Internal hemorrhoids are a type of varicose veins that are found inside the rectum. Although external hemorrhoids are more noticeable and painful, internal hemorrhoids can also cause significant discomfort and health problems if not treated in time.

In this article, we will consider in detail the most effective methods of their treatment.

 

1. Home methods for the treatment of internal hemorrhoids

 

Treatment for internal hemorrhoids often begins with home remedies that can relieve symptoms and prevent the condition from getting worse. These methods are affordable, easy to apply, and can be extremely effective for milder forms of hemorrhoids.

Here are some of the most popular and proven home remedies:

 

Good hydration

Staying well hydrated is a key factor in combating constipation, which is a major cause of internal hemorrhoids. Drinking enough water helps to soften the stool and make it easier for it to pass through the intestines. We recommend drinking at least 8 glasses of water a day (about 2 liters).

 

Diet rich in fiber

Fiber increases the volume and softness of stools, which makes it easier to pass and reduces the need to strain during bowel movements. Dietary sources of fiber include fruits, vegetables, whole grains, legumes, and nuts. Sometimes it may be necessary to add fiber in the form of supplements.

 

Diet rich in fiber

 

Hot baths

Warm baths, also known as sitz baths, can provide significant relief from the symptoms of internal hemorrhoids. Soaking in warm water for 15-20 minutes several times a day helps reduce inflammation and relieve pain and discomfort. Epsom salt (magnesium sulfate) can be added to the water for added effect.

 

Topical means - creams, ointments, suppositories

Products containing hydrocortisone or lidocaine can reduce inflammation and pain. Follow the instructions for use carefully.

 

Maintaining good hygiene

Maintaining good anal hygiene is important to prevent further irritation and infections. After a bowel movement, use wet wipes instead of dry toilet paper. Avoid products with fragrances and alcohol, which can irritate the skin.

 

Ice packs

Applying ice packs can help reduce swelling and relieve pain. Compresses should be applied for about 10-15 minutes several times a day. It is important to use a towel or other intermediate material between the ice and the skin to avoid direct contact and frostbite.

 

Physical exercises

Regular physical activity improves blood circulation and supports a healthy digestive system. Avoid exercise that involves heavy lifting or excessive straining, as these can worsen symptoms.

 

Avoiding prolonged sitting

Prolonged sitting, especially on hard surfaces, can increase pressure on the veins in the anal area. If your job requires prolonged sitting, take frequent breaks and walk around to stimulate circulation. Using a soft pillow or special hemorrhoid pad can also help.

 

Avoiding prolonged sitting

 

Aromatherapy and herbal remedies

Certain herbal remedies and essential oils can provide relief from the symptoms of internal hemorrhoids. Chamomile, witch hazel, yarrow, hazelnut and tea tree oil have anti-inflammatory and soothing properties.

 

Home remedies for internal hemorrhoids can be extremely effective in mild cases and as supportive therapy. However, if symptoms do not improve or worsen, it is important to seek medical attention for further evaluation and treatment.

 

2. Medical treatment of internal hemorrhoids

 

Medical treatment for internal hemorrhoids may be necessary when home remedies are not enough to relieve symptoms or when the hemorrhoids are more advanced. Doctors offer a variety of treatments that range from drug therapy to minimally invasive procedures and surgical interventions.

 

Medicines

 

When treating internal hemorrhoids, doctors often prescribe a variety of medications, which may include:

  • Creams, ointments, and suppositories: These products usually contain hydrocortisone or lidocaine, which reduce inflammation and relieve pain. They can be used for short-term relief of symptoms;
  • Oral medications: Pain relievers or anti-inflammatory medications are sometimes prescribed to reduce discomfort;
  • Phlebotonics: These drugs improve venous tone and reduce inflammation. They are especially useful for chronic hemorrhoids.

 

Minimally invasive procedures

 

When medications aren't enough, minimally invasive procedures are the next step. They include:

  • Rubber band ligation: This procedure involves placing small rubber bands around the base of the hemorrhoid. This cuts off the blood supply and the hemorrhoid falls off after a few days. Rubber band ligation is effective for second and third stage hemorrhoids;
  • Sclerotherapy: Sclerotherapy involves injecting a chemical into the hemorrhoid that causes the veins to shrink and the hemorrhoid disappears. This procedure is painless and suitable for smaller hemorrhoids;
  • Infrared coagulation: This procedure uses infrared light to burn the hemorrhoid tissue. This cuts off the blood supply and the hemorrhoid shrinks. The procedure is quick and minimally invasive;

 

3. Surgical treatment of internal hemorrhoids

 

Surgical treatment of internal hemorrhoids is applied when other methods are not effective or when the hemorrhoids are at an advanced stage. Surgical interventions offer lasting relief, but also require a longer recovery period and may be associated with a greater risk of complications.

 

Here are the main surgical methods used to treat internal hemorrhoids:

 

Hemorrhoidectomy

 

Hemorrhoidectomy is the most traditional and widely used surgical method for removing internal hemorrhoids. The procedure involves surgical excision of the hemorrhoidal tissues. This technique is particularly effective for large and stubborn hemorrhoids that do not respond to other treatments.

 

Types of hemorrhoidectomy

  • Open Hemorrhoidectomy: In this method, the hemorrhoids are excised and the wounds are left open for natural healing. This approach reduces the risk of infection, but may be associated with a longer period of pain and recovery;
  • Closed hemorrhoidectomy: The wounds are closed with stitches after the hemorrhoids are excised. This method can speed recovery, but it also carries a greater risk of infection.

