Can You Leave Haemorrhoids Alone if They Don’t Hurt? A Doctor Answers

Haemorrhoids are a surprisingly common condition that many people experience but rarely talk about openly. These swollen blood vessels in the rectal or anal area can affect anyone, often resulting in discomfort, bleeding, or itching. However, not all haemorrhoids come with noticeable symptoms. For some, they exist quietly in the background, causing no pain or inconvenience at all. 

This often raises questions we frequently encounter: If my haemorrhoids don’t hurt, is it safe to leave them alone? It’s a reasonable question — after all, why seek treatment for something that isn’t causing any obvious problems? But health is rarely that simple. Even conditions that seem harmless can sometimes develop into more serious issues if left unchecked. 

While it’s tempting to ignore something that doesn’t seem to be causing immediate trouble, understanding the nature of haemorrhoids is key to making an informed decision. Not all haemorrhoids are created equal, and while some may remain harmless for years, others can progress or lead to unexpected complications if left unchecked.

In this blog, we’ll provide a detailed and clear answer to this question. We’ll explain when it’s safe to leave non-painful haemorrhoids untreated, the potential risks of doing so, and how small lifestyle changes can help prevent complications. Whether you are seeking reassurance or simply want to understand more about your body, this guide will help you make informed decisions about your health.

Haemorrhoids are swollen blood vessels in the anal or rectal area, often caused by straining during bowel movements, which can lead to pain, itching, or bleeding. 

What Are Haemorrhoids?

Haemorrhoids are swollen and inflamed blood vessels located in or around the anus and lower rectum. They occur when the veins in these areas become stretched and engorged, often as a result of increased pressure during bowel movements, prolonged sitting, or other factors that strain the rectal area. Although haemorrhoids are often referred to as “piles,” the terms are used interchangeably to describe the same condition.

There are two primary types of haemorrhoids, each with distinct characteristics:

Internal Haemorrhoids

Internal haemorrhoids form inside the rectum and are typically not visible or palpable during self-examination. They are usually painless because the rectum lacks nerve endings that sense pain. However, they may cause symptoms such as bleeding during bowel movements, which is often the first noticeable sign. In some cases, internal haemorrhoids may prolapse, meaning they protrude through the anus, which can lead to irritation or discomfort [1].

External Haemorrhoids

External haemorrhoids develop beneath the skin around the anus. Unlike internal haemorrhoids, they are rich in nerve endings, which makes them more likely to cause pain, especially if they become thrombosed [2]. Thrombosis occurs when a blood clot forms within the haemorrhoid, resulting in significant swelling, pain, and tenderness. External haemorrhoids may also present with itching or irritation around the anus, often exacerbated by friction or poor hygiene.

Internal haemorrhoids develop inside the rectum and are typically painless, while external haemorrhoids form under the skin around the anus and can cause pain, itching, or swelling.

Are Haemorrhoids Dangerous If They Don’t Hurt?

For many individuals, the discovery of haemorrhoids that don’t cause pain or discomfort raises a simple yet crucial question: “Are they dangerous, or can they safely be left alone?” Generally, haemorrhoids that are asymptomatic are not considered harmful. However, this doesn’t mean they should be completely ignored, as their silent nature can sometimes mask underlying changes.

The reason some haemorrhoids remain symptom-free often depends on their location and size. Internal haemorrhoids, which form inside the rectum, are less likely to cause pain due to the absence of pain-sensitive nerve endings in this area [3]. Their presence might only be noticeable if they cause occasional bleeding during bowel movements. Similarly, small haemorrhoids, whether internal or external, may not swell enough to irritate surrounding tissues, allowing them to remain unnoticed and free of discomfort.

While these haemorrhoids might seem harmless, it’s important to remain vigilant. Changes in bowel habits, prolonged straining, or increased pressure on the rectal area could cause even silent haemorrhoids to evolve into more serious conditions [4].

Potential Risks of Ignoring Non-Painful Haemorrhoids

While non-painful haemorrhoids may seem harmless, they are not entirely without risk. Sometimes, we see patients delay addressing haemorrhoids because they assume the absence of pain means no problem. Unfortunately, this is not always the case, as silent haemorrhoids can progress or lead to complications if ignored.

