Internal Hemorrhoids

Internal HemorrhoidInternal hemorrhoids refer to piles that are present above a point within the rectum called the dentate line. They are not visible externally though they can cause symptoms that are similar to external piles.

In this article, we shall take a look at internal hemorrhoids treatment in a bit more detail.

General Principles for Internal Hemorrhoid Treatment

The treatment of internal hemorrhoids is similar to management of external hemorrhoids. Specifically, there are no nerve fibers that supply the internal hemorrhoids and given this, treatments can be offered without having to inject local anesthetic into the area. Broadly classified, treatment can be either nonsurgical treatments or surgical treatments.

Nonsurgical Treatment

Regular ExerciseNonsurgical treatment is based around lifestyle modifications that must be observed when managing any type of piles. Following a high fiber diet, attempting to lose weight, regular exercise and consuming sufficient amount of fluid everyday can help relax the bowels and ease bowel movements. These in turn can help reduce the pain and symptoms that patients experience from internal piles.

Nonsurgical treatments can be provided as a day case in clinics or can be done by patients themselves in the comfort of their own home. Depending on how severe the hemorrhoids are, the treatment for internal hemorrhoids depends upon the grade.

Grade I hemorrhoids which are essentially early stages of hemorrhoids can be treated with conservative treatments and simple painkillers such as non-steroidal anti-inflammatory drugs. However, as the grade progresses, treatments need to become a lot more advanced.

Surgical Treatment

Surgery as an internal hemorrhoid treatment is a commonly adopted strategy in managing this condition. Treatment is usually offered to patients who have prolapsed internal hemorrhoids that are protruding outside the anal verge and causing symptoms.

Stapled hemorrhoid surgeryStapled hemorrhoid surgery is often the choice of treatment in these patients. The basic principle involves cutting off the blood supply to each of these hemorrhoids and removing them completely. Following this, patients are recommended to continue with their regular diet and lifestyle modifications in order to prevent recurrence of internal hemorrhoids in the future. Of course, there are a small amount of risks associated with this procedure but the long-term benefits seem to outweigh the risks by a large margin.

Other treatment options that are available in managing internal hemorrhoids include rubber band ligation (where the base of the hemorrhoid is tied with a type a rubber band, cutting off the blood supply and eventually resulting in the hemorrhoid falling off), injection sclerotherapy (where an irritant is injected into the hemorrhoids and this results in it falling off) and laser coagulation. The choice of technique depends on the size of the hemorrhoids and the physicians and patients preference.

Hemorrhoid with skin tagsSome patients who suffer from internal hemorrhoids may have skin tags as well. These skin tags are also resected during surgery.

One of the main concerns with internal hemorrhoids is that the blood within them can clot and as a result the hemorrhoids can become thrombosed. This makes it an urgent matter and treatment must be commenced as soon as possible.


Internal hemorrhoids often do not cause symptoms but can be riddled with complications if left untreated. Treatments vary between nonsurgical and surgical methods and the long-term outcomes are generally good with the latter.

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