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 Deng Heng

Colorectal Surgery

45sec

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Why is internal hemorrhoid bleeding painless?

Bleeding from internal hemorrhoids, also known as rectal bleeding, is the most common primary clinical manifestation in patients with internal hemorrhoids. Internal hemorrhoids refer to the venous clusters that grow above the dentate line, and their onset occurs above this line. The area above the dentate line is mainly controlled by the autonomic nervous system, making it insensitive to pain and irritation. Therefore, many patients with bleeding internal hemorrhoids may not even realize it themselves, as it does not cause pain. In contrast, external and mixed hemorrhoids, which involve the area below the dentate line, are controlled by somatic nerves, making pain more readily felt.

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Written by Yu Xu Chao

Colorectal Surgery

1min 11sec

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Do internal hemorrhoids definitely need to be pushed back in?

If internal hemorrhoids prolapse, they must be pushed back in because prolonged prolapse at the anus can lead to increased secretions in the anal area, causing itching. Moreover, internal hemorrhoids that prolapse can rub against underwear, resulting in damage, or even provoke inflammatory infections causing swelling and pain in the anus. Additionally, prolonged prolapsed hemorrhoids may also lead to poor local circulation, potentially forming blood clots, causing severe swelling and pain, and even possibly leading to necrosis of the hemorrhoids. Therefore, if internal hemorrhoids prolapse, they should be pushed back in as much as possible. If they cannot be pushed back, it is advisable to promptly visit the hospital's colorectal surgery department to consider procedures such as hemorrhoidal banding, PPH (Procedure for Prolapse and Hemorrhoids), or TST (Transanal Hemorrhoidal Dearterialization). After the surgery, it is crucial to adhere to changing dressings to avoid wound infection and inflammation. Furthermore, if the internal hemorrhoids repeatedly prolapse after being pushed back, surgical treatment is also necessary.

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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 Deng Heng

Colorectal Surgery

41sec

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Symptoms of internal hemorrhoids outbreak

Symptoms of internal hemorrhoids: Internal hemorrhoids refer to the venous clusters located above the dentate line at the end of the rectum, which are branches of the superior rectal vein. The main symptoms of internal hemorrhoids include the following: The first is rectal bleeding, which is generally bright red in color and usually not accompanied by pain. The bleeding can be in droplets or in a spraying manner; the second is the prolapse of the hemorrhoidal nucleus, which can protrude outside the anus during bowel movements; the third is that once the hemorrhoidal nucleus has prolapsed outside the anus, symptoms such as moisture and itching around the anus may occur.

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Written by Yu Xu Chao

Colorectal Surgery

1min 11sec

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How long does it take for internal hemorrhoids to reposition after being pushed back in?

This situation mainly depends on how much the internal hemorrhoids have prolapsed and the severity of the prolapse. If the internal hemorrhoids can be pushed back in after prolapsing, it generally takes half an hour to an hour to reposition them. However, if the patient overexerts themselves or strains during coughing or defecation, the internal hemorrhoids may prolapse again. For patients whose internal hemorrhoids repeatedly prolapse, it is advisable to consider surgical treatment as soon as possible. Because repeated prolapse of internal hemorrhoids can lead to further pathological hypertrophy and descent of the anal cushion, in such cases of organic lesions, simple repositioning cannot solve the problem. It may even cause the prolapse to become larger over time and lead to complications like incarcerated edema, resulting in local thrombosis, swelling, and anal pain. Therefore, for patients with repeated prolapse, it is recommended to visit the hospital's colorectal surgery department for surgical treatment as soon as possible, such as internal hemorrhoid ligation, TST, and other surgical methods.