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 13sec

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The difference between rectal polyps and internal hemorrhoids

Rectal polyps are skin-like mucosal protrusions that grow on the rectal mucosa, whereas internal hemorrhoids are confined to congestion and protrusion of the mucosa around the dentate line. The formation of rectal polyps is mainly due to long-term stimulation by feces, or certain constitutional and genetic factors, while the most likely cause of internal hemorrhoids is chronic congestion and edema around the anal area or the formation of venous thrombosis, leading to local varicose clusters. After the discovery of rectal polyps, it is necessary to perform surgery as soon as possible; however, the treatment for internal hemorrhoids in the early stages is primarily conservative, aimed at delaying the frequency of disease attacks and improving the quality of life for the patient. If the internal hemorrhoids reach a later stage or become severe, manifested by recurrent prolapse and rectal bleeding, surgical removal is recommended.

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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.)

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Written by Deng Heng

Colorectal Surgery

38sec

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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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Written by Deng Heng

Colorectal Surgery

40sec

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How to completely treat internal hemorrhoids?

In recent years, there have been numerous treatment methods for internal hemorrhoids, primarily divided into non-surgical and surgical treatments. Non-surgical treatment mainly involves conservative management, which generally includes measures such as increasing the intake of vegetables and fruits, maintaining smooth bowel movements, and using medications or applying ointments locally. Surgical treatment mainly includes injection therapy and excision of the hemorrhoidal nodes. For a complete cure, surgical treatment is typically required, which involves thoroughly removing the pathological hemorrhoidal nodes. (The use of medications should be under the guidance of a doctor.)

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Written by Deng Heng

Colorectal Surgery

54sec

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Is bleeding from internal hemorrhoids serious?

Bleeding from internal hemorrhoids, also known as rectal bleeding, is a common primary symptom in patients with internal hemorrhoids. Although the bleeding from internal hemorrhoids is painless and not itchy, it occurs during bowel movements and can be either a trickle or a spray of blood. Although the amount of bleeding might not be large and may subside naturally, in clinical practice, we have seen a minority of patients with long-term chronic bleeding leading to severe anemia. For example, the normal hemoglobin level in adults should be 120g/L, but at the time of consultation, their hemoglobin has dropped to 30, 40, or 50g/L. Treatment then requires an initial blood transfusion followed by surgery, which can be quite complicated. Therefore, bleeding from internal hemorrhoids should be taken seriously.