What should I do if internal hemorrhoids have prolapsed and not retracted for two or three days?

Written by Chen Tian Jing
Colorectal Surgery
Updated on May 04, 2025
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If internal hemorrhoids prolapse and cannot be reduced back into the anus on their own, and even after they are manually repositioned by a patient or a doctor they prolapse again, it may indicate that local incarceration or necrosis has occurred. It is recommended to undergo surgery as soon as possible to prevent circulatory disturbances from prolonged prolapse, which can lead to necrotic changes in the local muscle tissues. The surgical methods primarily include hemorrhoidectomy with mixed hemorrhoid stripping and ligation, combined with an internal excision procedure. Additionally, sclerotherapy injections for internal hemorrhoids can be used to improve the overall treatment effects. After surgery, avoid straining during bowel movements to prevent local pain or bleeding.

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Will internal hemorrhoids affect menstruation?

Internal hemorrhoid bleeding can potentially affect menstruation. Although brief internal hemorrhoid bleeding does not affect menstruation, if the hemorrhoid bleeding is heavy, prolonged, frequent, and occurs daily or frequently, exceeding the body's ability to replace the lost blood, it can cause severe systemic anemia. In such cases, it might affect menstruation.

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The color of the blood from internal hemorrhoids.

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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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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How many days will it take for internal hemorrhoids to heal after prolapse?

If a patient exhibits prolapsed internal hemorrhoids, it is first recommended that a professional proctologist reposition the prolapsed hemorrhoids. If prolapse continues to recur after repositioning, the likelihood of spontaneous recovery is low, and the patient will likely need further surgical treatment. Prolapse is a common clinical symptom of hemorrhoids. If it is a simple prolapse that can retract spontaneously, symptoms can be relieved within 3 to 5 days after medication treatment. However, if the prolapse requires manual repositioning by the patient, or if it recurs repeatedly, surgical removal is necessary. Recovery from the surgery typically takes about 2 to 3 weeks.

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Do internal hemorrhoids definitely require surgery?

Internal hemorrhoids bleeding does not necessarily require surgical treatment; conservative treatment is also an option. The main clinical symptom of internal hemorrhoids is bleeding, which can vary in amount and is generally bright red. Treatment for internal hemorrhoids mainly includes conservative treatment and surgical treatment. For first and second-degree internal hemorrhoid bleeding, conservative treatment can be adopted, which involves ensuring that stools are smooth, soft, and well-formed, reducing irritation to the anal area. Secondly, some hemostatic medications can be taken. Surgical treatment is primarily targeted at third and fourth-degree internal hemorrhoids.