What should I do if internal hemorrhoids always bleed?

Written by Deng Heng
Colorectal Surgery
Updated on October 28, 2024
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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.

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Written by Chen Tian Jing
Colorectal Surgery
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How long does it take to recover from internal hemorrhoidectomy surgery?

The recovery time after internal hemorrhoidectomy mainly depends on the severity of the condition before the surgery. Most internal hemorrhoidectomies, specifically referring to internal hemorrhoid ligation surgeries combined with sclerotherapy injections, generally require a recovery period of about 2-3 weeks. If the internal hemorrhoids were significantly prolapsed before the surgery or if there were multiple prolapsed hemorrhoids, the recovery time might be relatively longer. If the procedure involved only localized ligation or sclerotherapy injections and there are no external wounds around the anus, the recovery time is approximately one week. During the recovery period, patients need to maintain a light diet, avoid dry stools and excessive straining during bowel movements, which could lead to pain or bleeding at the surgical site.

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Written by Deng Heng
Colorectal Surgery
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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.

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Written by Deng Heng
Colorectal Surgery
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Internal hemorrhoids bleeding is what color?

Rectal bleeding is the primary clinical symptom of internal hemorrhoids, typically characterized by bright red blood. Bleeding after bowel movements is one of the early symptoms of internal hemorrhoids, which often have no significant initial conscious symptoms, commonly presenting as blood-streaked stool after defecation. Bleeding after bowel movements can appear as dripping or spraying, bright red, painless, and not mixed with the stool. This distinction is crucial for differentiating from cancer. Rectal bleeding generally increases in severity over time, progressing from small amounts of blood to significant bleeding. Prolonged and repeated bleeding can lead to severe anemia in patients.

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Written by Ren Zheng Xin
Gastroenterology
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Is bleeding from hemorrhoids internal hemorrhoids?

Hemorrhoids causing blood in the stool are mostly due to internal hemorrhoids, which are a manifestation of varicose veins in the hemorrhoidal veins. During defecation, because the stool is rather dry and hard, it can easily scratch the hemorrhoidal veins as it moves downward. Due to internal hemorrhoids, the hemorrhoidal veins become distended and the vein walls become very thin, making them easily damaged, thus leading to bleeding. Minor cases may involve blood during defecation or dripping blood, while more severe cases can present with spraying blood during bowel movements. Depending on the amount of bleeding, one should choose treatments such as medications, minimally invasive procedures, or surgery.

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Written by Chen Tian Jing
Colorectal Surgery
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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.