Will internal hemorrhoids be painful?

Written by Chen Tian Jing
Colorectal Surgery
Updated on January 19, 2025
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If internal hemorrhoids experience local mucosal rupture or repeated prolapse leading to friction of the mucosa, it is likely to cause pain and even bleeding. To avoid pain caused by internal hemorrhoids, it is recommended that patients use hemorrhoid suppositories for local administration in the rectum for early flare-ups to reduce swelling, relieve pain, and cool and stop bleeding. If internal hemorrhoids prolapse and cannot retract back into the anal canal on their own after each prolapse, it is suggested that patients consider surgery to ligate and excise the affected internal hemorrhoids, or inject sclerosants under the mucosa of the hemorrhoids to cause local mucosal consolidation and shedding. Patients with internal hemorrhoids are advised not to strain excessively during bowel movements to avoid worsening local congestion and edema.

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Written by Chen Tian Jing
Colorectal Surgery
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Do internal hemorrhoids require surgery?

The clinical symptoms of internal hemorrhoids are numerous, and surgery is only recommended if the internal hemorrhoids frequently recur, or if the clinical symptoms are severe. Severe internal hemorrhoids are primarily characterized by substantial rectal bleeding or recurrent prolapses, and due to repeated prolapses, friction on the local mucosa may even cause anal pain. A severe symptom of prolapsed internal hemorrhoids is that after each prolapse, the patient needs to manually reposition them, accompanied by jet-like or dripping fresh red rectal bleeding. Surgical methods for internal hemorrhoids mainly include hemorrhoidectomy with ligation or local injection of sclerosing agents.

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Written by Wu Hai Wu
Gastroenterology
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Does bleeding after defecation followed by a feeling of discomfort in the anus indicate internal hemorrhoids?

Bleeding after bowel movements followed by discomfort in the anus may be due to internal hemorrhoids, but could also indicate ulcerative proctitis, rectal cancer, or infections around the anus. To confirm the diagnosis, it is necessary to conduct a thorough examination with a digital colonoscopy. Based on the results of the colonoscopy, appropriate treatment measures can be taken. If the symptoms are caused by internal hemorrhoids, surgical treatment may be considered. For diseases like ulcerative colitis, treatment with salicylate preparations may also be used.

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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 Deng Heng
Colorectal Surgery
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Hemorrhoids: What dietary considerations should be noted?

Patients with internal hemorrhoids should primarily focus on a reasonable diet, paying attention to eat less or avoid spicy and stimulating foods and condiments. Additionally, they should cultivate the habit of drinking more water, preferably light salt water or honey water. For constipation and hemorrhoids, it's important to consciously drink more water and eat more fruits and fresh vegetables, especially those that are rich in coarse fiber. Stimulating foods such as chili peppers, black pepper, ginger, garlic, and onions should be consumed minimally.

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Written by Chen Tian Jing
Colorectal Surgery
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What should I do if internal hemorrhoids have been bleeding for several days?

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.)