How to stop bleeding from internal hemorrhoids prolapse?

Written by Chen Tian Jing

Colorectal Surgery

Updated on November 09, 2024

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If internal hemorrhoids bleeding leads to unstoppable bleeding, the most common and direct way to stop the bleeding primarily involves local ligation. The prolapse and bleeding of internal hemorrhoids are mainly due to the repeated prolapse and friction of the local mucosa causing rupture and bleeding, or the persistent bleeding from ruptured small arteries. If prompt hemostatic treatment is not administered, it could potentially lead to chronic blood loss and subsequent anemia due to decreased blood volume. Therefore, if patients experience bleeding from internal hemorrhoids, especially if the bleeding is prolonged or substantial, it is advised to visit a proctology department for relevant examinations soon. If necessary, it may be crucial to promptly proceed with internal hemorrhoidal ligation surgery.

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Written by Yu Xu Chao

Colorectal Surgery

1min 19sec

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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.)

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Written by Yu Xu Chao

Colorectal Surgery

1min 25sec

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Can internal hemorrhoids be treated by prolapse and bloodletting?

Bleeding should not be used for prolapsed internal hemorrhoids, as this condition is primarily caused by improper defecation habits leading to pathological enlargement and descent of the anal cushion, which results in the prolapse of internal hemorrhoids. In the early stage, prolapsed internal hemorrhoids can retract back into the anus after defecation, and under such circumstances, it is only required for the patient to develop good bowel habits. For example, avoid spending too much time on defecation, don't exert excessive force, perform sphincter exercises after defecation, and maintain smooth bowel movements. Attention should also be paid to perianal hygiene; it is advised to wash the area with warm saline water after defecation to avoid worsening the prolapse or causing incarcerated edema. However, for cases where incarcerated edema occurs, it is generally recommended to consider prompt surgical intervention, such as hemorrhoidal ligation, PPH (Procedure for Prolapse and Hemorrhoids), or TST (Transanal Stapling Technique). The use of bleeding as a treatment does not have significant therapeutic effects for prolapsed internal hemorrhoids, and thus is not recommended in clinical practice. Furthermore, patients should pay attention to a light diet and avoid spicy, stimulating, and dry-hot foods as much as possible.

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Written by Deng Heng

Colorectal Surgery

50sec

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Symptoms of internal hemorrhoids prolapse

Internal hemorrhoids prolapse, generally refers to the hemorrhoidal tissue prolapsing from inside the anus to outside of it, and typically divided into four stages based on the extent of prolapse. First-degree internal hemorrhoids refer to hemorrhoidal tissue that does not prolapse outside the anus. Second-degree internal hemorrhoids refer to hemorrhoidal tissue prolapsing outside the anus but can retract back inside automatically after defecation. Third-degree internal hemorrhoids refer to hemorrhoidal tissue that, after prolapsing outside the anus, requires manual assistance to be pushed back inside. Fourth-degree internal hemorrhoids are when the prolapsed tissue cannot be retracted, not even manually, and this condition can be accompanied by pain in the anus.

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Written by Chen Tian Jing

Colorectal Surgery

46sec

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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.

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Written by Deng Heng

Colorectal Surgery

46sec

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What should I do if internal hemorrhoids always bleed?

Internal hemorrhoids refer to the venous clumps located above the dentate line. When these hemorrhoids are injured or ruptured, bleeding during bowel movements occurs, which is the most common primary symptom in patients with internal hemorrhoids. Frequent bleeding from internal hemorrhoids can first be treated conservatively, such as by taking oral hemostatic medications, followed by the local application of hemorrhoid creams, suppositories, and the like. If bleeding consistently persists, surgical treatment may be required. Once internal hemorrhoids present symptoms of bleeding or prolapse, they typically indicate the need for surgery, hence treatment for frequent bleeding in internal hemorrhoids can be either conservative or surgical.