Hemorrhoids can progress to a stage where there is rectal bleeding characterized by bright red blood that is separate from the stool. This is caused by the severe tortuosity and dilation of the superior hemorrhoidal veins. As the hemorrhoids worsen, congestion and dilation of the hemorrhoidal venous plexus become more pronounced. In the presence of bowel dysfunction and hard stools, the hemorrhoidal venous plexus can be injured, leading to rupture and bleeding. Initially, the bleeding is typically minimal yet frequent. Over time, this may lead to frequent and substantial bleeding. Chronic bleeding from hemorrhoids can cause chronic blood loss anemia, which impacts the physical and mental health of the individual.