Internal hemorrhoids


Do internal hemorrhoids require surgery?
Surgical indications for internal hemorrhoids include bleeding and prolapse of anal masses. These symptoms necessitate surgical treatment. Secondly, if scheduling surgery is not possible due to being busy, conservative treatment like applying ointment to the anus or taking medication can be used initially to alleviate the symptoms. If conservative treatment fails, it is still not too late to opt for surgery. (Specific medications should be used under the guidance of a physician.)


How is internal hemorrhoids treated? Is there a way?
There are many treatment methods for internal hemorrhoids, the most common being medication. If the internal hemorrhoids repeatedly prolapse or bleed significantly, direct surgical removal can also be considered. Conservative treatments primarily involve the local use of hemorrhoid suppositories, combined with oral hemostatic and anti-swelling traditional Chinese medicine. If surgical criteria are met, direct surgical removal can be performed. Surgical methods mainly include injection of sclerosing agents into the mucosa of internal hemorrhoids, internal hemorrhoid banding, and internal hemorrhoid ligation and excision. To prevent recurrence after surgery, patients should maintain good dietary and bowel habits postoperatively, avoid overly spicy and stimulating foods, and try to keep bowel movements under ten minutes without straining excessively.


Do internal hemorrhoids need treatment?
Internal hemorrhoids require active treatment. If not actively treated, internal hemorrhoids may prolapse and worsen, or bleeding may intensify. This can lead to severe local symptoms and potentially develop from early-stage symptoms that are mild, into more severe cases that may only be significantly improved through surgery. The treatment methods for internal hemorrhoids primarily involve the use of topical and oral medications. When prolapse or severe swelling occurs, patients can take oral medications that clear heat, cool the blood, reduce swelling, and alleviate pain, specifically for hemorrhoids. These should be combined with local anal suppositories for symptomatic treatment. For cases accompanied by bleeding, oral hemostatic medications can be administered. If the prolapse is substantial, or if the internal hemorrhoids cannot retract back into the anus, surgical removal is recommended. (The use of medications should be under the guidance of a doctor.)


Can you drink beer if you have internal hemorrhoids bleeding?
During the bleeding phase of internal hemorrhoids, patients should not drink beer or other alcoholic beverages, nor eat spicy and stimulating foods such as chili peppers and seafood. This is because both drinking alcohol and consuming spicy, stimulating foods can cause the mucous membrane in the anal area to become congested. If there are any bleeding spots locally, the likelihood and volume of bleeding will be greater than normal. Therefore, further hemostatic treatment is necessary during the bleeding period. If alcohol is consumed, the volume of bleeding will increase and the severity of the bleeding condition will become worse. It is recommended that patients use external hemorrhoid creams for hemostasis, or take oral hemostatic drugs for symptomatic treatment. If the bleeding is substantial or the condition is not under control, further surgical treatment may be needed. (Please use medication under the guidance of a doctor.)


Is the bleeding from internal hemorrhoids bright red?
The majority of internal hemorrhoid bleeding is bright red, but if there is a significant amount of bleeding, blood may accumulate within the anal canal and form clots, resulting in darker colored blood in the stool. To identify and diagnose whether it is bleeding from internal hemorrhoids, it is recommended that patients undergo an anoscopic examination. If obvious bleeding points are found near the mucosa around the dentate line, it is mostly due to internal hemorrhoids. To treat bleeding from internal hemorrhoids, it is first necessary to take oral or topical hemostatic medications for symptomatic treatment. If the internal hemorrhoid bleeding has been prolonged, or in cases of chronic blood loss, further surgical ligation may be necessary to stop the bleeding and prevent anemia due to excessive blood loss. (The use of medications should be under the guidance of a doctor.)


The difference between rectal prolapse and internal hemorrhoids prolapse
Rectal prolapse primarily refers to the prolapse of the rectal mucosa or part of the sigmoid colon mucosa, partially or completely falling out of the anus. Generally, there is a ring-shaped or cylindrical mucosa protrusion outside the anus. Internal hemorrhoid prolapse involves the partial prolapse of the mucosa near the dentate line, typically appearing as small lumps or accompanied by local venous thrombosis and varicose clusters, with rectal prolapse being more severe than internal hemorrhoid prolapse. The treatment of rectal prolapse mainly involves surgery, while early stages of internal hemorrhoid prolapse can be treated with medications. This involves using topical hemorrhoid creams or suppositories to alleviate symptoms. If there are recurrent prolapses or accompanying bleeding during bowel movements, surgical treatment may also be considered. Surgical methods for rectal prolapse primarily involve local mucosal ring excision, whereas surgeries for internal hemorrhoids mainly include hemorrhoid ligation or banding procedures.


How to treat internal hemorrhoids?
Hemorrhoids are divided into internal, external, and mixed types. The clinical symptoms of internal hemorrhoids mainly include local pain, prolapse, and rectal bleeding due to rupture. If there are recurrent episodes or associated inflammation, there may also be an increase in secretions, which can irritate the local skin around the anus and cause itching. Therefore, the primary treatment for internal hemorrhoids involves the use of suppository hemorrhoid plugs. If there is accompanying bleeding, it is also necessary to combine this with oral hemostatic medications. In cases of perianal itching, options such as sichuan pepper water or other insecticidal and anti-itch traditional Chinese medicine washes can be used for fumigation and hot compresses on the affected area.


Can internal hemorrhoids heal on their own?
To determine whether internal hemorrhoids bleeding is self-healing, one should primarily assess the amount of bleeding and the duration of bleeding to further evaluate the severity of the condition. If it is the first occurrence or if the bleeding is mostly noticeable on toilet paper and is relatively minor, self-healing of internal hemorrhoids bleeding can be achieved through lubrication of the stool during defecation and, if necessary, oral administration of cooling blood-stopping medications. However, if the bleeding duration is prolonged, or if the amount of bleeding is significant each time, it is unlikely to achieve complete healing simply through lifestyle adjustments, dietary changes, or even medication. Further surgical ligation and hemostasis treatment may be required for the patient.