Bob VogelQ. I am a T8 complete para, 12 years post-injury. Lately I’ve been noticing some bleeding when I do my bowel program. Other wheelers I hang out with say it is probably hemorrhoids. This has me worried. A friend’s hemorrhoids got so bad he needed to have them surgically removed and it took over two weeks of bed rest to recover.

What are hemorrhoids? Are they more common in people with SCI? Can they be prevented or managed to avoid surgery?

— Steve

A. Steve, hemorrhoids are swelling of veins in the rectum and around the anus. When they swell too much, they lose their elasticity and bulge out in sac-like protrusions. Unfortunately hemorrhoids are extremely common in people with SCI, and the longer you have been injured, the more likely you are to get them. Clinicians I spoke with say that in people with SCI, the main cause seems to be chronic minor irritation or trauma that happens during a bowel program.

Although a major sign of hemorrhoids in people with SCI is bleeding during a bowel program, never assu