How to Treat Prolapsed Internal Hemorrhoids: Surgical vs. Non-Surgical Options

Q: How to Treat Prolapsed Internal Hemorrhoids: Surgical vs. Non-Surgical Options

Hello： In response to your question, based on your description, it seems that acute thrombosed external hemorrhoids may have been caused by diarrhea. <br>If the pain is not severe, applying a topical ointment for about one to two weeks may lead to healing. <br>If the pain is unbe

How to treat prolapsed internal hemorrhoids?

Hello, Director Ke.
I would like to ask you about a situation I experienced two days ago.
After having diarrhea, something suddenly protruded from my anus.
It is painful when I press on it, but I can push it back inside.
However, it soon pops out again on its own.
Do I need surgery for this condition, or can it be treated with medication or topical ointments? I would appreciate your explanation.
Thank you.

Da Tou, 30~39 year old female. Ask Date: 2013/04/02

Dr. Ke Fangxu reply Surgery

Hello: In response to your question, based on your description, it seems that acute thrombosed external hemorrhoids may have been caused by diarrhea.
If the pain is not severe, applying a topical ointment for about one to two weeks may lead to healing.
If the pain is unbearable, you can undergo thrombectomy in an outpatient setting, which can quickly relieve discomfort.
If the thrombosis is too large and not suitable for outpatient surgery, hospitalization for surgical intervention may be necessary.
Some patients choose to start with oral medication treatment and then monitor the subsequent changes.
However, it is essential to consult a physician for a surgical evaluation first.
Dr.
Ke Fang-Hsu's response.

Reply Date: 2013/04/02

More Info

Prolapsed internal hemorrhoids, a common condition, can be quite uncomfortable and distressing. They occur when the internal hemorrhoids protrude through the anal opening, often due to increased pressure in the rectal area, such as from straining during bowel movements, chronic constipation, or diarrhea. The symptoms you describe, including pain and the ability to push the hemorrhoid back in, are characteristic of this condition.

When it comes to treatment options for prolapsed internal hemorrhoids, there are both surgical and non-surgical approaches. The choice between these options largely depends on the severity of the hemorrhoids, the frequency of symptoms, and the overall health of the patient.

Non-Surgical Options
1. Dietary Changes: Increasing fiber intake can help soften stools and reduce straining during bowel movements. Foods rich in fiber include fruits, vegetables, whole grains, and legumes. Additionally, staying well-hydrated is essential.

2. Topical Treatments: Over-the-counter creams and ointments can provide temporary relief from pain and itching. These products often contain ingredients like hydrocortisone or witch hazel.

3. Sitz Baths: Soaking in warm water for 10-15 minutes several times a day can help reduce discomfort and promote healing.

4. Medications: Oral pain relievers, such as acetaminophen or ibuprofen, can help manage pain associated with hemorrhoids.

5. Rubber Band Ligation: This is a minimally invasive procedure where a small rubber band is placed around the base of the hemorrhoid to cut off its blood supply. The hemorrhoid shrinks and falls off within a week.

Surgical Options
If non-surgical treatments fail to provide relief or if the hemorrhoids are particularly large or painful, surgical options may be considered:
1. Hemorrhoidectomy: This is a surgical procedure to remove the hemorrhoids. It is typically reserved for severe cases and can provide long-term relief.

2. Stapled Hemorrhoidopexy: This technique involves using a stapling device to reposition and secure the hemorrhoids back into their normal position in the rectum, cutting off their blood supply.

When to Consider Surgery
In your case, since you can push the hemorrhoid back in but it keeps coming out, it may indicate a more significant prolapse. If the symptoms persist despite conservative measures, or if you experience severe pain, bleeding, or other complications, surgical intervention might be necessary.
It is essential to consult with a healthcare professional, preferably a colorectal surgeon, who can evaluate your specific situation and recommend the best course of action. They may perform a physical examination and possibly recommend further tests to assess the severity of the hemorrhoids.

Conclusion
In summary, while many cases of prolapsed internal hemorrhoids can be managed effectively with non-surgical treatments, surgical options are available for more severe cases. It is crucial to seek medical advice to determine the most appropriate treatment for your condition. Early intervention can lead to better outcomes and prevent complications associated with untreated hemorrhoids.

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