Can internal hemorrhoids be treated by prolapse and bloodletting?

Written by Yu Xu Chao
Colorectal Surgery
Updated on March 02, 2025
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Bleeding should not be used for prolapsed internal hemorrhoids, as this condition is primarily caused by improper defecation habits leading to pathological enlargement and descent of the anal cushion, which results in the prolapse of internal hemorrhoids. In the early stage, prolapsed internal hemorrhoids can retract back into the anus after defecation, and under such circumstances, it is only required for the patient to develop good bowel habits. For example, avoid spending too much time on defecation, don't exert excessive force, perform sphincter exercises after defecation, and maintain smooth bowel movements. Attention should also be paid to perianal hygiene; it is advised to wash the area with warm saline water after defecation to avoid worsening the prolapse or causing incarcerated edema. However, for cases where incarcerated edema occurs, it is generally recommended to consider prompt surgical intervention, such as hemorrhoidal ligation, PPH (Procedure for Prolapse and Hemorrhoids), or TST (Transanal Stapling Technique). The use of bleeding as a treatment does not have significant therapeutic effects for prolapsed internal hemorrhoids, and thus is not recommended in clinical practice. Furthermore, patients should pay attention to a light diet and avoid spicy, stimulating, and dry-hot foods as much as possible.

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Written by Yu Xu Chao
Colorectal Surgery
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Internal hemorrhoids that prolapse need to be operated on within a few days.

In clinical practice, if internal hemorrhoids prolapse and cannot retract for three to four days, then it is necessary to proceed with surgical treatment as soon as possible. This is because prolonged prolapse of internal hemorrhoids at the anus can lead to local swelling and even thrombosis. Severe cases may experience anal distension and pain, or necrosis of the hemorrhoids, thus early surgical intervention is recommended. The surgical options for prolapsed internal hemorrhoids include internal hemorrhoid ligation, PPH (Procedure for Prolapse and Hemorrhoids), or TST (Transanal Hemorrhoidal Dearterialization) among others. Postoperative dressing changes are crucial, as improper care can easily lead to pseudohealing or infection and edema. Typically, anal washes, hemorrhoidal suppositories, or hemorrhoidal ointments can be chosen for postoperative dressing. Moreover, it is important for patients to develop good bowel habits post-surgery, maintaining smooth bowel movements and avoiding hard, dry stools to prevent irritation to the wound, which could lead to bleeding or swelling.

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

Internal hemorrhoids bleeding does not necessarily require surgical treatment; conservative treatment is also an option. The main clinical symptom of internal hemorrhoids is bleeding, which can vary in amount and is generally bright red. Treatment for internal hemorrhoids mainly includes conservative treatment and surgical treatment. For first and second-degree internal hemorrhoid bleeding, conservative treatment can be adopted, which involves ensuring that stools are smooth, soft, and well-formed, reducing irritation to the anal area. Secondly, some hemostatic medications can be taken. Surgical treatment is primarily targeted at third and fourth-degree internal hemorrhoids.

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Written by Yu Xu Chao
Colorectal Surgery
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Mild bleeding due to internal hemorrhoids prolapse.

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

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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Written by Chen Tian Jing
Colorectal Surgery
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Can internal hemorrhoids heal by themselves?

The vast majority of internal hemorrhoid bleeding is not self-healing. Only a small amount of mucosal bleeding or if the patient actively takes care of themselves after bleeding, there might be a tendency to self-heal. Internal hemorrhoid bleeding is mainly caused by excessive local congestion pressure or hard stools piercing the local mucosal skin, leading to bleeding, generally related to poor dietary habits and defecation habits of the patient. Therefore, to achieve self-healing from internal hemorrhoid bleeding, the patient firstly needs to adjust their diet and defecation habits to avoid repeated occurrences of bleeding during bowel movements. If the bleeding is significant or lasts for a long time and cannot heal on its own, it is recommended that the patient seek treatment as soon as possible to avoid long-term internal hemorrhoid bleeding which could lead to anemia.