How is internal hemorrhoids bleeding caused?

Written by Deng Heng

Colorectal Surgery

Updated on February 05, 2025

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Internal hemorrhoids bleeding is caused primarily by venous dilation and congestion. Anatomically speaking, hemorrhoids are varicose veins, which means they contain a lot of fresh blood. When straining during defecation, the hemorrhoids rub against the dry stool, causing the mucous membrane of the hemorrhoids to rupture and leading to bleeding symptoms. When the bleeding symptoms are mild, blood can be seen in the stool during defecation, or drops of blood may appear during bowel movements. In severe cases, spraying bleeding may occur. Generally, the bleeding stops after defecation.

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Written by Chen Tian Jing

Colorectal Surgery

1min 38sec

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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 Chen Tian Jing

Colorectal Surgery

54sec

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How to stop bleeding from internal hemorrhoids prolapse?

If internal hemorrhoids bleeding leads to unstoppable bleeding, the most common and direct way to stop the bleeding primarily involves local ligation. The prolapse and bleeding of internal hemorrhoids are mainly due to the repeated prolapse and friction of the local mucosa causing rupture and bleeding, or the persistent bleeding from ruptured small arteries. If prompt hemostatic treatment is not administered, it could potentially lead to chronic blood loss and subsequent anemia due to decreased blood volume. Therefore, if patients experience bleeding from internal hemorrhoids, especially if the bleeding is prolonged or substantial, it is advised to visit a proctology department for relevant examinations soon. If necessary, it may be crucial to promptly proceed with internal hemorrhoidal ligation surgery.

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Written by Deng Heng

Colorectal Surgery

46sec

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What should I do if internal hemorrhoids always bleed?

Internal hemorrhoids refer to the venous clumps located above the dentate line. When these hemorrhoids are injured or ruptured, bleeding during bowel movements occurs, which is the most common primary symptom in patients with internal hemorrhoids. Frequent bleeding from internal hemorrhoids can first be treated conservatively, such as by taking oral hemostatic medications, followed by the local application of hemorrhoid creams, suppositories, and the like. If bleeding consistently persists, surgical treatment may be required. Once internal hemorrhoids present symptoms of bleeding or prolapse, they typically indicate the need for surgery, hence treatment for frequent bleeding in internal hemorrhoids can be either conservative or surgical.

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Written by Chen Tian Jing

Colorectal Surgery

53sec

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The hazards of internal hemorrhoids bleeding

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

58sec

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Is the bleeding from internal hemorrhoids bright red?

The majority of internal hemorrhoid bleeding is bright red, but if there is a significant amount of bleeding, blood may accumulate within the anal canal and form clots, resulting in darker colored blood in the stool. To identify and diagnose whether it is bleeding from internal hemorrhoids, it is recommended that patients undergo an anoscopic examination. If obvious bleeding points are found near the mucosa around the dentate line, it is mostly due to internal hemorrhoids. To treat bleeding from internal hemorrhoids, it is first necessary to take oral or topical hemostatic medications for symptomatic treatment. If the internal hemorrhoid bleeding has been prolonged, or in cases of chronic blood loss, further surgical ligation may be necessary to stop the bleeding and prevent anemia due to excessive blood loss. (The use of medications should be under the guidance of a doctor.)