Case history
Case history #1
A 42-year-old man presents to his primary care physician complaining of a 3-month history of lower intestinal bleeding. He describes the bleeding as painless, bright blood appearing on the tissue following a bowel movement. He has had 2 episodes recently where blood was visible in the toilet bowl following defecation. He denies any abdominal pain and any family history of gastrointestinal malignancy. Physical examination reveals a healthy man with the only finding being bright blood on the examining finger following a digital rectal examination.
Case history #2
A 28-year-old woman presents complaining of rectal pain of 3 days' duration. She states that on the day before the onset of symptoms she had been moving boxes at her home. She describes the pain as sharp and present constantly, but worse with bowel movements or sitting. She denies any fevers or chills or perianal discharge. Physical examination reveals a 2-cm, painful, bluish lesion adjacent to the anal canal.
Other presentations
Haemorrhoids can also present with complaints of excess tissue surrounding the anal canal, causing pruritus or difficulty in cleaning following a bowel movement.
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