The hazards of internal hemorrhoids bleeding

Written by Chen Tian Jing
Colorectal Surgery
Updated on September 18, 2024
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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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Written by Yu Xu Chao
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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 Deng Heng
Colorectal Surgery
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Is bleeding from internal hemorrhoids serious?

Bleeding from internal hemorrhoids, also known as rectal bleeding, is a common primary symptom in patients with internal hemorrhoids. Although the bleeding from internal hemorrhoids is painless and not itchy, it occurs during bowel movements and can be either a trickle or a spray of blood. Although the amount of bleeding might not be large and may subside naturally, in clinical practice, we have seen a minority of patients with long-term chronic bleeding leading to severe anemia. For example, the normal hemoglobin level in adults should be 120g/L, but at the time of consultation, their hemoglobin has dropped to 30, 40, or 50g/L. Treatment then requires an initial blood transfusion followed by surgery, which can be quite complicated. Therefore, bleeding from internal hemorrhoids should be taken seriously.

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Written by Deng Heng
Colorectal Surgery
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What department should I go to at the hospital for internal hemorrhoids?

Patients with internal hemorrhoids should go to the proctology department at the hospital, because internal hemorrhoids are venous clusters that grow above the dentate line of the rectum. The main symptom is rectal bleeding, along with prolapse, pain, anal itching, and a feeling of heaviness around the anus as the primary clinical manifestations. Proctologists have a good knowledge base about diseases around the anal area and are well-versed in diagnosing and treating internal hemorrhoids, as well as managing post-surgical recovery. Therefore, it is appropriate for patients with internal hemorrhoids to consult the proctology department after arriving at the hospital.

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Written by Deng Heng
Colorectal Surgery
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Why is it difficult to cure internal hemorrhoids bleeding?

Internal hemorrhoids refer to the soft venous masses formed by the dilation and varicosity of the hemorrhoidal venous plexus located beneath the mucosa at the end of the rectum, above the dentate line of the anus. Once these masses have formed, they contain blood vessels which can rupture, leading to bleeding during bowel movements, evident as blood mixed with stool. Once these pathological masses have formed, it is very difficult to completely heal them with medication alone; surgical removal of these venous masses is required to prevent recurrent bleeding. Therefore, if conservative treatment is applied, it only slightly alleviates symptoms. If any triggering factors are present, bleeding may recur.

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Written by Deng Heng
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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.