How to treat internal hemorrhoids?

Written by Chen Tian Jing
Colorectal Surgery
Updated on September 06, 2024
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Hemorrhoids are divided into internal, external, and mixed types. The clinical symptoms of internal hemorrhoids mainly include local pain, prolapse, and rectal bleeding due to rupture. If there are recurrent episodes or associated inflammation, there may also be an increase in secretions, which can irritate the local skin around the anus and cause itching. Therefore, the primary treatment for internal hemorrhoids involves the use of suppository hemorrhoid plugs. If there is accompanying bleeding, it is also necessary to combine this with oral hemostatic medications. In cases of perianal itching, options such as sichuan pepper water or other insecticidal and anti-itch traditional Chinese medicine washes can be used for fumigation and hot compresses on the affected area.

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Written by He Cai Dong
Colorectal Surgery Department
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What should I do if the internal hemorrhoids hurt after being pushed back in?

If the pain does not subside after pushing back a prolapsed internal hemorrhoid, it is often due to the formation of a thrombus, which is why the localized pain is quite noticeable. In such cases, it is advised to use topical medications for treatment. You can use hemorrhoid suppositories or ointment, inserting them into the anus to alleviate the pain. If the pain remains significant, you can also take oral pain relievers temporarily. If pain persists even after these treatments, it may be considered a strangulated hemorrhoid, which is more serious. It is recommended that you visit a formal hospital's proctology department. There, a doctor can perform a digital rectal examination and an anoscopy to establish a definitive diagnosis and provide appropriate treatment. If very severe, surgery may be needed. (Use of medications should be under the guidance of a physician.)

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Written by Chen Tian Jing
Colorectal Surgery
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Can internal hemorrhoids lead to anemia?

Internal hemorrhoids bleeding easily leads to anemia in patients, especially when internal hemorrhoids bleed frequently and recurrently, or each bleeding episode is relatively severe, potentially causing a trend of decreased blood volume in patients. When blood volume reaches a certain threshold, symptoms of anemia can appear. If the anemia is assessed as mild or moderate, besides using local hemostatic hemorrhoid creams or suppositories, patients can also take oral traditional Chinese medicine that supplements qi and generates blood for symptomatic treatment, to enhance body immunity and physical constitution. If anemia primarily presents as severe, to avoid further exacerbation of anemia or impairment of overall organ functions, it is recommended that patients undergo surgical ligation for hemostasis and, if necessary, blood transfusion. (Medication should be used under the guidance of a doctor.)

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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 Yu Xu Chao
Colorectal Surgery
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Can internal hemorrhoids that protrude outside the anus be cured by taking medicine?

Internal hemorrhoids that prolapse outside the anus cannot be cured by medication alone. This is because when internal hemorrhoids prolapse, it indicates a significant pathological enlargement and downward displacement of the anal cushions, which are structural changes. Merely taking medication will not result in significant improvement; surgery is the primary option at this point. For this condition, surgical options such as PPH (Procedure for Prolapse and Hemorrhoids) or TST (Transanal Hemorrhoidal Dearterialization) can be employed. Consistent postoperative care and dressing changes can facilitate recovery. Because prolapsed internal hemorrhoids are located at the anal opening, if not treated surgically, they can lead to impaired blood flow, which may cause incarceration leading to edema or thrombosis, and even potentially result in infected necrosis. Therefore, early surgical intervention is required for prolapsed internal hemorrhoids. Additionally, patients should regularly perform anal sphincter exercises, avoid straining excessively during bowel movements, and not spend too much time on the toilet.

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Written by Yu Xu Chao
Colorectal Surgery
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Can internal hemorrhoids burst by themselves?

Internal hemorrhoids that prolapse should not be burst forcibly. As internal hemorrhoids are located at the anus, they are continuously exposed to contaminants from fecal and secretion matter over time. If the prolapsed hemorrhoids burst, it could lead to local infections and even necrosis. Therefore, do not burst prolapsed hemorrhoids, but rather, try to push them back into the anus. If they cannot be reinserted, it is recommended to opt for surgical treatment early to avoid rupture or strangulated edema, which can lead to swelling, pain, or necrosis in the anal area. Surgical options include hemorrhoidal banding, PPH, or TST procedures. Post-surgery, treatments may include the use of anal washes, red ointment gauze, aureomycin ointment, etc. Moreover, patients should eat a light diet, maintain smooth bowel movements, and regularly perform pelvic floor exercises.