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 Deng Heng
Colorectal Surgery
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How to treat internal hemorrhoids stage II?

Internal hemorrhoids, according to the provisional standards for the diagnosis of hemorrhoids set by the Coloproctology Group of the Surgical Branch of the Chinese Medical Association in September 2002, stage II internal hemorrhoids primarily exhibit symptoms of bleeding during defecation. Additionally, the hemorrhoidal mass prolapses outside the anus during bowel movements but retracts back inside autonomously after defecation. This condition is referred to as stage II internal hemorrhoids, indicating the onset of symptoms like bleeding and prolapse, thus requiring surgical treatment. Indications for surgery include procedures like hemorrhoid banding or hemorrhoidectomy to remove the hemorrhoids. Conservative treatment options like using hemorrhoidal suppositories or ointments are also available if surgery is not immediately considered, but if these treatments are ineffective, surgery should be pursued. (Please use medications under the guidance of a physician to avoid misuse.)

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Written by Yu Xu Chao
Colorectal Surgery
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How to relieve pain and swelling from internal hemorrhoids prolapse?

Internal hemorrhoids prolapse with pain and swelling. This is often due to inflammatory edema or thrombosis caused by the prolapse, which leads to pain and swelling. At this time, you can choose to apply lidocaine gel externally or apply golden ointment externally for anti-swelling and analgesic effects. You can also choose to insert sodium diclofenac suppositories into the anus, which has anti-inflammatory and analgesic effects, and take diosmin tablets orally to relieve anal swelling, as well as use anal cleansers or potassium permanganate solution for sitz baths to eliminate local bacteria and secretions, and reduce local infectious inflammation. After using the medication, it is still recommended to go to the hospital's proctology department as soon as possible for treatments like internal hemorrhoid banding, PPH, or TST, because the swelling of prolapsed internal hemorrhoids indicates a severe condition, and mere medication alone cannot achieve effective treatment outcomes.

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Written by Deng Heng
Colorectal Surgery
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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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Written by Yu Xu Chao
Colorectal Surgery
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Can internal hemorrhoids be treated with wet compresses?

After prolapse of internal hemorrhoids, moist compresses can be applied, but the therapeutic effect of moist compresses is not significant. The prolapse of internal hemorrhoids mainly occurs when the anal cushion pathologically enlarges and shifts downward, leading to the prolapse. If the prolapsed hemorrhoids cannot be retracted back into the anus, this can lead to incarcerated edema, causing swelling and pain around the anus. If the incarceration lasts too long, it can induce local thrombosis or even necrosis. In such cases, it is recommended to opt for surgical treatment as soon as possible. Common surgical methods include internal hemorrhoid ligation, internal hemorrhoid excision, PPH (Procedure for Prolapse and Hemorrhoids), or TST (Transanal Hemorrhoidal Dearterialization). After surgery, it is advisable to use anal washes or potassium permanganate solutions for sitz baths, and then apply topical treatments such as hemorrhoid creams, red oil gauze strips, and yellow ointments to promote postoperative recovery. Moreover, patients should develop good bowel habits after surgery to maintain smooth bowel movements, which further aids recovery. (Under the guidance of a doctor for medication use)

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Written by Chen Tian Jing
Colorectal Surgery
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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.