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Internal hemorrhoids: symptoms and treatment regimen

Hemorrhoids are not always visually determined. Formed inside the rectum varicose cones are called internal hemorrhoids. Internal hemorrhoids in women gives more severe symptoms than external nodes (located at the anal sphincter).

Great trauma to the internal varicose veins during bowel movements causes frequent complications, so the treatment of the disease should be timely and comprehensive.


Internal hemorrhoids: the essence of the disease and the degree of development

Internal hemorrhoids, photo and scheme

photo and scheme

What it is? Internal hemorrhoids are a hemorrhoidal disease with the location of the nodes inside the rectum, rectal varicose veins (see photo).

Like varicose veins of the lower extremities, in the vessels penetrating the rectum, at first minor extensions are formed. This condition is called the 1 degree of development of the disease, while the woman only occasionally notes little disturbing symptoms.

The next, second stage of internal hemorrhoids is characterized by more pronounced varicose protrusions, which impede the act of defecation. The disease proceeds in waves: severe symptoms are replaced by a period of improvement. However, even during remission, a woman notes discomfort in the rectal area.

At stage 3 (chronic internal hemorrhoids) varicose bumps reach significant sizes, periods of some improvement are short. Symptoms gradually become harder, and hemorrhoidal protrusions fall out during defecation.

Stage 4 - varicose nodes that have fallen from the rectum, palpable even without exacerbation. The condition requires radical intervention. Lack of treatment is fraught with serious complications.

The causes of both external and internal hemorrhoids are absolutely identical:

  • constipation provoked by diseases of the gastrointestinal tract, low motor activity and poor nutrition;
  • pregnancy / childbirth (especially repeated);
  • heavy physical work and sport associated with weight lifting;
  • genetic predisposition;
  • obesity;
  • alcohol abuse, smoking (adversely affect vascular tone).

The first signs of internal hemorrhoids

The first signs of internal hemorrhoids

The initial stage of the development of hemorrhoidal disease is often overlooked. A woman periodically feels discomfort (foreign body sensation in the rectum) during bowel movements and for some time after emptying the bowels.

Primary signs of internal hemorrhoids quickly pass and can resume after a fairly long time. A provocateur of exacerbation can serve as stress, a plentiful feast, weight gain, even a rise in the hands of a small child.

Symptoms of internal hemorrhoids

The periods of occurrence of unpleasant symptoms are becoming longer and more severe than the previous. The discomfort gradually joins the more severe symptoms of internal hemorrhoids:

  • burning inside the intestine ( micro cracks appear);
  • itching triggered by mucus and an inflammatory reaction;
  • pain - first with bowel movements, then almost constant (it is difficult for the patient to sit on the 3-4 stage, to stand for a long time);
  • bleeding - initially scanty (bloody traces remain on toilet paper), then more abundant (blood drips or oozes out a trickle) and prolonged;
  • loss of knots - on 2 stages only during strong straining, on 3 stages they appear when lifting of insignificant gravity, on 4 stages they are not set.



Visual inspection at the initial stages of the development of internal hemorrhoids does not give the doctor any information. Internal nodes are detected only by finger examination of the rectum. The patient must be assigned to the analysis that evaluates blood clotting.

To clarify the diagnosis (determine the localization and size of varicose cones, identify a bleeding vessel), a sigmoidoscopy is performed - an endoscopic examination of the rectal mucosa.

The procedure is rather difficult, but necessary, especially when complications appear. If necessary, during the diagnostic examination, the doctor may conduct minimally invasive therapeutic procedures.

Treatment of internal hemorrhoids

Treatment of internal hemorrhoids

The earlier complex treatment is begun, the better the prognosis for internal hemorrhoids and the lower the risk of complications. The main treatment of internal hemorrhoids - candles of various effects and venotonic drugs:

  1. Eliminating constipation - suppositories with glycerin (suitable for pregnant women), Microclyster Microlax;
  2. Painkillers - papaverine suppositories, Anestezol and Anuzol (have anti-inflammatory effect);
  3. Wound healing - suppositories with sea buckthorn, Methyluracil;
  4. Thrombosis prevention - Hepatotrombin;
  5. Oral (tablets, capsules) venotonics - Detralex, Ginkor Fort, Venodiol.

