Do internal hemorrhoids require surgery?

Written by Deng Heng
Colorectal Surgery
Updated on September 11, 2024
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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.)

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Written by Deng Heng
Colorectal Surgery
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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.

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Written by Deng Heng
Colorectal Surgery
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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.

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Written by Chen Tian Jing
Colorectal Surgery
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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.)

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Written by He Cai Dong
Colorectal Surgery Department
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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.)

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Written by Chen Tian Jing
Colorectal Surgery
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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.)