Hemorrhoids in men – why is it so difficult to talk about it?

Content author: physician. Kamil Smok, surgeon · Editorial work: Editorial team of Wyspa Medycyny Przyjaznej · Medical review: lek. Kamil Smok · Date of creation: 07.08.2026 · Date of review: 07.08.2026 · Updated: 07.08.2026

The article is of an educational nature and does not replace a proctological examination. Heavy bleeding, black tarry stool, weakness, fainting, fever with severe pain around the anus, and bleeding in a person taking anticoagulants require immediate medical attention. Rectal bleeding, changes in bowel habits and weight loss always require diagnosis, regardless of the presence of hemorrhoids.

The most important information at a glance

• Hemorrhoids are a normal anatomical structure that every person has. Only their enlargement and symptoms become a disease.
• Hemorrhoidal disease is one of the most common ailments in adults and affects both sexes to a similar extent.
• Men usually present later than women - more often in the advanced stage and more often only when the pain is severe.
• The proctological examination is short, takes place in a separate office and does not require full undressing.
• The patient may stop the examination at any time. If the area is painful, the doctor applies local anesthesia or postpones part of the examination.
• Early stages are treated with conservative methods and outpatient procedures. Postponing your visit narrows these options.
• The most dangerous consequence of delaying is not the progression of the disease itself, but the attribution of symptoms to hemorrhoids that do not apply to them.
• Rectal bleeding should never be explained as hemorrhoids without examination - this is the most common mechanism for delaying the diagnosis of colorectal cancer.
• Chronic bleeding, even minor, can lead to iron deficiency anemia.
• There is usually no need to prepare for a proctological visit - the rules are confirmed by registration.

Find out more about the specialist

Doctor. Kamil Smok is a surgeon at the Island of Friendly Medicine in Gdańsk. He deals with surgery and proctology, including the diagnosis and treatment of hemorrhoidal disease. For a proctologist, examining the anal area is a daily, routine activity - the same as auscultating the lungs for an internist.

Meet the doctor. Kamila Smoka

Why do men delay?

In the office, the same scenario repeats itself regularly: a patient who noticed the first symptoms two or three years ago comes only when he cannot sit down or when the bleeding scares the family. The reasons vary, but a few come back most often.

The idea of ​​the test is worse than the test itself. This is the most common barrier. In the patient's imagination, the visit looks dramatic and long. In fact, the finger test takes several seconds and the entire assessment takes several minutes. The gap between imagination and reality can be huge - and this is what costs patients years of delay.

The feeling that this is a particularly embarrassing matter. The intimate area, anal examination, the need to talk about bowel movements - for many men it is a combination of topics that are not discussed anywhere. However, it is worth realizing the asymmetry: what is an exceptional situation for a patient, for a proctologist is the content of an ordinary working day.

Hope it will go away on its own. Symptoms of hemorrhoidal disease often disappear for some time and then return. Each such break confirms the belief that the problem has solved itself. Meanwhile, the disease progresses in stages, and symptom-free periods are a normal part of it.

The belief that it is a problem of older people. It is not. Symptoms often appear in men in their thirties and forties, especially with sedentary work, strength training with heavy loads, constipation and long journeys.

Fear of what the doctor will say. This is a barrier less often mentioned, but real. A patient who notices blood sometimes prefers not to know. The paradox is that in the vast majority of cases the conversation ends with a diagnosis of hemorrhoids or a fissure - that is, relief. And if the cause is more serious, early detection determines the prognosis.

Self-treatment. The availability of over-the-counter preparations means that the patient uses subsequent ointments and suppositories for years. The symptoms become less severe, so the visit seems unnecessary - and at the same time the symptom is treated without knowing the cause.

What does a proctological examination really look like?

Since the main barrier is imagination, it is worth replacing it with something concrete. Below is the course of a typical visit.

A few things are worth knowing in advance. There is no need to fully undress - just expose the area and keep the patient covered. The examination takes place in a separate office, without any other people. A lubricating gel is used, and in case of painful lesions, local anesthesia is used or part of the examination is postponed. The patient can stop the examination at any time, just say so.

There is usually no special preparation needed for a standard proctological visit. Some centers recommend having a bowel movement or taking an enema before your visit - the rules vary between facilities and it is worth confirming them when registering.

What happens when a patient delays

Postponing an appointment has real consequences - and it's not just about suffering in the meantime.

