How are Internal Hemorrhoids treated?
Hemorrhoids, also called piles, occur when the veins around the anus or in the lower rectum become swollen. Internal hemorrhoids develop inside the anus or rectum, and are commonly noticed as bleeding after a bowel movement. They are common, and treatment is available to relieve symptoms.
Treatment can take place at home or at a doctor’s office. Many people find that simple measures, such as more fibre and less straining, are enough, while others may need a procedure. Your doctor will recommend an approach based on your symptoms and the size of your hemorrhoids.
Symptoms of Internal Hemorrhoids
Internal hemorrhoids are graded according to how much they bulge, which helps your doctor to choose treatment.
- Grade 1: The hemorrhoid may bleed but does not bulge out of the anus.
- Grade 2: The hemorrhoid bulges out during a bowel movement, then returns inside on its own.
- Grade 3: The hemorrhoid bulges out and needs to be pushed back in by hand.
- Grade 4: The hemorrhoid stays outside the anus and cannot be pushed back in.
Home Care
- Eat more fibre: Fibre helps to soften the stool and avoids further straining of the swollen veins. Include more fruit, vegetables and whole grains in your diet.
- Drink plenty of fluids: Enough water helps to keep stools soft.
- Avoid straining: Do not strain or sit for a long time on the toilet.
- Soak in warm water: Sitting in a shallow bath of warm water for a few minutes may ease discomfort.
- Keep the area clean: Gently clean the area after each bowel movement, and pat it dry.
Medicines for Hemorrhoids
- Pain Relievers: Pain relievers such as acetaminophen (paracetamol) and non-steroidal anti-inflammatory medicines can be bought over the counter and can relieve pain, swelling and itching.
- Fibre Supplements: Supplements such as psyllium bulk up the stool so that it can be passed more easily, which helps to avoid straining.
- Creams and Ointments: Some creams and ointments can ease itching and discomfort.
Medical Procedure
- Injection (sclerotherapy): Your doctor injects a chemical directly into the blood vessel of the internal hemorrhoid, which causes the hemorrhoid to shrink and reduce in size.
- Rubber band ligation: A small rubber band is placed around the base of the hemorrhoid, which cuts off its blood supply. The loss of circulation causes the hemorrhoid to shrink.
- Surgery: For larger hemorrhoids, hemorrhoids that remain outside the anus, or when other treatments have not worked, your doctor may discuss surgery to remove them.
What to Expect After a Procedure
- You may feel some discomfort or a feeling of fullness in the area, which usually eases over a few days.
- A small amount of bleeding can occur, especially during bowel movements.
- Keep your stools soft by eating fibre and drinking plenty of fluids, and avoid straining.
- Your doctor will explain how to look after yourself, and when you can return to your usual activities.
Reducing the Chance of Hemorrhoids Returning
- Keep to a high-fibre diet with plenty of fluids.
- Go to the toilet when you feel the urge, and do not delay.
- Avoid straining or sitting for long periods on the toilet.
- Stay active, as regular exercise supports healthy bowel movements.
- Maintain a healthy weight.
