Do hemorrhoids require surgery?

Written by Chen Tian Jing
Colorectal Surgery
Updated on October 20, 2024
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When severe hemorrhoids are in an acute attack phase, it is necessary to undergo surgical treatment as soon as possible. Besides surgery, treatment options for hemorrhoids also include conservative medication to alleviate symptoms. For mild hemorrhoids, or those that flare up less frequently, the primary treatment is conservative topical medication. However, when hemorrhoids repeatedly prolapse, cause pain, and result in significant rectal bleeding, affecting the normal functioning of the patient’s body, it is advised to promptly proceed with hemorrhoidectomy surgery. This helps avoid complications such as severe pain that interferes with normal living, or significant bleeding that could lead to anemia in patients, thereby worsening the condition and increasing the difficulty of future treatments. (Please use medication under the guidance of a professional physician, and do not self-medicate.)

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Written by Ren Zheng Xin
Gastroenterology
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What causes hemorrhoids to bleed?

Internal hemorrhoids can easily cause rectal bleeding. The main reason is the varicosity of hemorrhoidal veins. During defecation, dry and hard stools scratch the hemorrhoidal veins causing them to rupture and bleed. Additionally, due to the long-term presence of hemorrhoids, the hemorrhoidal veins become overstretched, making the vein walls thin and fragile, and easily damaged during bowel movements. For hemorrhoid-induced rectal bleeding, treatment can be administered through medications aimed primarily at reducing bleeding symptoms and alleviating the varicosity of the hemorrhoidal veins. Sitz baths can also be used to reduce swelling around the anus. If medication provides limited relief, minimally invasive or surgical treatments may be considered.

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Written by Chen Tian Jing
Colorectal Surgery
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What to eat when hemorrhoids bleed?

When symptoms of bleeding occur in hemorrhoids, it is generally necessary to first carry out symptomatic treatment with oral hemostatic medications and local anal suppository for hemorrhoids. Simple bleeding or minor bleeding can be alleviated by oral medication or conservative topical drugs. If the bleeding hemorrhoids are accompanied by recurrent protrusion of internal masses or severe anal pain, in addition to oral hemostatic drugs, it is also necessary to combine surgical ligation or internal hemorrhoidal banding for hemostasis, and if necessary, combined with internal sclerosant mucosal injection for comprehensive treatment. When patients with hemorrhoids bleed, it is generally advised to eat liquid food and avoid hard textured food, and certainly not to eat spicy and irritating food.

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Written by Chen Tian Jing
Colorectal Surgery
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Consequences of hemorrhoids bleeding

Rectal bleeding, commonly seen in cases of hemorrhoids, usually appears as bright red blood. The bleeding is not mixed with the stool but is excreted along with it from the anus. Minor hemorrhoid bleeding can cause local anal itching. When the bleeding is heavy or prolonged, it can lead to a significant loss of blood volume, resulting in anemia in the patient. Anemia can then lead to other systemic diseases and problems. Therefore, it is important to treat hemorrhoid bleeding early. Treatment options include oral hemostatic medications combined with the topical application of hemorrhoid cream to stop the bleeding.

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Written by Ai Bing Quan
General Surgery
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Do hemorrhoids cause bleeding?

Hemorrhoids are a relatively common disease in surgical clinics, characterized by varicose veins. They generally occur when there is increased abdominal pressure or constipation, which can easily lead to hemorrhoids. Bleeding during defecation is the most common symptom of hemorrhoids. Not all hemorrhoids involve bleeding; it is most common in internal and mixed hemorrhoids. Minor bleeding may not require treatment, but significant bleeding may necessitate the use of topical ointments and oral hemostatics. Additionally, it is important to maintain a light diet, avoid spicy and irritating foods, drink plenty of water, consume fresh vegetables and fruits, and avoid prolonged sitting or standing.

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Written by Ren Zheng Xin
Gastroenterology
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What color is the blood in hemorrhoids?

Hemorrhoids are mainly divided into internal and external hemorrhoids. Internal hemorrhoids can cause rectal bleeding, the color of which is bright red. If the hemorrhoids are severe, then the amount of bleeding can be significant. Internal hemorrhoids mainly present with painless rectal bleeding, usually occurring after defecation. It is necessary to go to the hospital's proctology department timely for an anoscopy. Mild cases can be treated with medications for hemorrhoids and topical ointments, while severe cases may require surgical treatment. It is important to rest frequently, drink plenty of water, avoid sitting for long periods, eat less spicy food, and also avoid smoking and alcohol.