Hemorrhoids, also known as piles, are a common condition involving swollen, enlarged veins in the lowest part of the rectum and anus. They are similar to varicose veins found elsewhere in the body. While they can cause discomfort, itching, and bleeding, hemorrhoids are generally not life-threatening. Many people will experience hemorrhoids at some point in their lives, with about half of adults over 50 years old having them. These vascular cushions are a normal part of the anal anatomy, helping with stool control, but they become problematic when inflamed or swollen.
Hemorrhoids and Life-Threatening Risks
Direct mortality from hemorrhoids is extremely rare. While they can cause significant pain and discomfort, they typically do not lead to death. The pain and bleeding associated with hemorrhoids, though often alarming, do not usually pose a fatal risk.
However, in unusual circumstances, complications can arise that require medical intervention. These complications are infrequent but can lead to serious health issues if left unaddressed. Such severe outcomes typically stem from neglected conditions rather than the hemorrhoids themselves.
Serious Complications
Certain complications can develop from severe or untreated hemorrhoids.
One complication is anemia, which can result from chronic, significant blood loss. Persistent and heavy bleeding over time can deplete the body’s iron stores, leading to iron deficiency anemia. This can cause symptoms like extreme tiredness, shortness of breath, or chest pain.
Another complication is thrombosed hemorrhoids, which occur when a blood clot forms inside a hemorrhoid, typically an external one. This condition causes intense pain, swelling, and a hard, bluish lump around the anus. While not inherently dangerous, a thrombosed hemorrhoid can become infected if left untreated, potentially leading to an abscess.
Infection can occur in severe or thrombosed hemorrhoids, particularly if the skin is broken or hygiene is poor. These infections can lead to a perianal abscess, a collection of pus that requires medical drainage. In neglected situations, a localized infection could progress to sepsis, a life-threatening bloodstream infection where the body’s response damages its own tissues and organs.
Strangulated hemorrhoids are another complication. This occurs when an internal hemorrhoid prolapses, meaning it bulges outside the anus, and the anal muscles cut off its blood supply. This loss of blood flow can lead to tissue death (gangrene) and intense pain. If not promptly treated, the dead tissue can become infected, increasing the risk of complications like sepsis.
When to Seek Professional Care
Prompt medical evaluation is advisable if hemorrhoid symptoms are severe or persistent. You should seek professional care for excessive or continuous bleeding from the rectum, particularly if the toilet water turns red or you notice large blood clots. Severe pain that is not relieved by home remedies also warrants a doctor’s visit.
Immediate attention is necessary if you experience a sudden onset of severe pain, especially accompanied by a lump around the anus, as this could indicate a thrombosed hemorrhoid. Any signs of infection, such as fever, pus discharge, increased redness, or worsening swelling, require urgent medical assessment. It is also important to consult a healthcare provider if there are changes in bowel habits or if stools appear black and tarry, as these could signal bleeding from higher up in the digestive tract, unrelated to hemorrhoids, or other more serious conditions. If hemorrhoids do not improve after a week of home care, medical advice should be sought.