Bleeding Internal Hemorrhoids
Internal hemorrhoids are not visible from the outside, manifesting above the pectinate or dentate line in the anal canal. They are covered by a mucous
membrane. The most common sign of an internal hemorrhoid is
rectal bleeding. Hemorrhoids can ooze fresh red blood, whether
located externally or internally. But the main difference is
that bleeding internal hemorrhoids may produce fresh blood in
the stool. Blood can also be seen on the toilet seat or on toilet
Why do bleeding internal
The main reasons for bleeding internal
- chronic constipation and extra straining of the
- diarrhea where the expulsion of stools are
- sitting and standing for prolonged periods
- lifting very heavy weight or objects
How are Internal Hemorrhoids
The internal hemorrhoid is graded to assist with the
selection of a treatment plan. The treatment is then provided
according to the grade. The grade of the hemorrhoid depends on
the extent of descent into the anal canal and out of the
First stage: Here the internal hemorrhoids are enlarged, but
they never prolapse and rarely produce symptomatology. This
cannot be visualized during an external examination but requires
the use of a proctoscope.
Second stage: Here the internal hemorrhoids prolapse with
defecation but they return to their original position
spontaneously. Like the first degree this also cannot be
visualized during an external examination but requires the use
of a proctoscope.
Third stage: Unlike the first two stages, internal hemorrhoids
prolapse with each bowel movement and even with physical
exertion. Some hemorrhoids require manual replacement back to
their point of origin.
Fourth stage: They are permanently prolapsed despite attempts
to place them back in their original position.
How to deal with bleeding internal
a) Consult a doctor immediately. If you have been suffering
from bleeding internal hemorrhoids then inform him or her if your
bleeding does not stop. If you are not aware of why you are
bleeding then go for a check up, as quite often anal fissures
are mistaken for bleeding internal hemorrhoids.
b) Wipe yourself with clean wet toilet paper. Wetting the
paper makes it softer.
c) Ask for emergency care if you notice large amounts of
rectal bleeding along with dizziness or faintness.
Common treatments for bleeding
internal hemorrhoids include:
1. Rubber Band Ligation - In this process a small rubber
band is placed at the base of the internal hemorrhoid. The
blood supply to the hemorrhoid is cut off, resulting in it
shrinking up and falling off in about four to seven days.
2. Injection Sclerotherapy - A chemical solution is injected
into the mucous membrane near the hemorrhoid resulting in
inflammation and closure of the veins, thereby shrinking the
3. Infrared Photocoagulation - An infrared light is directed to
clot the dilated veins of the hemorrhoid. The hemorrhoids
shrink since the blood does not flow through the coagulated
4. Laser Coagulation - An electric current is applied to the
hemorrhoids triggering a chemical reaction that shuts down the
blood supply in the hemorrhoid and causes the inflamed tissue
5. Hemorrhoidectomy - Here the hemorrhoid groups are
surgically removed with a scalpel, cautery device or laser.