Hemorrhoids are the symptomatic swelling and enlargement of veins located inside the rectum or beneath the skin around the anus. While everyone has vascular cushions in this area, they become problematic when they swell, affecting roughly half of all people by age 50. Mild cases often resolve with simple lifestyle changes or over-the-counter care, but ignoring the problem can lead to a significant decline in quality of life or acute medical emergencies.
Worsening of Common Symptoms
Ignoring a mild hemorrhoid allows initial symptoms to progress from minor irritation to persistent discomfort. Occasional bright red bleeding often escalates to more frequent and greater volumes of blood loss during bowel movements. The constant irritation and friction increase tenderness and pain, especially while sitting or during defecation.
Internal hemorrhoids are categorized by how much they prolapse outside the anal opening. An untreated internal hemorrhoid can progress from retracting spontaneously to requiring manual repositioning, or eventually becoming permanently prolapsed. When a hemorrhoid remains outside, it can trap mucus and microscopic stool particles, causing severe, persistent itching known as pruritus ani.
Acute Complications Requiring Immediate Care
Leaving hemorrhoids unaddressed increases the risk of sudden events requiring prompt medical evaluation. One severe event is a thrombosed hemorrhoid, which occurs when blood pools within an external hemorrhoid and forms a painful clot, or thrombus. This clot causes the hemorrhoid to swell rapidly into a hard, bluish lump near the anus. The resulting pain is intense, sharp, and sudden, unlike the dull ache of a standard hemorrhoid.
For the quickest relief, a minor procedure called an excision or thrombectomy is often recommended within the first 72 hours of clot formation. A more severe complication is strangulation, which happens when a prolapsed internal hemorrhoid becomes tightly trapped by the anal sphincter muscles. This constriction cuts off the blood supply to the tissue, leading to severe pain, swelling (edema), and a risk of tissue death (necrosis).
Strangulation is a medical emergency because the lack of blood flow can lead to tissue decay and a high risk of infection. If the tissue becomes severely compromised, immediate surgical intervention is necessary to remove the damaged hemorrhoidal tissue.
Chronic Health Risks from Persistent Bleeding
Persistent, low-level bleeding from an untreated hemorrhoid can lead to long-term systemic problems. The slow loss of blood eventually depletes the body’s iron stores, resulting in iron deficiency anemia. This condition is marked by a reduced number of healthy red blood cells, which can cause symptoms like extreme fatigue, generalized weakness, and a pale complexion.
The resulting anemia can dramatically affect a person’s overall health and stamina. Chronic irritation and inflammation in the perianal area also lead to secondary skin and hygiene issues. When the swelling of an external thrombosed hemorrhoid resolves, it can leave behind permanent folds of skin known as skin tags. These tags, combined with constant moisture and irritation from a prolapsed hemorrhoid, complicate hygiene and create an environment susceptible to chronic inflammation and secondary skin infections.