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Learn more about what causes them, other associated symptoms, tips for relief, and information on surgery. Hemorrhoids, also called piles, are enlarged veins in your rectum and anus. But for others, they can lead to itching, burning, bleeding, and discomfort. The bleeding may result in bright red blood in the stool as well as maroon colored or black stool. The bleeding also may be occult (not visible with the human eye). The common causes of rectal bleeding from the colon include anal fissure, hemorrhoids, diverticulosis, colon cancer and polyps, colonic polyp removal, angiodysplasias. At other times, hemorrhoids may require specialist treatment or surgery. Unusual bowel movements, including hard stools and diarrhea, can cause the tender lining of the anus to tear. I have no skin tags and almost no bleeding, but a constant dull ache for many, many hours after a bowel movement. Fourth-degree hemorrhoids hemorrhoids that prolapse and cannot be pushed back in the anal canal. Fourth-degree hemorrhoids also include hemorrhoids that are thrombosed. The colon above the rectal area needs to be examined to exclude other important causes of bleeding other than hemorrhoids such as. If all else fails, surgery may be the last resort, as it may have secondary complications such as infection, urinary retention, bleeding and anal strictures. A hemorrhoidectomy is reserved for severe and persistent hemorrhoids that fail to respond to more conservative measures.