How to solve internal hemorrhoids that are prolapsed and incarcerated?

Written by Yu Xu Chao
Colorectal Surgery
Updated on April 03, 2025
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In clinical practice, for cases where internal hemorrhoids prolapse and become incarcerated, surgical treatment is often recommended. This is because the prolapse of internal hemorrhoids indicates a significant displacement and that the hemorrhoids have been prolapsed for a long time, which can lead to incarceration. In such cases, there is a risk of localized swelling or thrombosis formation, causing anal swelling and pain, and in severe cases, necrosis of the prolapsed tissue.

Therefore, it is advised to opt for surgical treatment as soon as possible for incarcerated internal hemorrhoidal prolapse. Surgical options include hemorrhoidal banding, PPH (Procedure for Prolapse and Hemorrhoids), and TST (Transanal hemorrhoidal dearterialization) among others. Anesthetic choices can range from local infiltration anesthesia, spinal anesthesia, to general intravenous anesthesia. With spinal and general anesthesia, the patient does not experience pain during surgery and does not feel fear of pain. Post-surgery, it is also necessary to select appropriate medications for dressing changes, such as anal washes, hemorrhoidal suppositories, and golden yellow ointment to promote wound healing.

Other Voices

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Will internal hemorrhoids affect menstruation?

Internal hemorrhoid bleeding can potentially affect menstruation. Although brief internal hemorrhoid bleeding does not affect menstruation, if the hemorrhoid bleeding is heavy, prolonged, frequent, and occurs daily or frequently, exceeding the body's ability to replace the lost blood, it can cause severe systemic anemia. In such cases, it might affect menstruation.

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What is the most effective treatment for internal hemorrhoids bleeding?

The most effective treatment method for internal hemorrhoid bleeding primarily depends on the severity of the bleeding. If it is only early-stage internal hemorrhoid bleeding, the most effective method is to choose hemorrhoid suppositories or ointments for anal administration, which can quickly stop the bleeding. At the same time, patients should pay attention to their diet and avoid spicy, irritating and dry foods as much as possible, which can also alleviate the bleeding of internal hemorrhoids. However, if the internal hemorrhoid bleeding is frequent and the amount of bleeding is substantial, then the most effective treatment method is to go to the hospital's colorectal surgery department for surgical treatment. The surgical treatments can include sclerotherapy injections, PPH or TST, and internal hemorrhoid banding, etc. Consistently changing dressings after surgery can effectively improve and control internal hemorrhoid bleeding.

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Written by Chen Tian Jing
Colorectal Surgery
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What to do if internal hemorrhoids bleed severely but there is no pain or itching?

If there is severe bleeding from internal hemorrhoids, it is recommended to promptly conduct an anoscopy to determine the exact locations and amount of bleeding. Generally, bleeding from internal hemorrhoids is painless, so it is often underestimated by patients. If the bleeding is heavy or persists for a long time, it is advised that patients undergo surgery as soon as possible to ligate and stop the bleeding, or combine this with oral hemostatic drugs for symptomatic treatment to avoid exacerbation of the bleeding and resulting anemia. Repeated bleeding from internal hemorrhoids can likely lead to varying degrees of anemia. If repeated bleeding occurs, or if the anemia worsens and leads to severe anemia, further treatment with blood transfusions may be necessary to correct the anemia.

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Colorectal Surgery
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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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The early symptoms of internal hemorrhoids are

If early symptoms of internal hemorrhoids appear, the main manifestations are local mucosal protrusion or sub-mucosal congestion and edema. Patients may experience varying degrees of anal pain and might even experience minor bleeding during bowel movements due to irritation from hard, dry stools. The bleeding is usually bright red. After taking oral and topical medications, early-stage internal hemorrhoids can be cured and relieved. However, to prevent recurrent attacks of internal hemorrhoids or worsening of the condition, it is advised that patients maintain good bowel movements to avoid overly dry stools, keep bowel movement time under ten minutes, and avoid consuming spicy and irritating foods as much as possible.