Here are some potential risks that may arise:

Progression and Prolapse

Haemorrhoids that start small and asymptomatic can gradually worsen over time. Internal haemorrhoids, for instance, may grow larger and eventually prolapse, meaning they extend outside the anus. Prolapsed haemorrhoids are not only uncomfortable but can also make hygiene difficult, increasing the risk of inflammation or irritation. Monitoring the size and behaviour of haemorrhoids is crucial to prevent this progression.

Chronic Bleeding and Anaemia

Even painless haemorrhoids, especially internal ones, can lead to minor but recurrent bleeding during bowel movements [5]. While a small amount of blood might seem insignificant, prolonged bleeding can cause anaemia. We have encountered patients presenting with fatigue, weakness, and pale skin, only to discover that undiagnosed bleeding from haemorrhoids was the underlying cause. It’s important to recognise that such silent blood loss should not be overlooked. 

Infection and Localised Irritation

Poor hygiene around the anal area, particularly if a haemorrhoid has prolapsed or become inflamed, increases the risk of infection [6]. This can lead to swelling, discomfort, and in some cases, the development of an abscess. We often advise patients to be mindful of cleanliness to minimise these risks, especially if the haemorrhoid has started causing mild irritation.

Thrombosis or Clot Formation

External haemorrhoids, though initially painless, are at risk of thrombosis. When a blood clot forms inside a haemorrhoid, it can cause sudden and severe pain, along with swelling and tenderness. Thrombosed haemorrhoids are one of the most common reasons patients seek urgent care, even if the haemorrhoid was previously asymptomatic.

Although non-painful haemorrhoids may not require immediate treatment, they shouldn’t be ignored entirely. Monitoring them for changes is essential. If you notice symptoms such as increased bleeding, a protruding lump that doesn’t retract, or new discomfort, seek medical advice promptly.

Generally, our advice is simple: pay attention to your body and act early. What starts as a harmless condition can become problematic if ignored for too long. Early intervention often means fewer complications and better outcomes. 

Even painless haemorrhoids, particularly internal ones, can cause minor yet recurrent bleeding during bowel movements.

When Should You See a Doctor?

We understand how it can be tempting to dismiss haemorrhoids as a minor inconvenience, especially if they aren’t causing pain. However, there are specific situations where seeking medical advice is not just advisable — it’s essential. Ignoring warning signs or delaying an evaluation can sometimes lead to complications that might have been avoided with timely intervention.

Here are the key indicators that you should consult a doctor about haemorrhoids:

Bleeding During Bowel Movements

One of the most common symptoms of haemorrhoids is rectal bleeding. While this might seem harmless, especially if it’s occasional, it is important to rule out other conditions that can cause bleeding, such as anal fissures, polyps, or even colorectal cancer. Generally, we advise patients not to assume that bleeding is “normal.” If you notice blood on your stool, toilet paper, or in the toilet bowl, it’s worth having it evaluated.

Prolapse or Visible Lumps

If you can feel or see a lump protruding from your anus, it could indicate a prolapsed haemorrhoid. While these can sometimes retract on their own or with gentle manoeuvring, persistent or recurring prolapse often requires medical attention.

Changes in Bowel Habits or Stool Appearance

Sudden changes in bowel habits, such as persistent diarrhoea or constipation, or alterations in the shape, size, or colour of stools, should always prompt further investigation. While these changes may be unrelated to haemorrhoids, they can sometimes indicate underlying gastrointestinal conditions that need to be addressed. 

Family History of Colorectal Cancer

A family history of colorectal cancer places you in a higher risk category, which makes it especially important to address any rectal bleeding, lumps, or bowel changes promptly. Even if haemorrhoids are the likely cause of your symptoms, it’s better to err on the side of caution. In cases like these, we recommend regular screenings to ensure no signs of more serious issues are overlooked. A quick consultation can determine whether your haemorrhoids require treatment or if simple lifestyle adjustments will suffice.