Therapy with internal hemorrhoids with candles is aimed at eliminating the symptoms of the disease, but it does not eliminate its root cause - a change in the vascular wall and a decrease in its tone. To prevent the development of hemorrhoidal disease, repeated courses of veno-tonic drugs are necessary.

Conservative therapy is effective only in the absence of complicating moments (loss of varicose nodes, heavy bleeding, etc.) and is necessarily combined with compliance with:

  • good diet (excluding fat / spicy, the inclusion of vegetables in the diet);
  • a commensurate state and age of physical activity;
  • giving up bad habits.

Radical treatments

Often, surgery is carried out on an emergency basis in life-threatening conditions: massive blood loss, thrombosis, necrosis of a node that has fallen from the rectum. This treatment is indicated for internal hemorrhoids with bleeding that is not amenable to drug therapy.

However, minimally invasive techniques should be carried out already on stage 2 of hemorrhoids during the formation of large vascular protrusions inside the intestine. Such a precautionary approach will avoid serious consequences in the future.

The following low-impact methods of elimination of rectal varicose nodes are widely practiced:

  • sclerotherapy
  • cryodestruction,
  • photocoagulation.

All techniques are based on a physical effect on hemorrhoids (adhesive substance, cold, high temperatures), which leads to the desolation of the varicose plexus and its permanent shutdown from the blood circulation.

The procedures are painless, require only local anesthesia, are performed on an outpatient basis and guarantee quick recovery.

A more radical intervention, thrombectomy, involves surgical excision of the thrombosed / necrotized areas of the vessels.
In the postoperative period, treatment with vascular wall strengthening and drugs that prevent thickening of the blood should be continued.


Internal hemorrhoids not only cause painful symptoms affecting the quality of life of a woman. Very often, the disease causes severe complications, sometimes representing a serious threat to the life of the patient:

  • anemia (with weak long-term or large-scale bleeding);
  • significant blood loss due to breakthrough bleeding and the development of a terminal state;
  • infection and paraproctitis;
  • pinching the node and its necrosis;
  • vascular thrombosis;
  • formation of adrectal or rectovaginal fistula;
  • malignancy of damaged tissues (oncology).

Any of these conditions requires urgent medical intervention (often surgical) and complex treatment of internal hemorrhoids.

Question answer

To which doctor to address for hemorrhoids?

Specialized specialist in the treatment of any form of hemorrhoids (internal, external) - Proctologist.

How to put candles for hemorrhoids?

The rectal suppository is freed from the shell; hands should be thoroughly washed before and after its introduction into the rectum. The most comfortable position is lying on the left side with half-bent legs: this eliminates the option of exiting the means to the outside.

Slightly pressing a finger candle is inserted 1-2 cm inside the intestine. It is advisable to lie in the starting position for a few minutes.

Are all antihemormal suppositories and pills pregnant?

The treatment of hemorrhoids in pregnant women deals only with the doctor. Independent use of certain drugs can adversely affect the future of the baby, and sometimes provoke premature placental abruption and bleeding.

Preference is given to low-toxic and herbal preparations: suppositories with sea buckthorn and glycerin, horse chestnut tincture. It is important to prevent constipation (proper nutrition, regular walks).

If necessary, radical intervention is carried out after childbirth and at the end of breastfeeding.

How to get rid of hemorrhoids once and for all?

  • Start treatment at the first signs of the disease.
  • Regularly (usually twice a year) courses to take venotonic.
  • Change your lifestyle: increase physical activity, eliminate heavy loads, eat right, give up cigarettes and alcohol.

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