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 Chen Tian Jing
Colorectal Surgery
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How long does it take to recover from internal hemorrhoidectomy surgery?

The recovery time after internal hemorrhoidectomy mainly depends on the severity of the condition before the surgery. Most internal hemorrhoidectomies, specifically referring to internal hemorrhoid ligation surgeries combined with sclerotherapy injections, generally require a recovery period of about 2-3 weeks. If the internal hemorrhoids were significantly prolapsed before the surgery or if there were multiple prolapsed hemorrhoids, the recovery time might be relatively longer. If the procedure involved only localized ligation or sclerotherapy injections and there are no external wounds around the anus, the recovery time is approximately one week. During the recovery period, patients need to maintain a light diet, avoid dry stools and excessive straining during bowel movements, which could lead to pain or bleeding at the surgical site.

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Written by Chen Tian Jing
Colorectal Surgery
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How to treat internal hemorrhoids?

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 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.

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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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Can internal hemorrhoids be treated with wet compresses?

After prolapse of internal hemorrhoids, moist compresses can be applied, but the therapeutic effect of moist compresses is not significant. The prolapse of internal hemorrhoids mainly occurs when the anal cushion pathologically enlarges and shifts downward, leading to the prolapse. If the prolapsed hemorrhoids cannot be retracted back into the anus, this can lead to incarcerated edema, causing swelling and pain around the anus. If the incarceration lasts too long, it can induce local thrombosis or even necrosis. In such cases, it is recommended to opt for surgical treatment as soon as possible. Common surgical methods include internal hemorrhoid ligation, internal hemorrhoid excision, PPH (Procedure for Prolapse and Hemorrhoids), or TST (Transanal Hemorrhoidal Dearterialization). After surgery, it is advisable to use anal washes or potassium permanganate solutions for sitz baths, and then apply topical treatments such as hemorrhoid creams, red oil gauze strips, and yellow ointments to promote postoperative recovery. Moreover, patients should develop good bowel habits after surgery to maintain smooth bowel movements, which further aids recovery. (Under the guidance of a doctor for medication use)