Will internal hemorrhoids falling out be painful?

Written by Chen Tian Jing
Colorectal Surgery
Updated on April 29, 2025
00:00
00:00

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.

Other Voices

doctor image
home-news-image
Written by Deng Heng
Colorectal Surgery
30sec home-news-image

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.

doctor image
home-news-image
Written by Chen Tian Jing
Colorectal Surgery
1min 1sec home-news-image

What to do if internal hemorrhoids bleed severely but there is no pain or itching?

If there is severe bleeding from internal hemorrhoids, it is recommended to promptly conduct an anoscopy to determine the exact locations and amount of bleeding. Generally, bleeding from internal hemorrhoids is painless, so it is often underestimated by patients. If the bleeding is heavy or persists for a long time, it is advised that patients undergo surgery as soon as possible to ligate and stop the bleeding, or combine this with oral hemostatic drugs for symptomatic treatment to avoid exacerbation of the bleeding and resulting anemia. Repeated bleeding from internal hemorrhoids can likely lead to varying degrees of anemia. If repeated bleeding occurs, or if the anemia worsens and leads to severe anemia, further treatment with blood transfusions may be necessary to correct the anemia.

doctor image
home-news-image
Written by Deng Heng
Colorectal Surgery
45sec home-news-image

Why is internal hemorrhoid bleeding painless?

Bleeding from internal hemorrhoids, also known as rectal bleeding, is the most common primary clinical manifestation in patients with internal hemorrhoids. Internal hemorrhoids refer to the venous clusters that grow above the dentate line, and their onset occurs above this line. The area above the dentate line is mainly controlled by the autonomic nervous system, making it insensitive to pain and irritation. Therefore, many patients with bleeding internal hemorrhoids may not even realize it themselves, as it does not cause pain. In contrast, external and mixed hemorrhoids, which involve the area below the dentate line, are controlled by somatic nerves, making pain more readily felt.

doctor image
home-news-image
Written by Chen Tian Jing
Colorectal Surgery
1min 13sec home-news-image

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.

doctor image
home-news-image
Written by Chen Tian Jing
Colorectal Surgery
1min 7sec home-news-image

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.)