Complications of Untreated Piles: What Can Happen
Reviewed by Dr. Gaurang Ramesh
MBBS, MS, FSGE, Surgical Gastroenterologist and Integrative & Functional Medicine Practitioner
Arka Anugraha Hospital, JP Nagar, Bangalore
Most piles are manageable and not dangerous, and we do not want to alarm you unnecessarily. At the same time, ignoring persistent symptoms for months or years can allow complications to develop that are harder to treat than the original piles would have been. This page explains those risks honestly, so you can make an informed decision about seeking care rather than continuing to wait.
For an overview of piles generally, see our complete piles guide, and if you are ready to explore treatment, see our piles treatment options page.
Thrombosed and Strangulated Piles
When a blood clot forms inside a pile, it becomes a thrombosed hemorrhoid, which Cleveland Clinic describes as a firm, painful, often dark blue or purple lump that can develop suddenly, most commonly in external piles. While uncomfortable, thrombosed piles are not usually dangerous and often improve with treatment. A strangulated hemorrhoid is more serious: according to Mayo Clinic, this occurs when the blood supply to an internal pile is cut off, typically after prolapse, causing significant pain and requiring prompt medical attention.
Chronic Bleeding and Anemia
Piles that bleed repeatedly over a long period, even in small amounts each time, can gradually lead to anemia, a condition where the body does not have enough healthy red blood cells to carry adequate oxygen, according to Mayo Clinic. Anemia from piles is uncommon but is a genuine reason not to dismiss “just a little blood” indefinitely, particularly if bleeding is frequent or you notice symptoms like fatigue or dizziness.
Skin Tags and Prolapse
Piles that have been present for a long time, particularly external piles that have resolved after a thrombosis, can leave behind excess skin known as skin tags around the anus. These are generally harmless but can cause hygiene difficulties and mild irritation. Similarly, untreated internal piles can progress in grade over time, moving from occasional prolapse (Grade II) to permanent prolapse (Grade IV), which is generally more difficult to manage without a procedure than earlier stages would have been. Our types and stages page explains this grading progression in detail.
Infection and Abscess Risk
While uncommon, untreated or thrombosed piles can occasionally become infected, and in rare cases, this can be associated with an abscess, a collection of pus that typically requires drainage. This is one of the less common complications, but it illustrates why persistent swelling, worsening pain, or fever alongside piles symptoms should prompt urgent evaluation rather than continued home care.
Link Between Piles, Fistula, and Fissure
Piles, anal fissures, and anal fistulas are separate conditions, but they can sometimes coexist, and a fissure or fistula can be mistaken for piles without proper examination. An anal fistula, an abnormal tunnel between the inside of the anus and the skin, often develops after an abscess rather than directly from piles, but distinguishing between these conditions matters because their treatments differ significantly. Our symptoms and diagnosis page explains how doctors tell these conditions apart.
Post-Surgery Complications
For patients who do progress to surgery, it is worth knowing that surgical complications, while uncommon, can include infection, bleeding in the days following the procedure, and, rarely, injury to the anal sphincter, according to Cleveland Clinic. This is not a reason to avoid necessary surgery; it is context for why timely treatment of earlier-stage piles, which is generally simpler and lower-risk, is preferable to delaying until more invasive surgery becomes the only option. Our piles surgery guide covers this in more detail.
Why Early Treatment Matters
The pattern across all of these complications is consistent: piles that are caught and treated earlier are generally simpler to manage than piles that have been left untreated for years. This is not about creating urgency where none exists; most piles genuinely are not dangerous. It is about recognizing that persistent bleeding, worsening pain, or a lump that is not going away are worth a proper evaluation, both to confirm the diagnosis and to catch any of the complications above before they progress further.
If any of this sounds familiar, we would encourage you to book an in-person consultation with our colorectal team at Arka Anugraha Hospital, JP Nagar, so you have clarity rather than continued uncertainty.
Frequently Asked Questions (FAQ)
Piles themselves do not turn into cancer. However, rectal bleeding can occasionally be a sign of colorectal cancer unrelated to piles, which is why persistent bleeding should always be properly evaluated rather than assumed to be piles.
A thrombosed pile typically appears as a firm, painful, dark blue or purple lump near the anus that develops suddenly. If you notice this, prompt evaluation can help manage the pain and confirm the diagnosis.
Untreated piles can progress to more advanced grades and, rarely, lead to complications like chronic anemia or skin tags, but with appropriate treatment, most piles do not cause lasting damage.
Occasional light bleeding from confirmed piles is not usually dangerous, but any rectal bleeding should be evaluated by a doctor at least once to confirm the cause and rule out other conditions.
A strangulated hemorrhoid, where blood supply to a prolapsed internal pile is cut off, causes significant pain and needs prompt medical attention, since the affected tissue can be damaged without treatment.
This content is for informational purposes only and does not replace professional medical advice. Always consult a qualified doctor.
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