How to Treat Internal Hemorrhoids

Internal hemorrhoids are swollen veins inside the rectum. Because this area has fewer pain-sensitive nerves, internal hemorrhoids are often painless. However, they can cause symptoms such as rectal bleeding, mucus discharge, and prolapse during bowel movements.

Treatment depends on the severity of hemorrhoids and the symptoms they produce. Many internal hemorrhoids respond well to lifestyle changes, medications, or simple office procedures.

Symptoms of Internal Hemorrhoids

Common signs of internal hemorrhoids include:

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

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

Grades of Internal Hemorrhoids

Internal hemorrhoids are classified by prolapse severity:

Treatment recommendations are based on the grade and severity of symptoms.

Lifestyle Treatments for Internal Hemorrhoids

Mild internal hemorrhoids often improve with simple lifestyle measures.

Increase Fiber Intake

Fiber softens stool and reduces straining.

High-fiber foods include:

• Fruits
• Vegetables
• Whole grains
• Legumes

Fiber supplements such as psyllium can also help.

Drink Adequate Fluids

Hydration keeps stool soft and reduces constipation. Most adults benefit from 6–8 glasses of water daily.

Improve Bathroom Habits

Healthy bowel habits reduce pressure on rectal veins:

• Avoid prolonged sitting on the toilet
• Respond promptly to bowel urges
• Avoid excessive straining

Medications for Internal Hemorrhoids

Medications can relieve symptoms but do not remove hemorrhoids permanently:

• Hemorrhoid creams
• Suppositories
• Anti-inflammatory medications

These reduce irritation, swelling, and discomfort.

Office Procedures for Internal Hemorrhoids

If symptoms persist, minimally invasive procedures may be used:

Rubber Band Ligation

• A rubber band is placed at the hemorrhoid base
• Blood supply is cut off, causing the hemorrhoid to shrink and fall off
• Commonly used for Grade I–III hemorrhoids

Infrared Coagulation

• Heat energy shrinks hemorrhoidal tissue
• Scar tissue reduces blood flow
• Typically used for smaller internal hemorrhoids

Sclerotherapy

• A chemical solution is injected into the hemorrhoid
• Closes blood vessels, causing shrinkage
• Recommended for bleeding hemorrhoids

Surgical Treatment for Internal Hemorrhoids

Severe or persistent hemorrhoids may require surgery.

Hemorrhoidectomy

• Removes hemorrhoidal tissue
• Used for large or persistent hemorrhoids
• Provides long-term relief, recovery may take several weeks

Stapled Hemorrhoidopexy

• Repositions prolapsed hemorrhoids
• Reduces blood flow to hemorrhoidal veins
• May involve less postoperative pain than traditional hemorrhoidectomy

When Should You See a Doctor?

Seek medical evaluation if you have:

• Persistent rectal bleeding
• Severe or worsening symptoms
• Large prolapsed hemorrhoid
• Symptoms lasting more than one week
• Changes in bowel habits

Rectal bleeding should always be evaluated to rule out other conditions, including colorectal cancer.

Learn More About Hemorrhoids

You may also explore these guides:

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