Hemorrhoids, also known as piles, are swollen, inflamed veins around the anus or in the lower rectum. They can be internal, forming inside the rectum, or external, developing under the skin around the anal opening. About half of all individuals may experience hemorrhoids by age 50.
What Happens When Hemorrhoids Are Left Untreated?
Leaving hemorrhoids unaddressed can lead to a progression of symptoms and various complications. Initially, individuals might notice increased discomfort, such as persistent pain, itching, and swelling. Over time, these symptoms may intensify, significantly impacting daily activities and quality of life.
One potential complication is anemia due to chronic blood loss. Internal hemorrhoids can bleed during bowel movements. Consistent bleeding over time can deplete the body’s iron stores, leading to fatigue, shortness of breath, and pale skin.
A common and painful complication is a thrombosed hemorrhoid, where a blood clot forms within an external hemorrhoid. This causes sudden, severe pain, swelling, and a hard, bluish lump around the anus. The pain can be intense, making sitting, walking, or having a bowel movement difficult.
Complications can arise if surrounding tissue is compromised. Skin breaks from irritation, excessive wiping, or a ruptured thrombosed hemorrhoid can allow bacteria to enter, leading to localized infection or an abscess. Signs include increased pain, redness, pus, and fever.
A severe complication, particularly with internal hemorrhoids, is strangulation. This happens when a prolapsed internal hemorrhoid has its blood supply cut off by anal sphincter muscles. A strangulated hemorrhoid causes extreme pain and can lead to tissue death if blood flow is not restored promptly.
Internal hemorrhoids can progressively prolapse, bulging further out of the anus over time. Initially, they might retract, but with continued straining, they may require manual reinsertion or remain permanently prolapsed. This can lead to increased irritation, pain, and difficulty with hygiene.
When to Seek Medical Attention
While many hemorrhoid symptoms can be managed at home, certain signs indicate professional medical evaluation is necessary. Persistent or severe pain that does not improve with home care after about a week warrants a doctor’s visit. Such pain could signal conditions like a thrombosed or strangulated hemorrhoid, requiring prompt intervention.
Significant or persistent rectal bleeding requires medical attention. While bright red blood on toilet paper or in the toilet bowl is often associated with hemorrhoids, it is essential to rule out other causes, such as inflammatory bowel disease or colorectal cancer. Any changes in bowel habits with bleeding also require immediate consultation.
If you notice a painful, hard lump around the anus that cannot be gently pushed back inside, seek medical advice. This could indicate a thrombosed external hemorrhoid or a trapped prolapsed internal hemorrhoid. These conditions cause intense discomfort and may require specific medical procedures for relief.
Signs of infection, such as increased redness, swelling, unusual discharge, or fever, especially if accompanied by severe anal pain, require immediate medical attention. Though uncommon, hemorrhoid infections can lead to complications like abscess formation if left untreated.
If home remedies have been applied for a week without noticeable improvement, consult a healthcare provider. A medical professional can diagnose the condition, rule out other issues, and recommend appropriate treatments tailored to the specific type and severity of hemorrhoids.
Managing Symptoms at Home
For mild hemorrhoid symptoms, several strategies can alleviate discomfort and promote healing. Adjusting dietary habits is a primary step, focusing on increasing fiber intake to soften stools and reduce straining during bowel movements. Consuming fruits, vegetables, whole grains, and legumes can help achieve the recommended 20 to 35 grams of fiber per day.
Alongside a high-fiber diet, adequate fluid intake is important, as water helps fiber work effectively to prevent constipation. Drinking at least eight glasses of water daily contributes to softer, easier-to-pass stools, reducing pressure on hemorrhoidal veins. Avoiding prolonged sitting on the toilet and regular physical activity also supports healthy bowel function.
Over-the-counter (OTC) remedies provide temporary relief from pain, itching, and swelling. Creams, ointments, and suppositories with hydrocortisone reduce inflammation, while local anesthetics like lidocaine numb the area to alleviate pain. Witch hazel pads offer a cooling and astringent effect, soothing irritation.
Sitz baths, which involve soaking the anal area in warm water for 10 to 20 minutes, can significantly reduce pain and inflammation. This can be done in a bathtub with a few inches of warm water or using a special basin that fits over the toilet. Sitz baths promote blood flow and relax anal muscles, providing comfort.
Maintaining good anal hygiene is also important; gently cleaning the area after bowel movements without harsh wiping prevents further irritation. Using moist toilet paper or a bidet is less abrasive than dry paper. Applying a cold pack wrapped in a cloth to the affected area for 5 to 10 minutes can also help reduce swelling and discomfort temporarily.