Are there any effects if internal hemorrhoids are constantly prolapsed?

Written by Yu Xu Chao
Colorectal Surgery
Updated on May 07, 2025
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Internal hemorrhoids that protrude permanently can easily lead to incarceration, causing inflammatory edema. Constant friction over a long period can also cause the surface of the hemorrhoids to break and bleed. Additionally, contamination and waste matter may infect the hemorrhoids. Due to the prolonged protrusion outside the anus, the local circulation can become obstructed, leading to swelling and even inducing local thrombosis, which causes pain in the anus. Therefore, it is not possible to reinsert the prolapsed internal hemorrhoids back into the anus. In such cases, it is advisable to seek prompt medical treatment at a hospital's colorectal surgery department. Surgical options like hemorrhoid banding, PPH (Procedure for Prolapse and Hemorrhoids), or TST (Transanal Hemorrhoidal Dearterialization) are recommended. Post-surgery care should include the use of anal cleansers, red oil gauze strips, and golden ointment for dressing changes. Additionally, it is crucial to maintain smooth bowel movements.

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Written by Yu Xu Chao
Colorectal Surgery
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Can internal hemorrhoids that prolapse be treated conservatively without surgery?

If internal hemorrhoids can be manually reduced after prolapse, then surgery can be temporarily avoided, and conservative treatment can be administered. For example, the patient should ensure smooth defecation, perform anal lifting exercises after defecation, strengthen the anal sphincter, and prevent the recurrence of internal hemorrhoids. Additionally, the duration of defecation should not be too long, and excessive straining should be avoided to prevent worsening of the prolapsed hemorrhoids. Moreover, patients must pay attention to the hygiene around the anus, and cleanse the peri-anal area with warm saline water after each bowel movement. However, if the internal hemorrhoids cannot be manually reduced after prolapse, or if incarceration and swelling occur, causing anal distension and pain, it is necessary to visit the hospital's colorectal surgery department promptly to undergo internal hemorrhoid ligation, TST, PPH, or other surgical procedures, followed by dressing changes. Since unresolved internal hemorrhoid prolapse can easily lead to incarceration or even necrosis, it is crucial to arrange for surgery as soon as possible, and patients should develop good bowel habits to maintain smooth defecation.

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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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Will internal hemorrhoids be painful?

If internal hemorrhoids experience local mucosal rupture or repeated prolapse leading to friction of the mucosa, it is likely to cause pain and even bleeding. To avoid pain caused by internal hemorrhoids, it is recommended that patients use hemorrhoid suppositories for local administration in the rectum for early flare-ups to reduce swelling, relieve pain, and cool and stop bleeding. If internal hemorrhoids prolapse and cannot retract back into the anal canal on their own after each prolapse, it is suggested that patients consider surgery to ligate and excise the affected internal hemorrhoids, or inject sclerosants under the mucosa of the hemorrhoids to cause local mucosal consolidation and shedding. Patients with internal hemorrhoids are advised not to strain excessively during bowel movements to avoid worsening local congestion and edema.

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Written by Chen Tian Jing
Colorectal Surgery
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Do internal hemorrhoids require surgery?

The clinical symptoms of internal hemorrhoids are numerous, and surgery is only recommended if the internal hemorrhoids frequently recur, or if the clinical symptoms are severe. Severe internal hemorrhoids are primarily characterized by substantial rectal bleeding or recurrent prolapses, and due to repeated prolapses, friction on the local mucosa may even cause anal pain. A severe symptom of prolapsed internal hemorrhoids is that after each prolapse, the patient needs to manually reposition them, accompanied by jet-like or dripping fresh red rectal bleeding. Surgical methods for internal hemorrhoids mainly include hemorrhoidectomy with ligation or local injection of sclerosing agents.

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Written by Deng Heng
Colorectal Surgery
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How should internal hemorrhoids be effectively treated?

The treatment methods for internal hemorrhoids are mainly divided into conservative treatment and surgical treatment. Conservative treatments include oral medications or topical medications, mainly aimed at relieving symptoms such as bleeding or prolapse during the remission phase, without addressing the pathological site. Surgical options include hemorrhoidal ligation, hemorrhoidectomy, PPH (stapled hemorrhoidopexy), and injection therapy, all of which are surgeries targeting the hemorrhoids themselves, and their effectiveness is generally quite definitive.