Why is it difficult to cure internal hemorrhoids bleeding?

Written by Deng Heng
Colorectal Surgery
Updated on January 28, 2025
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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 Yu Xu Chao
Colorectal Surgery
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Can internal hemorrhoids that protrude outside the anus be cured by taking medicine?

Internal hemorrhoids that prolapse outside the anus cannot be cured by medication alone. This is because when internal hemorrhoids prolapse, it indicates a significant pathological enlargement and downward displacement of the anal cushions, which are structural changes. Merely taking medication will not result in significant improvement; surgery is the primary option at this point. For this condition, surgical options such as PPH (Procedure for Prolapse and Hemorrhoids) or TST (Transanal Hemorrhoidal Dearterialization) can be employed. Consistent postoperative care and dressing changes can facilitate recovery. Because prolapsed internal hemorrhoids are located at the anal opening, if not treated surgically, they can lead to impaired blood flow, which may cause incarceration leading to edema or thrombosis, and even potentially result in infected necrosis. Therefore, early surgical intervention is required for prolapsed internal hemorrhoids. Additionally, patients should regularly perform anal sphincter exercises, avoid straining excessively during bowel movements, and not spend too much time on the toilet.

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Written by Ren Zheng Xin
Gastroenterology
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Is bleeding from hemorrhoids internal hemorrhoids?

Hemorrhoids causing blood in the stool are mostly due to internal hemorrhoids, which are a manifestation of varicose veins in the hemorrhoidal veins. During defecation, because the stool is rather dry and hard, it can easily scratch the hemorrhoidal veins as it moves downward. Due to internal hemorrhoids, the hemorrhoidal veins become distended and the vein walls become very thin, making them easily damaged, thus leading to bleeding. Minor cases may involve blood during defecation or dripping blood, while more severe cases can present with spraying blood during bowel movements. Depending on the amount of bleeding, one should choose treatments such as medications, minimally invasive procedures, or surgery.

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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 Chen Tian Jing
Colorectal Surgery
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The Difference between Mixed Hemorrhoids and Internal Hemorrhoids

Mixed hemorrhoids and internal hemorrhoids are both clinical types of hemorrhoids. Generally speaking, mixed hemorrhoids mainly occur simultaneously with both internal and external hemorrhoids, while internal hemorrhoids are mainly local mucosal bulges near the dentate line in the anal canal. Both mixed and internal hemorrhoids belong to hemorrhoids, so there are many similarities in treatment. However, since mixed hemorrhoids generally involve both internal and external hemorrhoids acting together, they are generally more severe than internal hemorrhoids alone. Treatment for both mixed and internal hemorrhoids can involve conservative medication, primarily focusing on topical applications; for mixed hemorrhoids, local anal suppositories and hemorrhoidal ointment applications are commonly used, while treatment for internal hemorrhoids primarily involves hemorrhoidal suppositories. If both mixed and internal hemorrhoids meet certain surgical criteria, surgical treatment can be chosen. The surgical approach for mixed hemorrhoids mainly includes excision and ligation, while the surgical approach for internal hemorrhoids mainly involves hemorrhoid ligation or hemorrhoid banding. (Note: This answer is for reference only, use medication under the guidance of a professional physician, do not self-medicate.)

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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.