The color of the blood from internal hemorrhoids.

Written by Ren Zheng Xin
Gastroenterology
Updated on September 18, 2024
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Bleeding from internal hemorrhoids is bright red. If the amount of bleeding is substantial, it can appear as a jet-like hemorrhoidal bleeding. This condition is caused by hard and dry stools scratching the hemorrhoidal veins during defecation, leading to bleeding. Repeated bleeding from internal hemorrhoids can cause chronic blood loss and result in symptoms of anemia. It is advisable to actively engage in medication or minimally invasive treatments, using drugs to stop bleeding and constrict hemorrhoidal veins. Some may undergo vein ligation surgery minimally invasively. At the same time, it is important to have a light diet, drink more water, eat more vegetables, and ensure smooth bowel movements.

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The difference between rectal polyps and internal hemorrhoids

Rectal polyps are skin-like mucosal protrusions that grow on the rectal mucosa, whereas internal hemorrhoids are confined to congestion and protrusion of the mucosa around the dentate line. The formation of rectal polyps is mainly due to long-term stimulation by feces, or certain constitutional and genetic factors, while the most likely cause of internal hemorrhoids is chronic congestion and edema around the anal area or the formation of venous thrombosis, leading to local varicose clusters. After the discovery of rectal polyps, it is necessary to perform surgery as soon as possible; however, the treatment for internal hemorrhoids in the early stages is primarily conservative, aimed at delaying the frequency of disease attacks and improving the quality of life for the patient. If the internal hemorrhoids reach a later stage or become severe, manifested by recurrent prolapse and rectal bleeding, surgical removal is recommended.

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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.

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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.

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Colorectal Surgery
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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.)

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"Internal hemorrhoids prolapse" means internal hemorrhoids have slipped downwards, typically so they protrude outside the anus.

Prolapse of internal hemorrhoids refers to the condition where the hemorrhoidal mass of internal hemorrhoids protrudes outside the anus. This condition occurs only in internal hemorrhoids of grade II or higher. Grade II internal hemorrhoids can spontaneously retract back inside the anus after defecation without the need for manual reduction. Grade III internal hemorrhoids, however, do not retract spontaneously and should be manually reduced after cleaning and a period of bed rest. If the hemorrhoids remain prolapsed for a long time without timely reduction, it can lead to painful swelling around the anus. If a patient is unable to manually reduce the prolapsed hemorrhoids themselves, it can lead to incarcerated hemorrhoids, and medical assistance should be sought promptly.