Internal Hemorrhoids Treatment

Internal hemorrhoids treatment depends on the stage of internal hemorrhoids. These processes are described in  the how to get rid of hemorrhoids article.

If not sure, read that article first before continuing with this one. The lower the level the less invasive will be the treatment required.

This is how to treat internal hemorrhoids.

Good bowel movement is essential both in the prevention and the treatment for each degree of hemorrhoids.

Constipation: Feces should always be soft with a certain consistency.

Lifestyle Change Is The Best Internal Hemorrhoids Treatment

Exercise – fibers – natural laxatie – drink

The main thing is to adjust your lifestyle: more exercise, more fiber in your diet, more natural laxatives and enough fluids intake. Medication is only secondary, that’s if you are not willing to rid yourself of hemorrhoids permanently.

Important: After adjusting your lifestyle you may have to allow three weeks or more before your results start to show up. So persevere!

More exercise is essential in the treatment of constipation.

Drink enough water: 1.5 to 2 liters/day.

Take enough time to go to the toilet. Provide literature to calmly wait for nature to do its job. Do not sit like a fool pressing very hard to have hemorrhoids.

A good method is to sit regularly every morning after breakfast, 5 minutes on the toilet sit, without squeezing. This will train your body and system over time that it is defacating time, immediately after breakfast.

Stop promoting constipation: if bowels feel one must go to the toilet, one must go to the toilet! Defecation reflexes that have disappeared over the years can be learned back to the body by conscientiously following any bowels and going to the toilet.

Do not skip meals and eat at regular intervals: our body likes regularity (biorhythm).

Avoid fatty foods, chocolate, white rice, white bread, bananas, biscuits, hard boiled eggs, too much coffee, tea, alcohol (the latter 3 works diuretic and thus drying out the stool).

Two squeezed oranges for breakfast can do wonders and are also an excellent source of natural vitamin C. Drink or spoon the crushed flesh also.

After breakfast eat wholewheat bread with fruit jam (no chocolate) + piece of fruit or dried figs, dates, prunes + coffee, which stimulates peristalsis.

A reasonable amount of fat is necessary: Good fats that is: 1 or 2 teaspoons of olive oil per day on your salad or 1 avo a day.

Sit in water as hot as possible (bidet or paddling) and sit long enough (1/2 hours). Usually one feels relaxation of the anus muscle and the soreness subsiding immediately.

Adding 2 bags of chamomile tea in the bath has a healing effect on eczema and reduces anal itching.


Ointments and suppositories usually consist of different products: local anesthetic, protectivum, cortisone. They are just a relief for hemorrhoids pain and burning but do nothing to the hemorrhoids themselves.

They simply provide some relief from hemorrhoids symptoms.
The ointments, containing corticoids can lead to atrophy of skin and mucosa during prolonged use.

“Core-enhancing agents” or venotropica usually give bad, little or no help. There is no evidence of their positive effects. Hemorrhoids are after all dilated veins more than anything.

Internal Hemorrhoids Treatment: RADICAL TREATMENT

The purpose of the following treatments is scarring hemorrhoids + hemorrhoids scar just above the back so they are held in place by the scar and no longer prolapse.

Sclerotherapy and rubber ligature give very good results with not too large hemorrhoids. The advantage is that they can be done on outpatients and show little to no side effects.

The disadvantage is in the amount of treatment time required, which sometimes needs to be repeated.

1. Sclerotherapy

Injections with drying substances (= sclerotherapy) just above hemorrhoids. The injections help against very good and no major bleeding hemorrhoids (stage II – III). Its not really painful. Only a few hours of an unpleasant feeling of pressure in the anus will be felt.

Treatment should be repeated several times every 2-3 weeks to the entire ring to shrink hemorrhoids and for a satisfactory result.

Adverse Effects

  • Pain and discomfort the first few hours after the injection
  • Syringes jabbed in too deep risk infection

2. How to Prevent Hemorrhoids with gummiligature or Elastic Ligature (Ligature Barron)

This technique can be used for hemorrhoids class II to class IV. With a small elastic rubber, a hemorrhoid is tied off. The blood supply is tied off so that the hemorrhoid withers away, or has necrotic nodule.

The hemorrhoid and the band fall off after a few days and there is a small scar that heals itself in two weeks.

This scarrying occurs as the veins or hemorrhoids lower layer attaches to the underlying muscle layer so that less sedimentation occurs.

By raising the entire hemorrhoids ring, prolapsed hemorrhoids are frequently observed to disappear even after just one session.

Giving injections in combination usually yields very good results if the hemorrhoids are not too large. 70 to 75% of patients who undergo this treatment were subsequently free of symptoms.

Adverse Effects

The first 24 hours can result in a depressing feeling with some false bowel distress. Exceptionally, slight bleeding may occur with weight loss of the rubber band.

Quite exceptionally (<1%) increased bleeding may occur as a small artery in the node itself can not be sufficiently closed off by the rubber.

Sepsis with a fever and is exceptional but usually occurs between 2 and 7 days after application.

Urinary retention after application is quite rare


  • Beware of endocarditis prevalence
  • If possible, stop aspirin. Certainly no anticoagulant therapy (coumarin derivatives).

3. Surgery:

In case of very large protruding hemorrhoids (stage 4) and after years of waiting this might be the only solution. The first 2 techniques give much less trouble than the classical hemorrhoidectomy.

Doppler guided haemorrhoidal artery ligation (DG-HAL)

Using a special probe, the afferent arterial branches to the haemorrhoidal tissue are identified and ligated. The hemorrhoids shrink as the arterial supply is interrupted.

Today DG-HAL is often combined with hemorrhoidopexy. In the latter the prolapsed hemorrhoidal tissue is pulled up by means of an on-going suture.

Stapled Apoplexy

Two centimeters above the upper limit of the haemorrhoidal tissue, rectal mucosa is stapled down with a circular stapler. Thus, the arterial supply to the haemorrhoidal tissue is interrupted and the haemorrhoidal tissue proximally pulled back to its original position.

Hemorrhoidectomy: Excision of Hemorrhoids

The hemorrhoids have 3 large pieces removed and the wound is not attached and grows very quickly. This operation is usually done under general anesthesia.

Stenosis by scarring with narrowing of the anal canal and mild fecal incontinence (rare) are the main complications.