 

Procedure and recovery

Hemorrhoidectomy is usually performed under general or regional anesthesia. Patients may experience significant pain after the procedure, which is managed with pain medication. Recovery can take from several weeks to several months, depending on the individual case and the type of hemorrhoidectomy.

 

Hemorrhoidopexy (Stapling Procedure)

 

Hemorrhoidopexy, also known as a stapling procedure, is a less invasive surgical option. This procedure involves the use of a special tool (a stapler) that removes some of the hemorrhoidal tissue and staples the rest back into place in the anal canal.

Advantages of hemorrhoidopexy

  • Less pain: Patients typically experience less pain after the procedure compared to a traditional hemorrhoidectomy;
  • Faster recovery: The recovery period is shorter, allowing a quicker return to normal activities.

 

Procedure and recovery

The stapling procedure is performed under general or regional anesthesia. Recovery is usually faster, with most patients recovering within one to two weeks. Pain and discomfort are less intense and the risk of complications is lower.

 

Laser surgery

 

Laser surgery is a modern technique in which a laser beam is used to vaporize or cut out hemorrhoidal tissue. This procedure offers a number of advantages, including minimal pain, less bleeding, and faster recovery.

 

Advantages of laser surgery

  • Precision: The laser allows precise cutting of tissue with minimal damage to surrounding structures;
  • Minimal invasiveness: The procedure is less invasive and usually requires a shorter recovery period;
  • Low risk of complications: The risk of infections and other complications is lower compared to traditional surgical methods.

 

Procedure and recovery

Laser surgery is usually performed under local or general anesthesia. Patients can recover quickly, often within a few days. Doctors may recommend the use of pain relievers and maintaining good hygiene to facilitate recovery.

 

Potential complications of surgical treatment

 

Despite the high effectiveness of surgical methods, they can be associated with potential complications, including:

  • Pain: Surgical procedures are usually associated with postoperative pain, which may require the use of pain relievers;
  • Bleeding: Bleeding is a common complication, especially with traditional hemorrhoidectomy;
  • Infection: Despite precautions, infections can develop after surgery;
  • Problems urinating: In rare cases, patients may experience difficulty urinating after the procedure.

 

Long term forecast

 

Surgical treatment of internal hemorrhoids offers lasting relief for many patients. After a successful surgical intervention, patients usually experience a significant improvement in symptoms and a reduction in hemorrhoids. However, maintaining a healthy lifestyle, including a high-fiber diet and regular physical activity, is essential to prevent relapses.

 

4. Prevention of internal hemorrhoids

 

Maintaining a healthy diet

One of the most important strategies for preventing internal hemorrhoids is maintaining a high-fiber diet. Fiber increases the volume and softness of stools, which facilitates their passage through the intestines and reduces the need to strain during defecation. Recommended sources of fiber include:

  • Fruits (apples, pears, raspberries);
  • Vegetables (broccoli, carrots, artichoke);
  • Whole grains (oatmeal, brown rice, whole grain bread);
  • Legumes (beans, lentils, chickpeas);
  • Nuts and seeds.

 

Keeping well hydrated

 

Keeping well hydrated

Drinking enough water is important to prevent constipation. Dehydration can lead to hard, dry stools that make defecation difficult and increase the pressure on the rectal veins. Consume at least 2 liters of water per day.

 

Regular physical activity

Regular physical activity improves the digestive system and reduces the risk of constipation. Exercise such as walking, swimming, and light aerobic exercise are especially helpful. Physical activity also helps maintain a healthy body weight, which reduces pressure on the veins in the rectum.

 

Avoiding prolonged sitting and standing

Prolonged sitting or standing can increase pressure on the veins in the rectum and anus. If your job requires prolonged sitting, take frequent breaks to move and stretch. Using a soft pillow or a special hemorrhoid pad can also help relieve the pressure.

 

Proper walking habits as needed

Proper bowel habits can significantly reduce the risk of internal hemorrhoids. Here are some recommendations:

  • Don't delay: Don't hold your stool when you feel the need to use the toilet. Retention can cause the stool to harden and make bowel movements more difficult;
  • Avoid straining: Try to avoid straining hard while having a bowel movement. Straining increases the pressure on the rectal veins and can lead to hemorrhoids;
  • Short sessions: Keep time spent on the toilet to a minimum. Prolonged sitting on the toilet can increase the pressure on the rectal veins.

 

Maintaining good hygiene

Maintaining good hygiene in the anal area is important to prevent irritations and infections that can contribute to the development of hemorrhoids. Use wet wipes or toilet paper that is fragrance and alcohol free. Regular sitz baths can also help maintain cleanliness and relieve discomfort.

 

Conclusion

 

Treating internal hemorrhoids requires a combination of healthy habits and, if necessary, medical intervention. From dietary and lifestyle changes to minimally invasive procedures and surgical interventions, there are many effective methods to address this problem.

It is important to recognize the symptoms in time and take the appropriate steps for treatment and prevention. Consultation with a doctor is essential to choose the most suitable treatment according to individual needs. With the right approach and care, you can achieve significant relief and improve the quality of your life.

 

SOURCES:

1. WebMD: Hemorrhoids: Symptoms, Causes, and Treatment (25.05.2024)
2. Healthline: Causes of Hemorrhoids and Tips for Prevention (25.05.2024)
3. Mayo Clinic: Hemorrhoids: Symptoms (25.05.2024)