Internal hemorrhoids


How to solve internal hemorrhoids that are prolapsed and incarcerated?
In clinical practice, for cases where internal hemorrhoids prolapse and become incarcerated, surgical treatment is often recommended. This is because the prolapse of internal hemorrhoids indicates a significant displacement and that the hemorrhoids have been prolapsed for a long time, which can lead to incarceration. In such cases, there is a risk of localized swelling or thrombosis formation, causing anal swelling and pain, and in severe cases, necrosis of the prolapsed tissue. Therefore, it is advised to opt for surgical treatment as soon as possible for incarcerated internal hemorrhoidal prolapse. Surgical options include hemorrhoidal banding, PPH (Procedure for Prolapse and Hemorrhoids), and TST (Transanal hemorrhoidal dearterialization) among others. Anesthetic choices can range from local infiltration anesthesia, spinal anesthesia, to general intravenous anesthesia. With spinal and general anesthesia, the patient does not experience pain during surgery and does not feel fear of pain. Post-surgery, it is also necessary to select appropriate medications for dressing changes, such as anal washes, hemorrhoidal suppositories, and golden yellow ointment to promote wound healing.


What color is a prolapsed internal hemorrhoid?
If internal hemorrhoids prolapse, it indicates that the hemorrhoidal venous plexus is severely varicose and congested, and the anal cushion has pathologically enlarged and descended, leading to the prolapse of the internal hemorrhoids. The color of prolapsed internal hemorrhoids at the anal opening commonly appears as purple lumps or swellings. If the prolapsed hemorrhoids cannot retract back into the anus, even with manual assistance, this condition may lead to necrosis of the internal hemorrhoids. If necrosis occurs and results in localized thrombosis, the hemorrhoids may turn black. In such cases, prompt surgical treatment is required to prevent necrosis and worsening infection of the hemorrhoids. Surgical options include internal hemorrhoid ligation, PPH (procedure for prolapse and hemorrhoids), or TST (transanal hemorrhoidal dearterialization), as well as the traditional excision and ligation. Postoperatively, consistent wound dressing changes are necessary to promote healing.


How to completely treat internal hemorrhoids?
In recent years, there have been numerous treatment methods for internal hemorrhoids, primarily divided into non-surgical and surgical treatments. Non-surgical treatment mainly involves conservative management, which generally includes measures such as increasing the intake of vegetables and fruits, maintaining smooth bowel movements, and using medications or applying ointments locally. Surgical treatment mainly includes injection therapy and excision of the hemorrhoidal nodes. For a complete cure, surgical treatment is typically required, which involves thoroughly removing the pathological hemorrhoidal nodes. (The use of medications should be under the guidance of a doctor.)


Is a severe internal hemorrhoid prolapse?
Internal hemorrhoids mainly refer to soft venous masses that occur above the dentate line, formed by congestion, dilation, and varicosity of the superior rectal venous plexus. The primary symptoms are rectal bleeding and prolapse of the lump outside the anus. Prolapse of internal hemorrhoids is one of the indications for surgery, meaning that if there is rectal bleeding or prolapse outside the anus at the dentate line, surgical treatment is required. Thus, internal hemorrhoids are considered severe if there is a prolapse, necessitating surgical treatment.


Will internal hemorrhoids affect menstruation?
Internal hemorrhoid bleeding can potentially affect menstruation. Although brief internal hemorrhoid bleeding does not affect menstruation, if the hemorrhoid bleeding is heavy, prolonged, frequent, and occurs daily or frequently, exceeding the body's ability to replace the lost blood, it can cause severe systemic anemia. In such cases, it might affect menstruation.


What should I do about internal hemorrhoids?
In clinical practice, the treatment of internal hemorrhoids mainly depends on the symptoms presented by the patient, and an appropriate treatment method is selected accordingly. For example, patients with early-stage internal hemorrhoids who experience intermittent rectal bleeding are usually advised to use hemorrhoid suppositories or ointments after defecation. However, as the condition of internal hemorrhoids worsens, which might include prolapse or even symptoms of anemia, surgical treatment is often recommended. Clinically, surgery for internal hemorrhoids can involve sclerotherapy injections, hemorrhoidal banding, or other surgical methods such as PPH (Procedure for Prolapse and Hemorrhoids) or TST (Transanal Hemorrhoidal Dearterialization). Post-surgery, dressing changes are necessary, and products such as rectal cleansing solutions, oil gauze strips, or ointments are commonly used. Moreover, it is crucial for patients to maintain smooth bowel movements post-surgery to avoid wound infection, bleeding, or edema, and they should adhere to a light diet avoiding spicy, stimulating, and dry foods. (Please follow medical advice regarding medication use.)


Internal hemorrhoids bleeding is what color?
Rectal bleeding is the primary clinical symptom of internal hemorrhoids, typically characterized by bright red blood. Bleeding after bowel movements is one of the early symptoms of internal hemorrhoids, which often have no significant initial conscious symptoms, commonly presenting as blood-streaked stool after defecation. Bleeding after bowel movements can appear as dripping or spraying, bright red, painless, and not mixed with the stool. This distinction is crucial for differentiating from cancer. Rectal bleeding generally increases in severity over time, progressing from small amounts of blood to significant bleeding. Prolonged and repeated bleeding can lead to severe anemia in patients.


What should I do if the internal hemorrhoids hurt after being pushed back in?
If the pain does not subside after pushing back a prolapsed internal hemorrhoid, it is often due to the formation of a thrombus, which is why the localized pain is quite noticeable. In such cases, it is advised to use topical medications for treatment. You can use hemorrhoid suppositories or ointment, inserting them into the anus to alleviate the pain. If the pain remains significant, you can also take oral pain relievers temporarily. If pain persists even after these treatments, it may be considered a strangulated hemorrhoid, which is more serious. It is recommended that you visit a formal hospital's proctology department. There, a doctor can perform a digital rectal examination and an anoscopy to establish a definitive diagnosis and provide appropriate treatment. If very severe, surgery may be needed. (Use of medications should be under the guidance of a physician.)


Can excessive bleeding from internal hemorrhoids cause dizziness?
Excessive bleeding from internal hemorrhoids can lead to symptoms of dizziness. Bleeding is one of the main clinical manifestations of internal hemorrhoids. The amount of bleeding can vary, and the color of the blood is typically bright red. If there is a large amount of bleeding, lasts for a long time, or occurs frequently, and it exceeds the body's ability to produce new blood, it can lead to systemic anemia. Prolonged conditions can result in severe anemia, which may cause dizziness.


Can warm water sitz baths improve internal hemorrhoids that have prolapsed?
Warm sitz baths for prolapsed internal hemorrhoids can improve anal heaviness to some extent, and prevent inflammatory edema caused by the prolapse. They can also help prevent further worsening of prolapsed hemorrhoids, as warm sitz baths promote circulation around the anal area, relieve heaviness, and can somewhat reduce the prolapse, but they cannot completely cure it. Prolapsed internal hemorrhoids are caused by pathological hypertrophy and descent of the anal cushions, representing an organic lesion. Simple conservative medical treatment can only prevent the hemorrhoids from worsening, but cannot fully cure them. For prolapsed internal hemorrhoids that can be manually reduced, conservative treatment is generally recommended. Regular smooth bowel movements should be maintained, long duration of defecation should be avoided, and frequent anal sphincter exercises should be performed. However, for prolapsed hemorrhoids that cannot be reduced, or those that develop incarceration with edema or thrombosis, surgical treatment is recommended.