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Internal hemorrhoids
What should I do if internal hemorrhoids have prolapsed and not retracted for two or three days?
If internal hemorrhoids prolapse and cannot be reduced back into the anus on their own, and even after they are manually repositioned by a patient or a doctor they prolapse again, it may indicate that local incarceration or necrosis has occurred. It is recommended to undergo surgery as soon as possible to prevent circulatory disturbances from prolonged prolapse, which can lead to necrotic changes in the local muscle tissues. The surgical methods primarily include hemorrhoidectomy with mixed hemorrhoid stripping and ligation, combined with an internal excision procedure. Additionally, sclerotherapy injections for internal hemorrhoids can be used to improve the overall treatment effects. After surgery, avoid straining during bowel movements to prevent local pain or bleeding.
Can internal hemorrhoids with prolapsed thrombus shrink?
If internal hemorrhoids prolapse and form thrombosis, it indicates poor local blood circulation in the internal hemorrhoids and damage to the hemorrhoidal veins, leading to thrombosis. Such thrombosis will not shrink and will cause a significant foreign body sensation in the anus and anal distension pain. For cases where internal hemorrhoids prolapse and form thrombosis, it is crucial to go to the hospital's colorectal surgery department for timely surgical treatment. Surgical options include internal hemorrhoidal banding, internal hemorrhoidectomy, or TST. Postoperatively, patients should use anal cleansers and medications like golden ointment and red oil ointment gauze for dressing changes to promote wound healing. Furthermore, patients should be cautious with their diet, avoiding spicy, stimulating, and dry foods to prevent irritation to the wound, which could lead to infection, inflammation, or swelling, and thus significant pain. Additionally, patients should maintain hygiene around the anal area and wear loose, breathable cotton underwear.
Will internal hemorrhoids falling out be painful?
If internal hemorrhoids can retract back into the anus on their own after prolapse, they generally do not cause severe pain. However, if the prolapse lasts for a long time or occurs repeatedly, and if the mucous membrane of the hemorrhoid core ruptures and bleeds due to friction from walking or exercising, this can lead to pain due to the localized prolapse. It may even lead to congestion and swelling of the local hemorrhoid core after prolapse, thereby causing inflammatory edematous hemorrhoids, further intensifying the pain. Therefore, to avoid pain from internal hemorrhoids, or for those that prolapse and cannot retract back, it is advisable to actively use medications for treatment at the early stages of prolapse. For recurrent cases, direct internal hemorrhoid ligation surgery can also be performed.
How to treat bleeding from internal hemorrhoids?
In clinical practice, for internal hemorrhoids with bleeding, conservative medication or surgical treatment are often used. The specific treatment method mainly depends on the severity of the bleeding from internal hemorrhoids and whether the patient also has anemia. For early-stage internal hemorrhoid bleeding, which is intermittent and infrequent, conservative medication treatment is usually recommended. Commonly used medications include hemorrhoid suppositories or ointments for anal administration, and oral hemostatic medications can also effectively improve bleeding from internal hemorrhoids. Meanwhile, it is advised that patients maintain a light diet, avoid spicy, stimulating, and dry foods, and ensure smooth bowel movements to alleviate bleeding from internal hemorrhoids. However, if a patient's bleeding from internal hemorrhoids has led to chronic hemorrhagic anemia or even severe anemia, surgical treatment is recommended. Options might include sclerotherapy injections for internal hemorrhoids, internal hemorrhoidal ligation, PPH (Procedure for Prolapse and Hemorrhoids), or TST (transanal hemorrhoidal dearterialization) and other surgical methods. (Please follow medical advice when using medications.)
How should internal hemorrhoids be effectively treated?
The treatment methods for internal hemorrhoids are mainly divided into conservative treatment and surgical treatment. Conservative treatments include oral medications or topical medications, mainly aimed at relieving symptoms such as bleeding or prolapse during the remission phase, without addressing the pathological site. Surgical options include hemorrhoidal ligation, hemorrhoidectomy, PPH (stapled hemorrhoidopexy), and injection therapy, all of which are surgeries targeting the hemorrhoids themselves, and their effectiveness is generally quite definitive.