If you’re experiencing any of the signs listed above, don’t hesitate to see a doctor. In many cases, haemorrhoids can be managed with minimally invasive treatments, but timely evaluation is critical for ruling out other conditions and ensuring your peace of mind. Remember, when it comes to your health, it’s always better to ask than to assume.

Can You Leave Haemorrhoids Alone?

When haemorrhoids are not causing pain, bleeding, or irritation, it is often acceptable to leave them untreated. Non-symptomatic haemorrhoids, especially those that do not interfere with daily life, generally do not pose an immediate threat to health. However, this decision should come with a basic understanding of their potential to change over time.

Painless haemorrhoids, particularly internal ones, are often harmless and may remain so for years. These can be monitored with minimal concern, provided they don’t exhibit symptoms like bleeding or prolapse. That said, even silent haemorrhoids deserve occasional attention. It is essential to periodically assess their condition and watch for warning signs, such as changes in bowel habits or new sensations of discomfort.

In our experience, many patients can manage their haemorrhoids effectively through preventive measures, which not only address the current issue but also reduce the risk of future complications.

For haemorrhoids — whether symptomatic or not — lifestyle adjustments can make a significant difference. These simple changes can prevent minor haemorrhoids from worsening and reduce the likelihood of future flare-ups:

  • Increase Fibre Intake: A diet rich in fibre is crucial for maintaining healthy digestion. Foods like fruits, vegetables, legumes, and whole grains help soften stools, reducing the need to strain during bowel movements. For those who find it challenging to get enough fibre from food, supplements like psyllium husk can be a helpful addition.
  • Stay Hydrated: Drinking enough water supports optimal bowel function and helps prevent constipation, which is a major contributor to haemorrhoids. Aim for at least eight glasses of water daily to keep stools soft and easy to pass.
  • Regular Physical Activity: Exercise improves circulation and supports healthy digestion. Simple activities like walking, swimming, or yoga can make a big difference in reducing the pressure on rectal veins.
  • Avoid Prolonged Sitting: Sitting for long periods, especially on the toilet, puts unnecessary pressure on haemorrhoids. It’s helpful to take breaks to stand and move, particularly if your job involves sitting for extended hours.
  • Practice Healthy Toilet Habits: Straining during bowel movements is one of the most common causes of haemorrhoids. Respond to the urge to pass stools promptly and avoid bearing down excessively. Taking your time on the toilet while maintaining proper posture can also help.

Pay Attention To Your Body

Non-painful haemorrhoids often don’t demand immediate treatment, but that doesn’t mean they should be ignored entirely. These seemingly harmless conditions have the potential to change over time, and regular monitoring is crucial to catch any early signs of progression. While many cases can be managed with simple lifestyle modifications, it’s important to remain vigilant and proactive about your health.

If you experience any changes — such as bleeding, swelling, or discomfort — it’s always better to seek professional advice rather than wait for the problem to escalate. As a medical professional, I’ve seen how early intervention can prevent complications and provide peace of mind.

At Ark Surgical, we understand that discussing haemorrhoids can feel awkward, but your health and comfort should always come first. If you’re unsure about your condition or have noticed any symptoms, don’t hesitate to schedule a consultation. Our team is here to provide personalised guidance and care according to your health conditions.

Remember, you don’t have to deal with this alone — let us help you take control of your health today.

References 

  1. Lohsiriwat, V. (2012). Hemorrhoids: From basic pathophysiology to clinical management. World Journal of Gastroenterology : WJG, 18(17), 2009–2017.
  2. Hemorrhoids | ascrs. (n.d.). Retrieved January 14, 2025
  3. Margetis, N. (2019). Pathophysiology of internal hemorrhoids. Annals of Gastroenterology, 32(3), 264–272.
  4. Sandler, R. S., & Peery, A. F. (2019). Rethinking what we know about hemorrhoids. Clinical Gastroenterology and Hepatology : The Official Clinical Practice Journal of the American Gastroenterological Association, 17(1), 8–15.
  5. Bleeding hemorrhoids: Causes, symptoms, treatment, and prevention. (2019, August 14).
  6. Infected hemorrhoid: Causes, symptoms, treatments, and more. (2018, September 25). Healthline.

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