The harm of internal hemorrhoids prolapse

Written by Deng Heng
Colorectal Surgery
Updated on January 08, 2025
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Prolapsed internal hemorrhoids are one of the main clinical manifestations of internal hemorrhoids, and their harm is mainly manifested in two aspects: Firstly, the prolapse of hemorrhoidal tissue outside the anus can lead to perianal skin eczema and itching, and anal eczema. Secondly, it can lead to incarcerated hemorrhoids, where the prolapsed internal hemorrhoid, held by the sphincter, forms congestion, and is accompanied by hardening of the hemorrhoidal tissue, pain, and even necrosis.

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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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Symptoms of internal hemorrhoids prolapse

Internal hemorrhoids prolapse, generally refers to the hemorrhoidal tissue prolapsing from inside the anus to outside of it, and typically divided into four stages based on the extent of prolapse. First-degree internal hemorrhoids refer to hemorrhoidal tissue that does not prolapse outside the anus. Second-degree internal hemorrhoids refer to hemorrhoidal tissue prolapsing outside the anus but can retract back inside automatically after defecation. Third-degree internal hemorrhoids refer to hemorrhoidal tissue that, after prolapsing outside the anus, requires manual assistance to be pushed back inside. Fourth-degree internal hemorrhoids are when the prolapsed tissue cannot be retracted, not even manually, and this condition can be accompanied by pain in the anus.

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Written by Yu Xu Chao
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What color is a prolapsed internal hemorrhoid?

If internal hemorrhoids prolapse, it indicates that the hemorrhoidal venous plexus is severely varicose and congested, and the anal cushion has pathologically enlarged and descended, leading to the prolapse of the internal hemorrhoids. The color of prolapsed internal hemorrhoids at the anal opening commonly appears as purple lumps or swellings. If the prolapsed hemorrhoids cannot retract back into the anus, even with manual assistance, this condition may lead to necrosis of the internal hemorrhoids. If necrosis occurs and results in localized thrombosis, the hemorrhoids may turn black. In such cases, prompt surgical treatment is required to prevent necrosis and worsening infection of the hemorrhoids. Surgical options include internal hemorrhoid ligation, PPH (procedure for prolapse and hemorrhoids), or TST (transanal hemorrhoidal dearterialization), as well as the traditional excision and ligation. Postoperatively, consistent wound dressing changes are necessary to promote healing.

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Colorectal Surgery
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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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How to treat bleeding from internal hemorrhoids?

In clinical practice, for internal hemorrhoids with bleeding, conservative medication or surgical treatment are often used. The specific treatment method mainly depends on the severity of the bleeding from internal hemorrhoids and whether the patient also has anemia. For early-stage internal hemorrhoid bleeding, which is intermittent and infrequent, conservative medication treatment is usually recommended. Commonly used medications include hemorrhoid suppositories or ointments for anal administration, and oral hemostatic medications can also effectively improve bleeding from internal hemorrhoids. Meanwhile, it is advised that patients maintain a light diet, avoid spicy, stimulating, and dry foods, and ensure smooth bowel movements to alleviate bleeding from internal hemorrhoids. However, if a patient's bleeding from internal hemorrhoids has led to chronic hemorrhagic anemia or even severe anemia, surgical treatment is recommended. Options might include sclerotherapy injections for internal hemorrhoids, internal hemorrhoidal ligation, PPH (Procedure for Prolapse and Hemorrhoids), or TST (transanal hemorrhoidal dearterialization) and other surgical methods. (Please follow medical advice when using medications.)