Mild bleeding due to internal hemorrhoids prolapse.

Written by Yu Xu Chao
Colorectal Surgery
Updated on February 18, 2025
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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.

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Written by Deng Heng
Colorectal Surgery
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Do internal hemorrhoids require surgery?

Surgical indications for internal hemorrhoids include bleeding and prolapse of anal masses. These symptoms necessitate surgical treatment. Secondly, if scheduling surgery is not possible due to being busy, conservative treatment like applying ointment to the anus or taking medication can be used initially to alleviate the symptoms. If conservative treatment fails, it is still not too late to opt for surgery. (Specific medications should be used under the guidance of a physician.)

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Written by Chen Tian Jing
Colorectal Surgery
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Is the bleeding from internal hemorrhoids bright red?

The majority of internal hemorrhoid bleeding is bright red, but if there is a significant amount of bleeding, blood may accumulate within the anal canal and form clots, resulting in darker colored blood in the stool. To identify and diagnose whether it is bleeding from internal hemorrhoids, it is recommended that patients undergo an anoscopic examination. If obvious bleeding points are found near the mucosa around the dentate line, it is mostly due to internal hemorrhoids. To treat bleeding from internal hemorrhoids, it is first necessary to take oral or topical hemostatic medications for symptomatic treatment. If the internal hemorrhoid bleeding has been prolonged, or in cases of chronic blood loss, further surgical ligation may be necessary to stop the bleeding and prevent anemia due to excessive blood loss. (The use of medications should be under the guidance of a doctor.)

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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.

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Written by Deng Heng
Colorectal Surgery
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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 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.