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Internal hemorrhoids
What should I do if internal hemorrhoids are bleeding?
The main symptoms of internal hemorrhoids are bleeding and protrusion, where the hemorrhoidal tissue prolapses outside the anus. There are several types of bleeding: the first is dripping blood during defecation, where blood drops steadily. Another type is spraying blood, similar to the way a syringe ejects fluid; these are all categorized under rectal bleeding. For internal hemorrhoids, the presence of either bleeding or prolapse outside the anus indicates a need for surgical treatment. This means that if internal hemorrhoids cause spraying blood, surgical treatment is required (i.e., removing the hemorrhoidal tissue), which can improve the bleeding and spraying issues.
Mild bleeding due to internal hemorrhoids prolapse.
Internal hemorrhoids have prolapsed with slight bleeding. This is primarily considered to be due to pathological hypertrophy and descent of the anal cushions, causing the internal hemorrhoids to prolapse and the mucosa of the hemorrhoids to erode, leading to symptoms of rectal bleeding. For such cases, if the prolapsed internal hemorrhoids cannot spontaneously reduce, it is necessary to promptly adopt surgical methods such as hemorrhoidal banding, PPH (Procedure for Prolapse and Hemorrhoids), or TST (Transanal Hemorrhoidal Dearterialization). If the prolapsed hemorrhoids can spontaneously reduce, conservative treatment with medication may be temporarily used, such as applying compound preparations like mixed hemorrhoid suppositories or Jiuhua suppositories anally. Moreover, attention should be paid to a light diet, avoiding foods such as fishy seafood. It is also important to maintain smooth bowel movements; thus, eating less cold, hard food and avoiding difficult defecation that can lead to prolonged toileting times.
What department should I go to at the hospital for internal hemorrhoids?
Patients with internal hemorrhoids should go to the proctology department at the hospital, because internal hemorrhoids are venous clusters that grow above the dentate line of the rectum. The main symptom is rectal bleeding, along with prolapse, pain, anal itching, and a feeling of heaviness around the anus as the primary clinical manifestations. Proctologists have a good knowledge base about diseases around the anal area and are well-versed in diagnosing and treating internal hemorrhoids, as well as managing post-surgical recovery. Therefore, it is appropriate for patients with internal hemorrhoids to consult the proctology department after arriving at the hospital.
Is infusion useful for internal hemorrhoids bleeding?
Useful. Bleeding is one of the main clinical manifestations of internal hemorrhoids, and the amount of bleeding can be large or small, generally bright red in color. The treatment methods for internal hemorrhoids are divided into conservative treatment and surgical treatment, and infusion can be used in both. In conservative treatment, infusion can administer hemostatic drugs to stop bleeding, or some nutritional drugs to reduce stool and protect the mucosa. For surgical patients, infusion can include antibiotics to prevent infection.
Can internal hemorrhoids that prolapse be treated conservatively without surgery?
If internal hemorrhoids can be manually reduced after prolapse, then surgery can be temporarily avoided, and conservative treatment can be administered. For example, the patient should ensure smooth defecation, perform anal lifting exercises after defecation, strengthen the anal sphincter, and prevent the recurrence of internal hemorrhoids. Additionally, the duration of defecation should not be too long, and excessive straining should be avoided to prevent worsening of the prolapsed hemorrhoids. Moreover, patients must pay attention to the hygiene around the anus, and cleanse the peri-anal area with warm saline water after each bowel movement. However, if the internal hemorrhoids cannot be manually reduced after prolapse, or if incarceration and swelling occur, causing anal distension and pain, it is necessary to visit the hospital's colorectal surgery department promptly to undergo internal hemorrhoid ligation, TST, PPH, or other surgical procedures, followed by dressing changes. Since unresolved internal hemorrhoid prolapse can easily lead to incarceration or even necrosis, it is crucial to arrange for surgery as soon as possible, and patients should develop good bowel habits to maintain smooth defecation.
How is internal hemorrhoids bleeding caused?
Internal hemorrhoids bleeding is caused primarily by venous dilation and congestion. Anatomically speaking, hemorrhoids are varicose veins, which means they contain a lot of fresh blood. When straining during defecation, the hemorrhoids rub against the dry stool, causing the mucous membrane of the hemorrhoids to rupture and leading to bleeding symptoms. When the bleeding symptoms are mild, blood can be seen in the stool during defecation, or drops of blood may appear during bowel movements. In severe cases, spraying bleeding may occur. Generally, the bleeding stops after defecation.
Do internal hemorrhoids require surgery?
The clinical symptoms of internal hemorrhoids are numerous, and surgery is only recommended if the internal hemorrhoids frequently recur, or if the clinical symptoms are severe. Severe internal hemorrhoids are primarily characterized by substantial rectal bleeding or recurrent prolapses, and due to repeated prolapses, friction on the local mucosa may even cause anal pain. A severe symptom of prolapsed internal hemorrhoids is that after each prolapse, the patient needs to manually reposition them, accompanied by jet-like or dripping fresh red rectal bleeding. Surgical methods for internal hemorrhoids mainly include hemorrhoidectomy with ligation or local injection of sclerosing agents.
What should I do if the internal hemorrhoids bleeding is very severe?
Internal hemorrhoids bleeding, also known as rectal bleeding, is the main clinical manifestation in patients with internal hemorrhoids. In clinical practice, we often see a minority of patients with internal hemorrhoids experiencing long-term chronic bleeding, which can lead to severe anemia. In our clinical practice, the normal hemoglobin level in adults is 120g/L, but some patients are found to have hemoglobin levels of 30-40g/L upon consultation, indicating severe anemia. Therefore, these patients need to receive blood transfusions first, followed by surgical treatment.
Can internal hemorrhoids that protrude outside the anus be cured by taking medicine?
Internal hemorrhoids that prolapse outside the anus cannot be cured by medication alone. This is because when internal hemorrhoids prolapse, it indicates a significant pathological enlargement and downward displacement of the anal cushions, which are structural changes. Merely taking medication will not result in significant improvement; surgery is the primary option at this point. For this condition, surgical options such as PPH (Procedure for Prolapse and Hemorrhoids) or TST (Transanal Hemorrhoidal Dearterialization) can be employed. Consistent postoperative care and dressing changes can facilitate recovery. Because prolapsed internal hemorrhoids are located at the anal opening, if not treated surgically, they can lead to impaired blood flow, which may cause incarceration leading to edema or thrombosis, and even potentially result in infected necrosis. Therefore, early surgical intervention is required for prolapsed internal hemorrhoids. Additionally, patients should regularly perform anal sphincter exercises, avoid straining excessively during bowel movements, and not spend too much time on the toilet.
Does bleeding after defecation followed by a feeling of discomfort in the anus indicate internal hemorrhoids?
Bleeding after bowel movements followed by discomfort in the anus may be due to internal hemorrhoids, but could also indicate ulcerative proctitis, rectal cancer, or infections around the anus. To confirm the diagnosis, it is necessary to conduct a thorough examination with a digital colonoscopy. Based on the results of the colonoscopy, appropriate treatment measures can be taken. If the symptoms are caused by internal hemorrhoids, surgical treatment may be considered. For diseases like ulcerative colitis, treatment with salicylate preparations may also be used.