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 1 hemorrhoids are treated with conservative medical therapy and avoidance of nonsteroidal anti-inflammatory drugs and spicy or fatty foods Grade 2 or 3 hemorrhoids are initially treated with nonsurgical procedures Very symptomatic grade 3 and grade 4 hemorrhoids are best treated with surgical hemorrhoidectomy Treatment of grade 4 internal hemorrhoids requires prompt surgical consultation..