• Narrow down treatment options. Early stages of hemorrhoidal disease are treated conservatively and on an outpatient basis. In advanced stages, the range of possible solutions decreases and treatment becomes more burdensome.
• Acute complications. A blood clot in a hemorrhoid may appear suddenly and exclude the patient from normal functioning for several days.
• Anemia. Chronic bleeding, even minor, leads to iron deficiency over time. It manifests itself as weakness, shortness of breath on exertion and worse condition - symptoms that the patient does not associate with hemorrhoids.
• Established habits. The longer constipation, pushing and sitting on the toilet last, the more difficult it is to change them and the faster the disease progresses.
• Impact on everyday life. Pain when sitting, avoidance of physical activity, worse sleep, tension before each bowel movement.
• Risk of missing another cause. This is the most serious consequence and deserves a separate discussion.

The most important reason not to postpone your visit

Most adults have hemorrhoids. This means that in a man with rectal bleeding they can almost always be diagnosed - regardless of whether they are responsible for the symptoms. And that's the trap.

A patient who explains his bleeding as hemorrhoids for years may have a completely different cause of the problem: polyps, inflammatory bowel disease or colon cancer. These diseases may have few symptoms in their early stages, and bleeding is often their first and only symptom.

Special vigilance is required when bleeding is accompanied by:

• blood mixed with the stool and not only on its surface,
• change in the rhythm of bowel movements lasting for several weeks,
• change in the shape of the stool,
• feeling of incomplete bowel movement,
• unintentional weight loss,
• weakness, pallor and shortness of breath on exertion,
• first bleeding in life after the age of 45–50. years of age,
• family history of colon cancer.

The conclusion is simple and worth remembering: the diagnosis of hemorrhoids does not exclude another, coexisting cause of bleeding. Therefore, the visit serves not only to treat the symptom, but above all to determine its source.

What are hemorrhoids and where do the symptoms come from

It is worth dispelling a basic misunderstanding. Hemorrhoids are not a disease in themselves - they are normal vascular plexuses in the anal canal that every person has from birth. They participate in the mechanism of stool and gas continence.

We only talk about hemorrhoidal disease when these plexuses become enlarged, hyperemic and the supporting structures weaken. Then symptoms appear: bleeding, feeling of prolapse, itching, moistness of the area, feeling of incomplete bowel movements, discomfort when sitting.

It is characteristic that internal hemorrhoids usually do not hurt - the upper part of the anal canal has poor sensory innervation. Bleeding can be painless, which further contributes to downplaying it. Pain occurs in the presence of complications, external changes or a coexisting anal fissure.

Contributing factors include constipation and urge to defecate, long sitting - also in the toilet with a telephone - sedentary work, lifting and strength training with breathing, obesity, low-residue diet, insufficient hydration and chronic diarrhea.

What can be done today

These actions do not replace consultations, but they actually reduce symptoms and slow down the progression of the disease. Common goal: bowel movements should be soft, regular and quick.

• more fiber: vegetables, fruits, whole grains, legumes,
• adequate amount of fluids during the day,
• responding to the need to have a bowel movement instead of postponing it,
• short visits to the toilet - without a phone and without incubation,
• giving up pushing; in case of difficulties, it is better to soften the stool than to struggle,
• footrest for the feet, changing the bending angle and facilitating defecation,
• regular physical activity and breaks from long periods of sitting,
• during strength training: proper breathing, without holding the air under heavy load,
• gentle hygiene - washing with lukewarm water instead of rough paper,
• sitz baths in lukewarm water with severe symptoms.

Over-the-counter preparations can alleviate symptoms, but they have one drawback: they effectively postpone the visit. If you use them for more than a few weeks or the symptoms return after discontinuation - this is a signal that diagnosis is needed, not another package.

The most common myths

• "Hemorrhoids are a problem for older people." No. Symptoms often appear after the age of thirty, especially with sedentary work and training with heavy loads.
• "Proctological examination is very painful." No. It can be embarrassing, but it doesn't last long; for painful lesions, local anesthesia is used.
• "You must undress completely." No. It is enough to expose the area and the patient remains covered.
• "If it doesn't hurt, it's not hemorrhoids." Conversely - internal hemorrhoids usually do not hurt, and bleeding can be painless.
• "It will go away on its own." Symptoms may be intermittent, but the disease progresses. Breaks in symptoms are a normal part of the disease.
• "All you need is some ointment from the pharmacy." The ointment alleviates the symptom, but does not determine the cause and may mask a more serious problem.
• "Blood from the anus is definitely hemorrhoids." No. This is the most common cause, but hemorrhoids may coexist with another disease.
• "The doctor will evaluate me." No. For a proctologist, this is a daily, routine activity - one of a dozen or so activities that day.

Have you been putting off this visit for months or years?

The test takes a few minutes and is intended to determine the cause of symptoms - not to evaluate the patient. The earlier, the more treatment options and the lower the risk of missing another cause.

