The harm of internal hemorrhoids prolapse

Written by Deng Heng

Colorectal Surgery

Updated on January 08, 2025

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Prolapsed internal hemorrhoids are one of the main clinical manifestations of internal hemorrhoids, and their harm is mainly manifested in two aspects: Firstly, the prolapse of hemorrhoidal tissue outside the anus can lead to perianal skin eczema and itching, and anal eczema. Secondly, it can lead to incarcerated hemorrhoids, where the prolapsed internal hemorrhoid, held by the sphincter, forms congestion, and is accompanied by hardening of the hemorrhoidal tissue, pain, and even necrosis.

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Written by Chen Tian Jing

Colorectal Surgery

54sec

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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

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.

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Written by Deng Heng

Colorectal Surgery

38sec

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How to reposition a prolapsed internal hemorrhoid?

Some internal hemorrhoids that prolapse can retract on their own, corresponding to second-degree internal hemorrhoids. If manual repositioning is required, these are typically third-degree or fourth-degree internal hemorrhoids. Third-degree internal hemorrhoids need to be manually repositioned because the external anal sphincter obstructs the retraction of the hemorrhoids. Generally, the method of taking a warm water sitz bath is used to relax the external anal sphincter, after which the hemorrhoids can be manually repositioned. During repositioning, applying some paraffin oil can facilitate the process, making it easier to accomplish.

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Written by Chen Tian Jing

Colorectal Surgery

56sec

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How is internal hemorrhoids treated? Is there a way?

There are many treatment methods for internal hemorrhoids, the most common being medication. If the internal hemorrhoids repeatedly prolapse or bleed significantly, direct surgical removal can also be considered. Conservative treatments primarily involve the local use of hemorrhoid suppositories, combined with oral hemostatic and anti-swelling traditional Chinese medicine. If surgical criteria are met, direct surgical removal can be performed. Surgical methods mainly include injection of sclerosing agents into the mucosa of internal hemorrhoids, internal hemorrhoid banding, and internal hemorrhoid ligation and excision. To prevent recurrence after surgery, patients should maintain good dietary and bowel habits postoperatively, avoid overly spicy and stimulating foods, and try to keep bowel movements under ten minutes without straining excessively.

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Written by Yu Xu Chao

Colorectal Surgery

1min 18sec

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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.