digestive disorders center

What Happens If Hemorrhoids Don't Hurt?

Reviewed on 7/8/2022
A woman speaks to her doctor about hemorrhoid treatment
Hemorrhoids usually don’t hurt, cause other problems, or need to be treated. However, even painless hemorrhoids often develop into hemorrhoids that cause discomfort or other problems, which will eventually require treatment.

Hemorrhoids are swollen veins in the anal region. Hemorrhoids are a common, painful and uncomfortable condition that can affect anyone. 

Hemorrhoids can be internal, in the lower rectum, or external, occurring under the skin around the anus.

  • External hemorrhoids are the ones that usually cause symptoms.
  • Internal hemorrhoids usually don’t hurt, even if they bleed. These painless hemorrhoids may cause you to notice bright red blood on toilet paper or blood dripping into the toilet bowl. Internal hemorrhoids may extend beyond the anus (prolapse) at some point, causing problems.
  • A prolapsed hemorrhoid can collect small amounts of mucus and tiny stool particles that can cause anal itching (pruritus ani). 

In general, if hemorrhoids don’t hurt or cause other problems, they don’t need to be treated. However, even painless hemorrhoids often develop into hemorrhoids that cause discomfort or other problems and they will eventually require treatment. 

When symptoms of hemorrhoids occur, they may include: 

  • Rectal bleeding
    • Often painless 
    • Bright red
    • Tends to be a small amount
    • Visible blood on toilet paper after wiping following a bowel movement
    • Noticed especially after bowel movements
  • Tissue bulging from the anal area
    • May appear dark blue to purple in color if there is a blood clot
  • Pain and pressure in the rectal area
  • Anal itching 
  • Burning sensation in the anal area
  • Feeling a need to have a bowel movement
  • Difficulty cleaning after a bowel movement
  • Leakage of feces 

What Causes Hemorrhoids?

Causes of hemorrhoids include: 

  • Straining during bowel movements
  • Chronic constipation or diarrhea
  • Prolonged sitting (especially sitting on the toilet)
  • Inadequate fiber intake
  • Lifting heavy objects frequently
  • Weakening of the supporting tissues in the anus and rectum that occurs with aging
  • Pregnancy
  • Tumors

What Is the Treatment for Hemorrhoids?

Mild cases of hemorrhoids may resolve on their own in a few days. 

Home treatments for hemorrhoids include: 

  • Don’t strain during bowel movements
  • Don’t sit on the toilet for long periods of time
  • Drink plenty of water
  • Take warm sitz baths 
    • Available in drugstores
    • Soak the buttocks in two to three inches of warm water for 10 to 15 minutes, two to three times daily
    • Avoid use of soap, bubble bath, or other additives in the water
  • Increase fiber intake 
  • Topical treatments 
    • Over-the-counter (OTC) pain-relieving creams and hydrocortisone rectal suppositories may help temporarily relieve pain, inflammation, and itching
      • Do not use topical treatments for more than one week, unless your doctor recommended it
  • Laxatives
    • Only use if increased fiber intake does not relieve constipation
  • Over-the-counter (OTC) pain relievers 

Medical treatments for hemorrhoids include: 

  • Rubber band ligation
  • Laser, infrared, or bipolar coagulation 
  • Sclerotherapy 
  • Surgery

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Reviewed on 7/8/2022
References
REFERENCES:

Image source: iStock Images

https://www.uptodate.com/contents/hemorrhoids-beyond-the-basics?search=Hemorrhoids&source=search_result&selectedTitle=2~150&usage_type=default&display_rank=2

https://www.niddk.nih.gov/health-information/digestive-diseases/hemorrhoids/definition-facts

https://www.medstarhealth.org/blog/5-signs-its-time-to-seek-care-for-hemorrhoids

https://hemorrhoidanswers.com/blog/painless-hemorrhoids/