From the Guidelines
I strongly recommend consulting a healthcare provider for proper evaluation and treatment of internal hemorrhoids, especially if you're experiencing bright red blood per rectum (BRBPR). Initial self-care measures include:
- Increasing fiber intake to 25-30 grams daily
- Drinking plenty of water (6-8 glasses daily)
- Using over-the-counter medications like hydrocortisone creams or suppositories for discomfort
- Taking warm sitz baths for 10-15 minutes 2-3 times daily
- Using over-the-counter pain relievers such as acetaminophen or ibuprofen as directed Avoid straining during bowel movements, limit time spent on the toilet, and use moist wipes instead of dry toilet paper. Internal hemorrhoids occur when blood vessels in the rectum become swollen and inflamed, often due to increased pressure from straining, constipation, prolonged sitting, or pregnancy. While bleeding from internal hemorrhoids is typically bright red and painless, it's essential to have this symptom evaluated by a healthcare provider to rule out more serious conditions like colorectal cancer, especially if you're over 45 or have a family history of colorectal issues 1.
Symptoms of internal hemorrhoids may include:
- Bright red blood per rectum (BRBPR)
- Prolapse of the rectal mucosa
- Itching and discomfort
- Pain (in some cases)
Treatment options for internal hemorrhoids may include:
- Rubber band ligation
- Sclerotherapy
- Infrared photocoagulation
- Bipolar diathermy
- Direct-current electrotherapy
- Hemorrhoidectomy (in severe cases)
It's crucial to note that a healthcare provider should evaluate any anorectal symptoms to rule out other conditions that may require different treatment approaches 1. Additionally, flavonoids may be suggested to relieve symptoms of complicated hemorrhoids, and topical muscle relaxants may be used for thrombosed or strangulated hemorrhoids 1.
In terms of evaluation, anoscopy and colonoscopy may be performed to diagnose and manage internal hemorrhoids, especially if there's concern for inflammatory bowel disease or cancer 1.
Overall, it's essential to prioritize a healthcare provider's evaluation and guidance for proper diagnosis and treatment of internal hemorrhoids to ensure the best possible outcome and prevent potential complications.
From the Research
Symptoms of Internal Hemorrhoids
- Internal hemorrhoids typically present with prolapse or painless rectal bleeding, also known as Bright Red Blood Per Rectum (Brbpr) 2
- Bleeding is one of the main symptoms of internal hemorrhoids 3
- Other symptoms may include discomfort, anal bleeding, and prolapsing 4, 2
Treatment Options for Internal Hemorrhoids
- Rubber band ligation is a commonly recommended therapy for grade I-III symptomatic internal hemorrhoids 5, 4, 2, 6
- Medical therapy should be initiated with stool softeners plus local therapy to relieve swelling and symptoms 2
- Dietary modifications, such as increased fiber and water intake, and behavioral therapies, such as sitz baths, are also recommended 6
- Office-based treatment of grades I to III internal hemorrhoids with rubber band ligation is the preferred next step if medical management is unsuccessful 6
- Excisional hemorrhoidectomy or stapled hemorrhoidopexy may be recommended for treatment of grade 4 hemorrhoids or recurrent disease 2, 6