Half of all Americans will experience hemorrhoids in their lifetimes. For most, hemorrhoids will go away on their own or with diet changes, topical treatments, medications or supplements. For some, they can also persist and cause bleeding, itching and painful bowel movements. These are commonly known as “chronic hemorrhoids.”
If conservative treatments have failed and symptoms continue, the potential complications of hemorrhoids and resulting painful conditions can include:
- Skin tags
- Pain
- Infection
- Bleeding (due to a burst hemorrhoid)
- Anemia
- Blood clots or Perianal thrombosi
- Prolapsing hemorrhoids, which can become trapped (incarcerated)
What causes hemorrhoids?
Most people have the wrong idea about hemorrhoids. Hemorrhoids are actually swollen veins inside the lower rectum or under the skin around the anus, similar in nature to varicose veins. They most commonly occur in those between 45 and 65, but can occur at any age. They may be caused by an increase in pressure in the lower rectum through one or more of the following factors:
- Sitting for long periods
- Straining or excessive exercise
- Spinal cord injury
- Chronic constipation or diarrhea
- Being overweight
- Pregnancy or childbirth
- Family history
A diet high in fiber, as well as drinking plenty of fluids and getting regular exercise can help decrease the risk of hemorrhoids.
What are my chronic hemorrhoid treatment options?
Conservative treatment for chronic hemorrhoids may include diet changes, topical treatments (such as an over-the-counter hemorrhoid cream), sitz baths and oral pain relievers (such as Tylenol). If the symptoms do not disappear, and if you are experiencing severe pain, bleeding, changes in bowel habits or changes to the color or consistency of your stools, you should talk with your doctor about other treatment options.
If conservative treatments fail, some patients opt for a hemorrhoidectomy, an invasive surgical procedure to remove hemorrhoids. However, surgery comes with risks and complications that can include infection, bleeding, difficulty emptying the bladder, rectal prolapse and more.1,2 Recovery takes at least 2 weeks, and it can be as long as 3-6 weeks before you feel normal again.
Another procedure, called rubber band ligation, is a less invasive technique that has been used more commonly in the last few years. However, this approach is also associated with pain and complications, especially for those taking anti-platelet or anti-coagulation medication and who have a higher risk of hemorrhage and infectious complications.3
A new and minimally invasive option to treat hemorrhoids is called hemorrhoidal artery embolization (HAE). This is typically recommended for patients with grade 1 to 3 internal hemorrhoids who have not responded to conservative treatment.
To learn more about HAE, click here »
- Hiroko Kunitake, MD, MPH and Vitaliy Poylin, MD, FACS, FASCRS2 Complications Following Anorectal Surgery Clin Colon Rectal Surg. 2016, Mar; 29(1): 14-21.
- Christos Simoglou et al. Milligan-Morgan Haemorrhoidectomy Complications. Hellenic Journal of Surgery 86, 68-71
- Andreia Albuquerque Rubber band ligation of hemorrhoids: A guide for complications. World J Gastrointest Surg. 2016 Sep 27; 8(9): 614-620