What should I do if internal hemorrhoids have been bleeding for several days?

Written by Chen Tian Jing
Colorectal Surgery
Updated on September 17, 2024
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If internal hemorrhoids have been bleeding continuously for several days, and the bleeding is substantial, it is advisable to promptly undertake active hemostasis treatment. Common treatments for bleeding internal hemorrhoids mainly include taking oral hemostatic medication, or using suppositories and ointments for hemorrhoids to actively stop the bleeding. However, conservative treatment can only provide temporary relief of symptoms. If after treatment, the patient does not pay attention to a light diet or good bowel habits, there may also be a recurrence of hemorrhoid bleeding. If the bleeding is already severe, and there is a possibility of serious anemia, it is advised to perform a local internal hemorrhoid ligation surgery as soon as possible to prevent anemia or exacerbate the severity of the disease. (Medication should be used under the guidance of a doctor.)

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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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How to solve internal hemorrhoids that are prolapsed and incarcerated?

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.

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Colorectal Surgery
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Do internal hemorrhoids cause a sensation of falling and swelling in the anus?

Internal hemorrhoids can cause a sensation of fullness or swelling in the anus. Although the main clinical symptoms of internal hemorrhoids are bleeding and prolapse of the hemorrhoidal nodes outside the anus, any stage of internal hemorrhoids can exhibit varying degrees of this sensation. Early to middle stages of internal hemorrhoids typically involve less severe swelling, while in the later stages, when the hemorrhoidal nodes prolapse, the sensation can be significantly more intense, especially after prolonged standing or physical exertion.

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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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What foods should be avoided if there is bleeding from internal hemorrhoids?

Internal hemorrhoids bleeding is the main clinical symptom of internal hemorrhoids; the amount of bleeding can vary greatly and is usually bright red. It can spray out or drip out. Patients with internal hemorrhoids bleeding are advised to avoid eating chili peppers and drinking alcohol. This is because chili peppers contain a component called capsaicin, which strongly irritates the gastrointestinal mucosa and can dilate blood vessels, exacerbating the bleeding. Alcohol can also dilate blood vessels and worsen the bleeding.