From the Guidelines
Hemorrhoids become dangerous when they cause severe bleeding, thrombosis, infection, or strangulation, and immediate medical attention is necessary if symptoms persist or worsen despite home treatment. According to the most recent and highest quality study, 1, warning signs of dangerous hemorrhoids include persistent bleeding, severe pain, fever, inability to have bowel movements, or significant swelling that doesn't improve with home treatments. Most hemorrhoids can be managed with conservative measures like increasing fiber intake, drinking plenty of water, using over-the-counter treatments, and warm sitz baths. However, if symptoms last more than a week despite home treatment, or if there is heavy bleeding or severe pain that doesn't respond to pain relievers, medical attention is necessary.
Some key points to consider when evaluating the danger of hemorrhoids include:
- Severe bleeding leading to anemia
- Thrombosis causing extreme pain
- Infection
- Strangulation where blood supply is cut off
- Persistent bleeding
- Severe pain
- Fever
- Inability to have bowel movements
- Significant swelling that doesn't improve with home treatments
The study 1 suggests that surgical treatment may be beneficial in selected patients with thrombosed hemorrhoids, and the decision between non-operative management and early surgical excision should be based on physician's expertise and patient's preference. However, the evidence is scarce and of low quality, making it difficult to provide evidence-based recommendations. In general, it is recommended to prioritize conservative management for hemorrhoids, and seek medical attention immediately if symptoms persist or worsen despite home treatment.
From the Research
When Hemorrhoids Become Dangerous
Hemorrhoids can become dangerous if left untreated or if they are not properly managed. Some signs that hemorrhoids may be becoming dangerous include:
- Increased bleeding or pain
- Prolapse or strangulation of the hemorrhoid
- Infection or abscess formation
- Anal stenosis or narrowing of the anal canal
Risk Factors for Complications
Certain factors can increase the risk of complications from hemorrhoids, including:
- Age: Hemorrhoids are more common in people over 50 years old 2
- Pregnancy: Hemorrhoids are common in pregnancy, occurring in 40% of women 2
- Comorbidities: Certain medical conditions, such as liver disease or heart disease, can increase the risk of complications from hemorrhoids 3
Treatment Options
Treatment options for hemorrhoids depend on the severity of symptoms and the presence of any complications. Some treatment options include:
- Medical management: Stool softeners, topical over-the-counter preparations, and topical nitroglycerine can help relieve symptoms 3
- Rubber band ligation: A procedure that involves placing a rubber band around the hemorrhoid to cut off blood flow 3, 4
- Excisional hemorrhoidectomy: A surgical procedure that involves removing the hemorrhoid 3, 5
- Stapled hemorrhoidopexy: A surgical procedure that involves stapling the hemorrhoid to the surrounding tissue 3, 5
Prevention
Preventing hemorrhoids involves maintaining a healthy diet and lifestyle, including:
- Eating a high-fiber diet to help prevent constipation 6
- Staying hydrated to help prevent constipation
- Avoiding straining during bowel movements
- Getting regular exercise to help improve bowel function