How long does an internal hemorrhoid last?

If you bleed when using the toilet without experiencing pain, you likely have an internal hemorrhoid. The immediate question is: will it go away on its own, and when?

That depends on the severity, the treatment, and what you continue to do between flare-ups. Here are the concrete benchmarks.

Why internal hemorrhoids often go unnoticed

Internal hemorrhoids form in the lower rectum, an area without nerve endings sensitive to pain. Many people have them without knowing. The only visible sign is often bright red bleeding when passing stool, sometimes accompanied by a feeling of discomfort or a mass in the rectum.

This is not insignificant, however. Repeated bleeding, even if painless, can cause anemia. And an internal hemorrhoid that gradually prolapses, what is called a prolapse, becomes increasingly difficult to manage over time.

Duration according to grade

Doctors classify internal hemorrhoids into four grades based on the degree of prolapse. The higher the grade, the longer the discomfort lasts without appropriate treatment.

At Grade I, the hemorrhoid remains inside the anal canal. A flare-up can resolve in a few days to a week with simple treatment and some dietary adjustments. At Grade II, the hemorrhoid protrudes during straining but then retracts spontaneously. Discomfort can last from one to three weeks. At Grade III, prolapse requires manual reinsertion. Returning to normal without medical intervention takes several weeks. At Grade IV, the hemorrhoid remains permanently prolapsed: spontaneous resolution does not occur, and medical or surgical treatment is necessary.

Treatment or not: what it changes for the duration

Without doing anything, a mild flare-up often subsides in a few days. But subsiding doesn't mean disappearing. The venous tissue remains weakened, and the next flare-up often comes faster and stronger.

With appropriate treatment, symptoms generally improve in less than a week. Venotonics to strengthen the venous wall, analgesics if needed, a fiber-rich diet to prevent constipation, and sufficient hydration.

What pharmacies offer as a first line, creams and suppositories based on cortisone, provide local relief. But these formulas do not address the underlying mechanism: the loss of tone in the venous tissue. This is why flare-ups return.

What makes things drag on

Chronic constipation is the primary factor: repeated straining during bowel movements increases pressure on the hemorrhoidal veins each time. Prolonged sitting, a diet low in fiber, and a sedentary lifestyle perpetuate the problem. In women, pregnancy or recent childbirth can trigger or worsen an internal hemorrhoid due to the pressure exerted on the pelvic veins.

When to consult without delay

Bright red bleeding in the toilet always warrants medical evaluation, even if the most likely cause is an internal hemorrhoid. It could be something else. If the bleeding is heavy, repeated, or accompanied by pain, do not wait. Similarly, if your symptoms do not improve after a week of treatment, a consultation is necessary.

An internal hemorrhoid diagnosed early is treatable. Waiting for it to resolve on its own for weeks, while the venous tissue continues to deteriorate between flare-ups, is a bad calculation.