What should I do if internal hemorrhoids prolapse and cause pain?

Written by Deng Heng
Colorectal Surgery
Updated on April 10, 2025
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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.

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How long does it take for internal hemorrhoids to reposition after being pushed back in?

This situation mainly depends on how much the internal hemorrhoids have prolapsed and the severity of the prolapse. If the internal hemorrhoids can be pushed back in after prolapsing, it generally takes half an hour to an hour to reposition them. However, if the patient overexerts themselves or strains during coughing or defecation, the internal hemorrhoids may prolapse again. For patients whose internal hemorrhoids repeatedly prolapse, it is advisable to consider surgical treatment as soon as possible. Because repeated prolapse of internal hemorrhoids can lead to further pathological hypertrophy and descent of the anal cushion, in such cases of organic lesions, simple repositioning cannot solve the problem. It may even cause the prolapse to become larger over time and lead to complications like incarcerated edema, resulting in local thrombosis, swelling, and anal pain. Therefore, for patients with repeated prolapse, it is recommended to visit the hospital's colorectal surgery department for surgical treatment as soon as possible, such as internal hemorrhoid ligation, TST, and other surgical methods.

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What foods should be avoided if there is bleeding from internal hemorrhoids?

Internal hemorrhoids bleeding is the main clinical symptom of internal hemorrhoids; the amount of bleeding can vary greatly and is usually bright red. It can spray out or drip out. Patients with internal hemorrhoids bleeding are advised to avoid eating chili peppers and drinking alcohol. This is because chili peppers contain a component called capsaicin, which strongly irritates the gastrointestinal mucosa and can dilate blood vessels, exacerbating the bleeding. Alcohol can also dilate blood vessels and worsen the bleeding.

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The hazards of internal hemorrhoids bleeding

Internal hemorrhoids or mixed hemorrhoids are most commonly diagnosed clinically, with prolapse and rectal bleeding being typical symptoms. If internal hemorrhoid bleeding occurs, the choice of treatment depends on the amount and duration of bleeding. Increased bleeding or prolonged bleeding duration requires early conservative medication or surgical ligation to prevent anemia due to local hemorrhoidal bleeding. Prolonged and significant rectal bleeding from internal hemorrhoids primarily endangers the patient by causing a decrease in overall blood volume due to chronic blood loss, leading to anemia. Following anemia, patients may experience symptoms such as palpitations and fatigue due to insufficient blood volume.

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How is internal hemorrhoids treated? Is there a way?

There are many treatment methods for internal hemorrhoids, the most common being medication. If the internal hemorrhoids repeatedly prolapse or bleed significantly, direct surgical removal can also be considered. Conservative treatments primarily involve the local use of hemorrhoid suppositories, combined with oral hemostatic and anti-swelling traditional Chinese medicine. If surgical criteria are met, direct surgical removal can be performed. Surgical methods mainly include injection of sclerosing agents into the mucosa of internal hemorrhoids, internal hemorrhoid banding, and internal hemorrhoid ligation and excision. To prevent recurrence after surgery, patients should maintain good dietary and bowel habits postoperatively, avoid overly spicy and stimulating foods, and try to keep bowel movements under ten minutes without straining excessively.

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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.