Managing Prolapsed Internal Hemorrhoids: Tips for Relief - Surgery

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Managing prolapsed internal hemorrhoids can be quite challenging, especially when you are unable to return home for treatment. It’s good to hear that you have found some relief from pain using topical ointments, but the ongoing issue of the hemorrhoids remaining prolapsed and the presence of bleeding requires careful management.


Understanding Prolapsed Internal Hemorrhoids
Prolapsed internal hemorrhoids occur when the tissue that cushions the blood vessels in the anal canal becomes swollen and protrudes outside the anus. This can happen due to increased pressure in the rectal area, often caused by factors such as straining during bowel movements, chronic constipation, or prolonged sitting. Symptoms can include pain, discomfort, bleeding, and irritation.


Immediate Management Strategies
1. Dietary Changes: One of the most effective ways to manage hemorrhoids is to improve your diet. Increasing your fiber intake can help soften stools and reduce straining during bowel movements. Aim for a diet rich in fruits, vegetables, whole grains, and legumes. Additionally, staying well-hydrated by drinking plenty of water can also help.

2. Over-the-Counter Treatments: Since you are already using a topical ointment, consider using over-the-counter hemorrhoid creams or suppositories that contain hydrocortisone or witch hazel. These can help reduce inflammation and provide temporary relief from discomfort.

3. Sitz Baths: Taking warm sitz baths for about 15-20 minutes several times a day can help soothe the area and promote healing. This can also help with blood circulation, which may assist in reducing swelling.

4. Avoid Straining: When using the bathroom, try to avoid straining. If you feel the urge to go, do so promptly. If you are experiencing constipation, consider using a stool softener or a mild laxative, but consult with a healthcare provider before starting any new medication.

5. Topical Treatments: If bleeding continues, you may want to explore topical treatments that contain astringents or anesthetics. These can help reduce bleeding and provide temporary relief.


When to Seek Medical Attention
While these strategies may provide relief, it’s important to monitor your symptoms closely. If you experience any of the following, seek medical attention promptly:
- Persistent Bleeding: If the bleeding does not stop or worsens, it could indicate a more serious condition.

- Severe Pain: If you experience significant pain that does not improve with over-the-counter treatments.

- Signs of Infection: Symptoms such as fever, increased swelling, or discharge could indicate an infection that requires medical intervention.


Long-Term Management
If you find that your symptoms persist despite these measures, it may be necessary to consider more definitive treatments. Options may include:
- Rubber Band Ligation: This is a common outpatient procedure where a small band is placed around the base of the hemorrhoid to cut off its blood supply, causing it to shrink and fall off.

- Surgical Options: In severe cases, surgical removal of the hemorrhoids may be necessary.


Conclusion
Managing prolapsed internal hemorrhoids while abroad can be challenging, but with dietary adjustments, over-the-counter treatments, and proper self-care, you can find relief. However, it is crucial to remain vigilant about your symptoms and seek medical attention if they worsen. If you have access to a healthcare provider where you are located, consider discussing your situation with them for tailored advice and potential treatment options. Remember, while self-management is important, professional guidance is invaluable for persistent or severe symptoms.