Proctology at the Island of Friendly Medicine in Gdańsk

At the Island of Friendly Medicine doctor. Kamil Smok consults patients with ailments in the anal area: bleeding, pain, lumps, itching and symptoms of hemorrhoidal disease. The visit includes a conversation, proctological examination and determining whether conservative treatment, surgery or further diagnosis of the large intestine is needed.

The purpose of the consultation is to determine the cause of the symptoms, not to alleviate the symptoms. If the clinical picture or the patient's age require it, evaluation of the entire large intestine is recommended. The current scope of treatments, availability of dates, prices and rules of preparation for the visit should be confirmed during registration.

Find out more about the medicine. Kamilu Smoku Proctological consultation Rectal bleeding

What to ask the doctor?

• Are my symptoms really due to hemorrhoids?
• What stage is the disease and what does this mean for treatment?
• Do I need further colon diagnostics?
• Should I get a blood count for anemia?
• What treatment methods are available in my case?
• Is the procedure necessary or can I start with conservative treatment?
• How long will treatment take and when will I notice improvement?
• How to change habits to reduce the risk of relapse?
• Do strength training and sedentary work require modifications?
• Can the medications I take make my symptoms or bleeding worse?
• What symptoms should prompt an urgent visit?
• When should I go for a check-up?

FAQ - hemorrhoids in men

Are hemorrhoids a common problem?

Yes, hemorrhoidal disease is one of the most common ailments in adulthood and affects both sexes. Hemorrhoids are a normal anatomical structure, and only their enlargement and symptoms become a disease.

Does a proctological examination hurt?

Usually no. It can be embarrassing and may be felt, but the finger test lasts several seconds. In case of painful lesions, local anesthesia is used or part of the examination is postponed.

Do you have to undress completely?

No. The patient undresses from the waist down, lies on his side with his legs tucked in and remains covered. The examination takes place in a separate office, without any other people.

How to prepare for the visit?

There is usually no special preparation needed for a standard proctological visit. Some centers recommend having a bowel movement before the test or taking an enema - it is worth confirming the rules when registering.

Can I stop the test?

Yes, anytime. Just tell your doctor. The examination can also be divided into stages or completed at the next visit if the area is very painful.

Do hemorrhoids always hurt?

No. Internal hemorrhoids usually do not hurt because the upper part of the anal canal has poor sensory innervation. Pain occurs with complications, external changes or a coexisting anal fissure.

Does bleeding always mean hemorrhoids?

No. This is the most common cause, but hemorrhoids may coexist with polyps, inflammatory bowel disease or colon cancer. Therefore, bleeding should not be explained by hemorrhoids without examination.

Will it go away on its own?

Symptoms are intermittent and may disappear for some time, but the disease usually progresses. Breaks in symptoms are a normal part of the disease and do not mean cure.

Are pharmacy ointments enough?

They may relieve symptoms but do not determine the cause. If you use them for more than a few weeks or symptoms return after discontinuation, you need a test, not another package.

Does strength training promote hemorrhoids?

Lifting heavy weights while holding your breath increases intra-abdominal pressure, which may contribute to symptoms. This does not mean you have to give up training, but it is worth discussing your breathing technique with your doctor.

Does delaying the visit matter?

Yes. Early stages are treated conservatively and on an outpatient basis, and postponing the visit narrows the options. However, the most serious risk remains missing another cause of symptoms.

Who consults such ailments at WMP?

On the WMP website, MD. Kamil Smok is described as a surgeon specializing in surgery and proctology. A proctological consultation includes an examination and determination of further proceedings.

Sources

• Island of Friendly Medicine, MD. Kamil Smok: https://www.wyspamedycynyPrzyjaznej.pl/pl/kamil-smok-zdrowia-gdansk
• Wyspa Medycyny Przyjaznej, proctological consultation: https://www.wyspamedycynyPrzyjaznej.pl/pl/konsultacja-proktologiczna-gdansk
• NHS, Piles (haemorrhoids): https://www.nhs.uk/conditions/piles-haemorrhoids/
• NHS, Rectal bleeding (bleeding from the bottom): https://www.nhs.uk/symptoms/rectal-bleeding/
• NHS, Anal fissure: https://www.nhs.uk/conditions/anal-fissure/
• NHS, Constipation: https://www.nhs.uk/conditions/constipation/
• NHS, Bowel cancer: https://www.nhs.uk/conditions/bowel-cancer/
• NHS, Iron deficiency anemia: https://www.nhs.uk/conditions/iron-deficiency-anaemia/
• NICE Clinical Knowledge Summaries, Haemorrhoids: https://cks.nice.org.uk/topics/haemorrhoids/
• NICE, Suspected cancer: recognition and referral (NG12): https://www.nice.org.uk/guidance/ng12