How long does it take to recover from internal hemorrhoidectomy surgery?

Written by Chen Tian Jing
Colorectal Surgery
Updated on September 15, 2024
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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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The color of the blood from internal hemorrhoids.

Bleeding from internal hemorrhoids is bright red. If the amount of bleeding is substantial, it can appear as a jet-like hemorrhoidal bleeding. This condition is caused by hard and dry stools scratching the hemorrhoidal veins during defecation, leading to bleeding. Repeated bleeding from internal hemorrhoids can cause chronic blood loss and result in symptoms of anemia. It is advisable to actively engage in medication or minimally invasive treatments, using drugs to stop bleeding and constrict hemorrhoidal veins. Some may undergo vein ligation surgery minimally invasively. At the same time, it is important to have a light diet, drink more water, eat more vegetables, and ensure smooth bowel movements.

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Written by Yu Xu Chao
Colorectal Surgery
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What are the symptoms of internal hemorrhoids?

Internal hemorrhoids are a common condition in proctology, clinically characterized primarily by intermittent, painless rectal bleeding. The blood is bright red, often appearing in a jetting or dripping pattern after defecation or on toilet paper during wiping. Simultaneously, the clinical symptoms of internal hemorrhoids vary with their stages. For instance, grade I internal hemorrhoids mainly exhibit intermittent rectal bleeding without any prolapse of anal materials. Grade II internal hemorrhoids show symptoms of intermittent rectal bleeding accompanied by prolapse of anal materials, which can spontaneously reduce. Grade III internal hemorrhoids are characterized by prolapsed anal materials that cannot reduce on their own and require manual intervention. This stage also involves rectal bleeding. Grade IV internal hemorrhoids are the most severe, presenting with irreducible prolapsed materials that can become trapped or may protrude during coughing or walking. Rectal bleeding is also a symptom. Surgical treatment is essential for grade IV 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 Yu Xu Chao
Colorectal Surgery
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Does pressing on an internal hemorrhoid cause pain?

If internal hemorrhoids prolapse and become incarcerated or a thrombus forms locally, pressing on the area will cause pain, especially when the patient is walking or sitting, making the pain more apparent. For such cases, which are considered a severe stage of internal hemorrhoids, it's advisable to undertake surgical treatment as soon as possible. Clinically, treatment options for internal hemorrhoids include procedures like rubber band ligation, PPH (Procedure for Prolapse and Hemorrhoids), or TST (Transanal Hemorrhoidal Dearterialization), with continued dressing changes required post-surgery. However, if the prolapsed internal hemorrhoids can retract spontaneously or can be manually reduced, pressing on them generally does not cause pain because internal hemorrhoids are located above the dentate line in the anal canal, an area innervated by autonomic nerves, which are less sensitive to pain. In the absence of inflammation or thrombosis, pressing on the area will not typically cause pain. In such cases, patients should develop good bowel habits to prevent the further worsening of internal hemorrhoids.

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Colorectal Surgery
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The difference between rectal prolapse and internal hemorrhoids prolapse

Rectal prolapse primarily refers to the prolapse of the rectal mucosa or part of the sigmoid colon mucosa, partially or completely falling out of the anus. Generally, there is a ring-shaped or cylindrical mucosa protrusion outside the anus. Internal hemorrhoid prolapse involves the partial prolapse of the mucosa near the dentate line, typically appearing as small lumps or accompanied by local venous thrombosis and varicose clusters, with rectal prolapse being more severe than internal hemorrhoid prolapse. The treatment of rectal prolapse mainly involves surgery, while early stages of internal hemorrhoid prolapse can be treated with medications. This involves using topical hemorrhoid creams or suppositories to alleviate symptoms. If there are recurrent prolapses or accompanying bleeding during bowel movements, surgical treatment may also be considered. Surgical methods for rectal prolapse primarily involve local mucosal ring excision, whereas surgeries for internal hemorrhoids mainly include hemorrhoid ligation or banding procedures.