You need immediate surgical attention.. Consult nearest surgeon for clinical examination as treatment depends upon clinical grading The following is a quick summary of treatment for internal hemorrhoids by grade: Grade I hemorrhoids are treated with conservative medical therapy and avoidance of nonsteroidal anti-inflammatory drugs (NSAIDs) and spicy or fatty foods Grade II or III hemorrhoids are initially treated with nonsurgical procedures Very symptomatic grade III and grade IV hemorrhoids are best treated with surgical hemorrhoidectomy Treatment of grade IV internal hemorrhoids or any incarcerated or gangrenous tissue requires prompt surgical consultation