If you have mild hemorrhoids, leaving them alone can be fine. The swelling and discomfort will usually go away within a few days. Occasionally, though, there may be complications related to hemorrhoids.
Hemorrhoids are an uncomfortable problem that many people have. These painful inflammations in the anus can be itchy and painful. Most of the time, you can safely manage hemorrhoids at home. There are some situations, though, that require a doctor to treat complications from hemorrhoids.
What are hemorrhoids?
Hemorrhoids are bumps that form around the anus when the veins and surrounding tissue get swollen. They can be painful or itchy, and they sometimes bleed. Some are mild and don’t cause significant discomfort. Others are large and quite painful.
There are two types of hemorrhoids:
Internal: Internal hemorrhoids are tucked away inside the rectum. They can get irritated and bleed, causing blood to be visible on your feces. Occasionally, an internal hemorrhoid can get very swollen and prolapse. When this happens, the hemorrhoids will bulge out of your anus and cause significant discomfort.
External: Hemorrhoids can also form on the outer skin of your anus. You can see them if you examine the area, and you may be able to feel them when you clean around your anus. These can be itchy or painful. They might swell and bleed if they are irritated.
What happens if you don’t treat hemorrhoids?
If you have mild hemorrhoids, leaving them alone can be fine. The swelling and discomfort will usually go away within a few days. You will need to be gentle with the skin around your anus, of course, so that you don’t irritate the already-inflamed tissue.
Soften bowel movements
Hard bowel movements or straining to pass stools can aggravate hemorrhoids. Eating a high-fiber diet rich in fruits and vegetables, in contrast, can make bowel movements easier to pass. Drink plenty of fluids to help soften stools. Over-the-counter stool softeners or laxatives can be used as well.
Soaking in a bathtub or sitz bath filled with warm water may ease discomfort. Some people also find adding Epsom salts will make hemorrhoids less painful. Wash the area with warm water and gentle soap if needed. Thoroughly pat the anus dry after washing. Loose-fitting clothing that doesn’t ride up your backside may be more comfortable.
You might find relief using over-the-counter treatments for hemorrhoids. Creams and ointments will reduce the pain and itching so you feel more comfortable. Follow the package instructions on these medicines.
If you are in a lot of pain from your hemorrhoids, you can take over-the-counter pain relievers to ease discomfort. Ask your doctor if you have questions about which pain medications are safe for you to take. An ice pack or cool compress may also help soothe pain from hemorrhoids.
Complications from untreated hemorrhoids
In general, hemorrhoids aren’t dangerous, and it is safe to wait and see if they clear up with home treatment. Occasionally, though, there are complications related to hemorrhoids. Certain combinations have a risk of significant pain, and you may need a doctor to help relieve it. There is also a risk of bleeding excessively from hemorrhoids.
A thrombosed hemorrhoid is an external hemorrhoid that develops a blood clot inside it. This is very painful, and the pain can last for several days. The hemorrhoids may look purple or blue and appear very swollen.
After a clot in a thrombosed hemorrhoid goes away, you may have a bit of loose skin. This can be uncomfortable. Regular bowel movements and wiping the area might cause the skin tag to get irritated and painful.
If a hemorrhoid causes serious bleeding, your red blood cell count might drop. If you have any bleeding from your anus, you should get medical attention. It could be a sign of something more serious than hemorrhoids.
Prolapsed hemorrhoids are at risk for loss of blood supply due to muscle pressure. This may be very painful. Loss of blood flow can lead to tissue death in the area.
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Medical treatment for hemorrhoids
If you have a thrombosed hemorrhoid, the pain may be so acute that you want treatment to relieve it. Your doctor can perform a procedure to remove the clot. This can provide significant relief very quickly.
If you have a hemorrhoid that doesn’t respond to home treatment or you have rectal bleeding, you should talk to your doctor. There are non-surgical treatments that can greatly reduce hemorrhoid symptoms or remove them altogether.
Rubber band treatment
Your doctor will place a tiny band around the hemorrhoid. The pressure cuts off the blood supply so the hemorrhoid shrinks down to nothing.
Your doctor injects liquid into your hemorrhoid to shrink them.
Your doctor will use a mild electric current to eliminate hemorrhoids.
Treatment with infrared light can cut off the blood supply to hemorrhoids.
If you have very severe hemorrhoids, you may need surgery to repair the problem. This is a major surgery that requires general anesthesia. The recovery process is quite painful, but the surgery is very effective and reduces recurrence of hemorrhoids 95% of the time.
Medically Reviewed on 1/14/2022
Harvard Health Publishing: “Hemorrhoids and what to do about them.”
Johns Hopkins Medicine: “Hemorrhoids.”
Merck Manual: “Hemorrhoids.”
Scripps Health: “Can Hemorrhoids Go Away on Their Own?”
University of Iowa Hospitals & Clinics: “Hemorrhoids.”