How to Treat Internal Hemorrhoids

Internal hemorrhoids are swollen veins that develop inside the rectum. Because they occur in an area with fewer pain-sensitive nerves, internal hemorrhoids often do not cause pain. However, they may cause symptoms such as rectal bleeding, mucus discharge, or prolapse during bowel movements.

Many patients want to know how to treat internal hemorrhoids and whether treatment requires medication, procedures, or surgery. The treatment approach depends on the severity of hemorrhoids and the symptoms they produce.

In many cases, internal hemorrhoids can be treated effectively with lifestyle changes or simple medical procedures.

Symptoms of Internal Hemorrhoids

Internal hemorrhoids may cause several symptoms, including:

• Bright red bleeding during bowel movements
• Blood on toilet paper
• Blood in the toilet bowl
• Tissue protruding from the anus
• Mild irritation or mucus discharge
• A feeling of incomplete bowel emptying

Unlike external hemorrhoids, internal hemorrhoids are usually painless unless they become prolapsed or irritated.

Grades of Internal Hemorrhoids

Internal hemorrhoids are commonly classified based on the degree of prolapse.

Treatment recommendations depend on the grade and severity of symptoms.

Lifestyle Treatments for Internal Hemorrhoids

Mild internal hemorrhoids often improve with simple lifestyle changes.

Increase Fiber Intake

Fiber softens stool and reduces straining during bowel movements.

High-fiber foods include:

• Fruits
• Vegetables
• Whole grains
• Legumes

Fiber supplements such as psyllium may also be helpful.

Drink Adequate Fluids

Drinking enough water helps prevent constipation and keeps stool soft.

Most adults benefit from drinking six to eight glasses of water daily.

Improve Bathroom Habits

Healthy bowel habits can reduce pressure on rectal veins.

Helpful habits include:

• Avoiding prolonged sitting on the toilet
• Not delaying bowel movements
• Avoiding excessive straining

These changes may help reduce hemorrhoid symptoms.

Medications for Internal Hemorrhoids

Several medications may help relieve symptoms.

Common options include:

• Hemorrhoid creams
• Suppositories
• Anti-inflammatory medications

These treatments may help reduce irritation and swelling, although they do not permanently remove hemorrhoids.

Office Procedures for Internal Hemorrhoids

If symptoms persist despite conservative treatment, medical procedures may be recommended.

These procedures are usually performed in a doctor’s office and require minimal recovery time.

Rubber Band Ligation

Rubber band ligation is the most common treatment for internal hemorrhoids.

During this procedure:

• A small rubber band is placed around the base of the hemorrhoid
• Blood supply to the hemorrhoid is cut off
• The hemorrhoid shrinks and falls off within several days

Rubber band ligation is commonly used for Grade I–III hemorrhoids.

Infrared Coagulation

Infrared coagulation uses heat energy to shrink hemorrhoidal tissue.

The heat causes scar tissue to form, reducing blood flow to the hemorrhoid.

This treatment is often used for smaller internal hemorrhoids.

Sclerotherapy

Sclerotherapy involves injecting a chemical solution into the hemorrhoid.

The solution causes the hemorrhoid to shrink by closing the blood vessels that supply it.

This treatment may be recommended for bleeding hemorrhoids.

Surgical Treatment for Internal Hemorrhoids

Surgery may be recommended for severe hemorrhoids that do not respond to other treatments.

Hemorrhoidectomy

Hemorrhoidectomy is a surgical procedure that removes hemorrhoidal tissue.

It is often used for large or persistent hemorrhoids.

Although recovery may take several weeks, this procedure provides long-term relief.

Stapled Hemorrhoidopexy

Stapled hemorrhoidopexy repositions prolapsing hemorrhoids and reduces blood flow to hemorrhoidal veins.

This procedure may involve less postoperative pain than traditional hemorrhoidectomy.

When Should You See a Doctor?

Medical evaluation is recommended if you experience:

• Persistent rectal bleeding
• Severe symptoms
• A large prolapsed hemorrhoid
• Symptoms lasting longer than one week
• Changes in bowel habits

Rectal bleeding should always be evaluated because other conditions, including colorectal cancer, may cause similar symptoms.

Learn More About Hemorrhoids

You may also explore these guides:

• Hemorrhoids Overview
• Hemorrhoids Symptoms
• Hemorrhoids Procedures
• Hemorrhoids FAQ
• Hemorrhoids Images & Diagrams