Second-degree internal hemorrhoids, what is the best way to treat them?
Second-degree internal hemorrhoids mainly refer to the intermittent rectal bleeding and anal prolapse caused by internal hemorrhoids, but the prolapsed tissues can retract back into the anus on their own after defecation. For this condition, it is generally recommended to use conservative medication treatments, change dietary habits, and develop good bowel habits to alleviate symptoms and prevent the progression of the prolapse. For example, patients can eat more foods rich in roughage to facilitate smoother bowel movements. It's also advised not to sit too long during defecation or strain excessively. After defecation, it is beneficial to perform anal exercises and take sits baths using anal washes or warm saline solution for five to ten minutes to promote local circulation and ease the prolapse. Additionally, patients should regularly perform anal exercises and maintain an active lifestyle. When using hemorrhoid suppositories or creams, it is important to choose the appropriate medication based on the symptoms.
How to reposition a prolapsed internal hemorrhoid?
Some internal hemorrhoids that prolapse can retract on their own, corresponding to second-degree internal hemorrhoids. If manual repositioning is required, these are typically third-degree or fourth-degree internal hemorrhoids. Third-degree internal hemorrhoids need to be manually repositioned because the external anal sphincter obstructs the retraction of the hemorrhoids. Generally, the method of taking a warm water sitz bath is used to relax the external anal sphincter, after which the hemorrhoids can be manually repositioned. During repositioning, applying some paraffin oil can facilitate the process, making it easier to accomplish.
Why do internal hemorrhoids prolapse without pain, itching, or bleeding?
Internal hemorrhoids that prolapse but do not hurt, itch, or bleed are primarily due to the large size of the prolapsed hemorrhoids and severe varicose veins underneath them, which leads to prolapse. At this time, they are less likely to bleed and will not cause itching. Since internal hemorrhoids are located above the dentate line in the anal canal, at the end of the rectum, and are innervated by the autonomic nervous system, they also do not cause pain. However, if internal hemorrhoids remain prolapsed at the anus for a long time, they can easily lead to local inflammatory edema, causing local pain and even a significant increase in secretion from the anal area. Therefore, when internal hemorrhoids prolapse, they should be pushed back into the anus as soon as possible. If repositioning is not possible, it is recommended to promptly undergo a hemorrhoid banding procedure, and regularly perform pelvic floor exercises to ensure smooth bowel movements.
What should I do if internal hemorrhoids prolapse and cause pain?
Generally, internal hemorrhoids do not cause pain. However, when internal hemorrhoids prolapse and become trapped outside the anus, leading to swelling, infection, or even necrosis, various degrees of pain can occur, which can be very painful. Therefore, when internal hemorrhoids prolapse and become trapped, surgery is required. Thus, hospitalization for surgery to relieve the trapped hemorrhoids is necessary to definitively cure the condition.
How to treat internal hemorrhoids stage II?
Internal hemorrhoids, according to the provisional standards for the diagnosis of hemorrhoids set by the Coloproctology Group of the Surgical Branch of the Chinese Medical Association in September 2002, stage II internal hemorrhoids primarily exhibit symptoms of bleeding during defecation. Additionally, the hemorrhoidal mass prolapses outside the anus during bowel movements but retracts back inside autonomously after defecation. This condition is referred to as stage II internal hemorrhoids, indicating the onset of symptoms like bleeding and prolapse, thus requiring surgical treatment. Indications for surgery include procedures like hemorrhoid banding or hemorrhoidectomy to remove the hemorrhoids. Conservative treatment options like using hemorrhoidal suppositories or ointments are also available if surgery is not immediately considered, but if these treatments are ineffective, surgery should be pursued. (Please use medications under the guidance of a physician to avoid misuse.)