Hemorrhoids and bleeding seems to be a pair of “fixed CP”, coupled with the common nature of hemorrhoids and bleeding is generally not large, so many hemorrhoid patients for bleeding is not strange. But there is a class of patients for the blood in the stool must be careful and cautious, timely treatment, they are the existence of coagulation disorders of patients. 1, coagulation disorder for hemorrhoid patients in the end how much impact? Coagulation disorder refers to the blood clotting disorder caused by blood vessel wall abnormality, coagulation factor deficiency, thrombocytopenia, medication factors and so on, thus causing an abnormal bleeding performance. Early symptoms include subcutaneous bleeding, petechiae, nosebleeds, bleeding gums and increased menstrual flow in women. If hemorrhoid patients are accompanied by blood clotting disorders, the common symptom in life is manifested as perianal localized persistent bleeding, repeated bleeding. Long-term this will lead to anemia, and coagulation disorders belong to most of the contraindications to surgery, so the choice of treatment, slightly limited. Therefore, for this kind of special hemorrhoid patients, of course, also need to make special treatment plan. 2, what are all the key points of hemorrhoid treatment for patients with coagulation disorders? – Main treatment modalities Since patients with coagulation disorder hemorrhoids belong to the group of people who are contraindicated to surgery, conservative treatment is preferred when choosing a treatment plan, i.e. general treatment and medication. Patients without obvious symptoms can be treated with general treatment. Such as lifestyle changes, that is, appropriate exercise, smoking and alcohol; adjust the diet, more intake of high-fiber foods, drink more water; develop good defecation habits, avoid long squatting, generally will control the defecation time in about 3-5 minutes can be. In addition, hemorrhoids acute episodes can also choose warm water sitz bath, 2-3 times a day, can reduce inflammation and edema, relieve perianal discomfort and itching. But pay attention to the water temperature should not be too hot, so as not to burn. General treatment effect is not good patients can choose drug treatment, including local topical drugs can be oral drug treatment. Common topical medications include ointment containing local anesthetics such as lidocaine, which can improve pain, and ointment containing glucocorticoids such as hydrocortisone, such as hydrocortisone cream, which can improve itching. Oral medication can choose some proprietary Chinese medicines such as hemorrhoid fast Ning tablets, locust angle pill, clear fire gardenia oatmeal tablets, etc., to promote hemorrhoidal venous reflux, reduce hemorrhoidal hemorrhage, make hemorrhoidal oedema subside, and is conducive to recovery. When hemorrhoids secondary infection, attention should be paid to the application of anti-infective drugs, such as erythromycin ointment, etc., in order to control the infection. – Other treatment options In case conservative treatment is ineffective and the patient’s discomfort is more obvious, injection therapy can be considered. This method is through the injection of sclerosing agent to make hemorrhoids and hemorrhoidal masses around the production of aseptic inflammatory reaction, submucosal tissue fibrosis, so as to achieve hemorrhoidal mass atrophy, for the treatment of Ⅰ, Ⅱ bleeding internal hemorrhoids of the better effect. After perianal local anesthesia, an anoscope is inserted to observe the location of hemorrhoidal cumbersome, and then 2-3 ml of sclerosing agent is injected into the submucosal layer of hemorrhoids. if the effect of one injection is not satisfactory, the injection can be repeated once after one month; if there are more hemorrhoidal lumps, it can also be divided into 2-3 injections. This method is relatively less traumatic, and patients with coagulation disorders can also choose it under the guidance of the doctor as appropriate. 3, the use of anticoagulant drugs patient precautions For patients who are using anticoagulant drugs, generally avoid the rubber band ligation. Because there is still controversy about whether anticoagulant drugs will increase the risk of postoperative bleeding collagen ligation results, but in order to ensure the safety of the patient’s treatment, clinical still recommended to avoid collagen ligation treatment, the patient can communicate with their own doctors, choose other safer treatment. Hemorrhoidal bleeding is not a small matter, do not take bleeding as a common thing, we can not treat the disease by chance, standardize the understanding of the disease, active treatment of the disease, is the best choice. References [1] China hemorrhoid diagnosis and treatment guidelines (2020)[J]. Colorectal and anal surgery,2020,26(05):519-533.