Will internal hemorrhoids be painful?

Written by Chen Tian Jing
Colorectal Surgery
Updated on January 19, 2025
00:00
00:00

If internal hemorrhoids experience local mucosal rupture or repeated prolapse leading to friction of the mucosa, it is likely to cause pain and even bleeding. To avoid pain caused by internal hemorrhoids, it is recommended that patients use hemorrhoid suppositories for local administration in the rectum for early flare-ups to reduce swelling, relieve pain, and cool and stop bleeding. If internal hemorrhoids prolapse and cannot retract back into the anal canal on their own after each prolapse, it is suggested that patients consider surgery to ligate and excise the affected internal hemorrhoids, or inject sclerosants under the mucosa of the hemorrhoids to cause local mucosal consolidation and shedding. Patients with internal hemorrhoids are advised not to strain excessively during bowel movements to avoid worsening local congestion and edema.

Other Voices

doctor image
home-news-image
Written by Deng Heng
Colorectal Surgery
40sec home-news-image

How is internal hemorrhoids bleeding caused?

Internal hemorrhoids bleeding is caused primarily by venous dilation and congestion. Anatomically speaking, hemorrhoids are varicose veins, which means they contain a lot of fresh blood. When straining during defecation, the hemorrhoids rub against the dry stool, causing the mucous membrane of the hemorrhoids to rupture and leading to bleeding symptoms. When the bleeding symptoms are mild, blood can be seen in the stool during defecation, or drops of blood may appear during bowel movements. In severe cases, spraying bleeding may occur. Generally, the bleeding stops after defecation.

doctor image
home-news-image
Written by Deng Heng
Colorectal Surgery
43sec home-news-image

Precautions for Internal Hemorrhoids Bleeding

Rectal bleeding is the primary clinical manifestation of internal hemorrhoids. When rectal bleeding occurs, it's essential first to rule out whether the bleeding is definitely from internal hemorrhoids because rectal bleeding can be caused by many diseases, including malignant tumors. Once it's determined that the bleeding is from internal hemorrhoids, it is important to pay attention to whether the volume of blood is large, the duration of bleeding is long, and the frequency of bleeding is high, and whether there is frequent or daily bleeding. If so, it will exceed the body's ability to replenish blood through its hematopoietic function, leading to severe systemic anemia.

doctor image
home-news-image
Written by Yu Xu Chao
Colorectal Surgery
1min 7sec home-news-image

Mild bleeding due to internal hemorrhoids prolapse.

Internal hemorrhoids have prolapsed with slight bleeding. This is primarily considered to be due to pathological hypertrophy and descent of the anal cushions, causing the internal hemorrhoids to prolapse and the mucosa of the hemorrhoids to erode, leading to symptoms of rectal bleeding. For such cases, if the prolapsed internal hemorrhoids cannot spontaneously reduce, it is necessary to promptly adopt surgical methods such as hemorrhoidal banding, PPH (Procedure for Prolapse and Hemorrhoids), or TST (Transanal Hemorrhoidal Dearterialization). If the prolapsed hemorrhoids can spontaneously reduce, conservative treatment with medication may be temporarily used, such as applying compound preparations like mixed hemorrhoid suppositories or Jiuhua suppositories anally. Moreover, attention should be paid to a light diet, avoiding foods such as fishy seafood. It is also important to maintain smooth bowel movements; thus, eating less cold, hard food and avoiding difficult defecation that can lead to prolonged toileting times.

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 Yu Xu Chao
Colorectal Surgery
1min 7sec home-news-image

Second-degree internal hemorrhoids, what is the best way to treat them?

Second-degree internal hemorrhoids mainly refer to the intermittent rectal bleeding and anal prolapse caused by internal hemorrhoids, but the prolapsed tissues can retract back into the anus on their own after defecation. For this condition, it is generally recommended to use conservative medication treatments, change dietary habits, and develop good bowel habits to alleviate symptoms and prevent the progression of the prolapse. For example, patients can eat more foods rich in roughage to facilitate smoother bowel movements. It's also advised not to sit too long during defecation or strain excessively. After defecation, it is beneficial to perform anal exercises and take sits baths using anal washes or warm saline solution for five to ten minutes to promote local circulation and ease the prolapse. Additionally, patients should regularly perform anal exercises and maintain an active lifestyle. When using hemorrhoid suppositories or creams, it is important to choose the appropriate medication based on the symptoms.