhoids I used to see loads of blood in the toilet... So it is possible that's what you have.
I would maintain your diet and stool softeners whilst on holiday as best you can, then book in to see the CRS as soon as you get home to have things checked over to be on the safe side.
Try not to worry... And enjoy the rest of your vacation.
OMB x

Huh, now I'm wondering if I have hemmorhoids instead (on top of) fissures due to the similar loads of blood in the toilet. No pain really though, which is very strange I think. I guess it's not painful because it's soft.
That's terrible that that's happening on vacation. Ugh, I can only imagine... If there's not a lot of pain, I wouldn't worry too much I think. Plus, you can't really do much until you get back and it's probably better to see your CRS. I'd say try to enjoy your vacation, unless it's a real significant amount of time before you're back.

Hiya,
Also sorry you're having to deal with this all on vacation!
Unfortunately, hems do seem to be a side effect of any anal surgery (certainly in my case they were) and they still come back to haunt me.....
I have also just got back from holiday and through a fair bit of diahrroea, aggravated one of my internal hems, which bled a lot and stung too after a BM - fortunately, the stinging disappeared completely an hour or so later and my stools got better, so all was OK. They can bleed a lot and that's frightening but generally, they settle and are pretty harmless, so I echo the above post and say try not to stress too much, keep your bowels as regular and soft as normal and just give yourself time. It should calm down soon for you hopefully.......

Sorry to hear about your worries. Internal hemorrhoids present with painless bleeding, whereas external hemorrhoids are usually symptomless unless they get thrombosed (where a blood clot clogs a vessel in the hem) - this is really painful but will resolve over a couple of days on its own.
However even with the int hem bleeding, the amount of blood loss is usually much less than it seems.. Think of how a few drops of red dye can turn an entire bowl vivid. If it is really an int hem, you shouldn't lose so much blood to turn anemic - symptoms to look out for would be rapid heart rate (>100), pale and cold, clammy extremities (hands, feet).
I agree with the other's views - continue with your regime, relax and enjoy the vacation as much as possible, but do get yourself checked out early if the level of pain increases exponentially, or when other alarming symptoms develop.

Hi All:
Thank you so much for the helpful advice.  It is enormously comforting.  Usually the past few days the irritation/pain level subsides very quickly following my morning BMs.  I've walking a bit also helps quite a bit with reducing the pain level following the BM.  My level of pain during the BM is no where near what experienced the immediate week following surgery so that is a good thing for me. As too the cold/clammy feeling.  I'm from Florida and am on vacation in Plymouth, Massachusetts right next to the ocean and the past two days have rainy and overcast so my ability to distinguish between "Real Clammy" and what the weather is throwing at me is kind of funny.  Overall I'm in very good spirits and very much enjoying the vacation time here with friends.  So I'm doing pretty good.  My concern for not getting any real information from the CRS staff when I called last week, really set me off a bit and I got a bit scared about my BMs.  Now that the very nice folks here have given me some good information I'm much more calm about what is going on.    Thanks again,  and Cheers,   Karin