Is minimally invasive surgery or traditional surgery better for internal hemorrhoids prolapse?

Written by Yu Xu Chao
Colorectal Surgery
Updated on December 11, 2024
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If the patient has only internal hemorrhoids prolapse without external hemorrhoids, it is better to opt for minimally invasive surgery, as it causes less damage and allows for faster postoperative recovery. Clinically, the TST surgical method is often recommended to avoid postoperative anal stenosis. However, if the internal hemorrhoids prolapse is accompanied by severe external hemorrhoids, it is advisable to opt for the traditional external peeling and internal ligation surgery, as this method can also effectively address external hemorrhoids, avoiding the need for a second surgery. Postoperatively, the use of anal cleansers, potassium permanganate solution, golden ointment, red oil ointment gauze, and hemorrhoid suppositories for dressing changes can promote recovery. Additionally, postoperative patients should avoid certain foods and maintain smooth bowel movements to prevent infections, swelling, and bleeding, which will aid in recovery.

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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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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
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What to do if internal hemorrhoids bleed severely but there is no pain or itching?

If there is severe bleeding from internal hemorrhoids, it is recommended to promptly conduct an anoscopy to determine the exact locations and amount of bleeding. Generally, bleeding from internal hemorrhoids is painless, so it is often underestimated by patients. If the bleeding is heavy or persists for a long time, it is advised that patients undergo surgery as soon as possible to ligate and stop the bleeding, or combine this with oral hemostatic drugs for symptomatic treatment to avoid exacerbation of the bleeding and resulting anemia. Repeated bleeding from internal hemorrhoids can likely lead to varying degrees of anemia. If repeated bleeding occurs, or if the anemia worsens and leads to severe anemia, further treatment with blood transfusions may be necessary to correct the anemia.

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Written by Deng Heng
Colorectal Surgery
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Hemorrhoids: What dietary considerations should be noted?

Patients with internal hemorrhoids should primarily focus on a reasonable diet, paying attention to eat less or avoid spicy and stimulating foods and condiments. Additionally, they should cultivate the habit of drinking more water, preferably light salt water or honey water. For constipation and hemorrhoids, it's important to consciously drink more water and eat more fruits and fresh vegetables, especially those that are rich in coarse fiber. Stimulating foods such as chili peppers, black pepper, ginger, garlic, and onions should be consumed minimally.

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Written by Yu Xu Chao
Colorectal Surgery
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Can warm water sitz baths improve internal hemorrhoids that have prolapsed?

Warm sitz baths for prolapsed internal hemorrhoids can improve anal heaviness to some extent, and prevent inflammatory edema caused by the prolapse. They can also help prevent further worsening of prolapsed hemorrhoids, as warm sitz baths promote circulation around the anal area, relieve heaviness, and can somewhat reduce the prolapse, but they cannot completely cure it. Prolapsed internal hemorrhoids are caused by pathological hypertrophy and descent of the anal cushions, representing an organic lesion. Simple conservative medical treatment can only prevent the hemorrhoids from worsening, but cannot fully cure them. For prolapsed internal hemorrhoids that can be manually reduced, conservative treatment is generally recommended. Regular smooth bowel movements should be maintained, long duration of defecation should be avoided, and frequent anal sphincter exercises should be performed. However, for prolapsed hemorrhoids that cannot be reduced, or those that develop incarceration with edema or thrombosis, surgical treatment is recommended.