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Internal Hemorrhoids
Internal hemorrhoids can cause bleeding, discomfort and difficulty during bowel movements. At GastroDoxs in Houston, Dr. Scott delivers comprehensive, expert diagnosis and effective, tailored treatments-from lifestyle and dietary guidance to medications, minimally invasive procedures and surgery-to bring you lasting relief.
Dr. Scott Liu, MD, is a board-certified gastroenterologist with over six years of experience and a background in military medicine. He earned his medical degree from the University of Maryland, Baltimore, completed his Internal Medicine residency at Naval Medical Center Portsmouth, and finished his Gastroenterology fellowship through the National Capital Consortium. Dr. Liu provides comprehensive care for a broad range of digestive conditions, including abdominal pain, acid reflux, liver disease, chronic diarrhea, and colon cancer screening. He is a member of the American College of Gastroenterology and is known for his disciplined, patient-focused approach and clear communication.
What Are Internal Hemorrhoids?
Internal hemorrhoids are swollen blood vessels located just inside the rectum, above the anal opening. Often they go unnoticed until they begin to bleed or prolapse during a bowel movement.
Common Causes and Risk Factors
Straining too hard during bowel movements
Chronic constipation or diarrhea
Pregnancy and vaginal delivery
Prolonged sitting-especially on the toilet
Diets low in fiber
Being overweight or frequently lifting heavy objects
Signs and Symptoms
Bright red blood on toilet paper or in the toilet bowl
Sensation of fullness or pressure when passing stool
Soft lump that protrudes during a bowel movement and retracts on its own
Itching or mild irritation around the anus
Mucus discharge from the rectum
How Dr. Scott Diagnoses Internal Hemorrhoids?
Dr. Scott uses a step-by-step approach:
Medical History and Physical Exam
He reviews symptoms such as painless rectal bleeding, anal itching, mucus discharge, or a feeling of incomplete evacuation. He also asks about bowel habits, straining during bowel movements, fiber intake, and any history of hemorrhoids or rectal procedures.
Visual and Digital Rectal Exam
Dr. Scott performs an external inspection followed by a digital rectal exam to check for masses, tenderness, or prolapsed internal hemorrhoids. This helps assess the grade and exclude other anorectal conditions.
Anoscopy
A small, lighted tube is used to directly visualize the internal hemorrhoids inside the rectum. This quick in-office procedure allows Dr. Scott to assess the location, size, and severity of the hemorrhoids.
Proctoscopy (if needed)
In some cases, a proctoscope may be used to evaluate the entire rectal canal for higher-grade internal hemorrhoids or other rectal pathology.
Colonoscopy (if indicated)
If rectal bleeding is persistent, unexplained, or associated with changes in bowel habits or age over 45, a colonoscopy may be recommended to rule out colorectal cancer, polyps, or inflammatory bowel disease.
Treatment
Our Team offers a full range of care for internal hemorrhoids.
1. Lifestyle and Diet Changes
Eat more fruits, vegetables, and whole grains
Drink plenty of water
Avoid straining during bowel movements
Limit time spent sitting on the toilet
Stay active throughout the day
2. Medications
Over-the-counter creams or suppositories for symptom relief
Stool softeners to ease bowel movements
Prescription ointments for stronger relief
3. Minimally Invasive Procedures
Rubber band ligation to cut off blood flow so the hemorrhoid falls off
Sclerotherapy injections to shrink the hemorrhoidal vein
Infrared coagulation using heat to reduce swollen tissue
4. Surgical Options
Hemorrhoidectomy to remove the swollen tissue
Stapled hemorrhoidopexy to reposition tissue and reduce symptoms
Dr. Scott Liu, MD, is a board-certified gastroenterologist with over six years of experience and a background in military medicine. He earned his medical degree from the University of Maryland, Baltimore, completed his Internal Medicine residency at Naval Medical Center Portsmouth, and finished his Gastroenterology fellowship through the National Capital Consortium. Dr. Liu provides comprehensive care for a broad range of digestive conditions, including abdominal pain, acid reflux, liver disease, chronic diarrhea, and colon cancer screening. He is a member of the American College of Gastroenterology and is known for his disciplined, patient-focused approach and clear communication.
Frequently Asked Questions
Do internal hemorrhoids go away on their own?
Some mild cases improve with diet and lifestyle changes like more fiber and less straining. Others may need medical treatment from Dr. Scott.
What's the difference between internal and external hemorrhoids?
Internal hemorrhoids sit inside the rectum and usually aren't painful. External hemorrhoids form under the skin around the anus and can be tender or itchy.
Can internal hemorrhoids cause constipation?
They don't directly cause constipation, but swollen hemorrhoids can make it harder and more uncomfortable to pass stool.
Is anoscopy painful?
No. Most patients feel only mild pressure during this quick, in-office exam that lets Dr. Scott see inside your rectum.
Will insurance cover hemorrhoid treatment?
Most insurance plans cover diagnosis and treatment of hemorrhoids. Our staff will verify your benefits and answer any coverage questions.
When should I see a doctor?
Make an appointment if you notice bleeding, a bulging lump, persistent discomfort, or if home treatments aren't helping.
Can pregnancy make hemorrhoids worse?
Yes. Increased pelvic pressure and hormonal changes during pregnancy can lead to new hemorrhoids or worsen existing ones.
