What should I do about internal hemorrhoids?

Written by Yu Xu Chao
Colorectal Surgery
Updated on March 17, 2025
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In clinical practice, the treatment of internal hemorrhoids mainly depends on the symptoms presented by the patient, and an appropriate treatment method is selected accordingly. For example, patients with early-stage internal hemorrhoids who experience intermittent rectal bleeding are usually advised to use hemorrhoid suppositories or ointments after defecation. However, as the condition of internal hemorrhoids worsens, which might include prolapse or even symptoms of anemia, surgical treatment is often recommended. Clinically, surgery for internal hemorrhoids can involve sclerotherapy injections, hemorrhoidal banding, or other surgical methods such as PPH (Procedure for Prolapse and Hemorrhoids) or TST (Transanal Hemorrhoidal Dearterialization). Post-surgery, dressing changes are necessary, and products such as rectal cleansing solutions, oil gauze strips, or ointments are commonly used. Moreover, it is crucial for patients to maintain smooth bowel movements post-surgery to avoid wound infection, bleeding, or edema, and they should adhere to a light diet avoiding spicy, stimulating, and dry foods. (Please follow medical advice regarding medication use.)

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Written by Chen Tian Jing
Colorectal Surgery
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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 Deng Heng
Colorectal Surgery
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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 Chen Tian Jing
Colorectal Surgery
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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 Ren Zheng Xin
Gastroenterology
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The color of the blood from internal hemorrhoids.

Bleeding from internal hemorrhoids is bright red. If the amount of bleeding is substantial, it can appear as a jet-like hemorrhoidal bleeding. This condition is caused by hard and dry stools scratching the hemorrhoidal veins during defecation, leading to bleeding. Repeated bleeding from internal hemorrhoids can cause chronic blood loss and result in symptoms of anemia. It is advisable to actively engage in medication or minimally invasive treatments, using drugs to stop bleeding and constrict hemorrhoidal veins. Some may undergo vein ligation surgery minimally invasively. At the same time, it is important to have a light diet, drink more water, eat more vegetables, and ensure smooth bowel movements.

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Written by Deng Heng
Colorectal Surgery
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How to treat internal hemorrhoids stage II?

Internal hemorrhoids, according to the provisional standards for the diagnosis of hemorrhoids set by the Coloproctology Group of the Surgical Branch of the Chinese Medical Association in September 2002, stage II internal hemorrhoids primarily exhibit symptoms of bleeding during defecation. Additionally, the hemorrhoidal mass prolapses outside the anus during bowel movements but retracts back inside autonomously after defecation. This condition is referred to as stage II internal hemorrhoids, indicating the onset of symptoms like bleeding and prolapse, thus requiring surgical treatment. Indications for surgery include procedures like hemorrhoid banding or hemorrhoidectomy to remove the hemorrhoids. Conservative treatment options like using hemorrhoidal suppositories or ointments are also available if surgery is not immediately considered, but if these treatments are ineffective, surgery should be pursued. (Please use medications under the guidance of a physician to avoid misuse.)