Help! My Hemorrhoid Won’t Go Away: Chronic Piles and Long-Term Solutions

Introduction: Acknowledging the Frustration and Offering a Path Forward

 

Dealing with a hemorrhoid that persists despite home remedies can be an incredibly frustrating and worrying experience. This situation often brings up critical questions: “Why isn’t this getting better?”, “Is this normal?”, “What can I do now?” and perhaps most importantly, “Could this be a sign of something more serious?”. These feelings are completely understandable, and many people face the same challenge.

This comprehensive guide is designed to answer those questions. Its goal is to move you from a state of confusion and concern to one of clarity and control. Here, we will dive deep into why some hemorrhoids are more stubborn than others and don’t respond to typical treatments. We’ll provide a clear checklist so you know exactly when a doctor’s visit is necessary. Furthermore, we will demystify all modern treatment options, from minimally invasive in-office procedures to advanced surgeries, and finally, lay out an actionable plan to prevent the problem from returning. This guide will empower you to take control of your health and make the best decision for your treatment.

 

Section 1: Understanding the “Stubborn” Hemorrhoid: Why Some Don’t Heal

To understand why a particular hemorrhoid won’t go away, we must first recognize that most mild cases typically resolve within a few days to a week with home care. This healing occurs as the blood trapped in the swollen veins gradually returns to the main vessels, causing the hemorrhoid to shrink. However, when a hemorrhoid won’t go away on its own, there are usually specific medical reasons that require more attention. Often, a user’s search for a “painful lump won’t shrink” points to a concerning physical symptom. This symptom usually relates to one of two common hemorrhoid complications: a thrombosed hemorrhoid or a prolapsed hemorrhoid. Understanding the difference is the first step toward finding the right treatment.

 

When the Problem is a Thrombosed Hemorrhoid

 

A thrombosed hemorrhoid occurs when a blood clot forms inside an external hemorrhoid. This condition is the most likely cause of a sudden, severely painful, firm, and purplish-blue lump around the anus. While this condition is not life-threatening, the pain can be intense, disrupting daily activities like sitting and walking.

The body can eventually reabsorb the blood clot, and the pain will gradually subside, but this process can be slow. Medical intervention, especially if performed within the first 72 hours of the clot forming, can provide rapid pain relief. This intervention typically involves a small incision to drain the clot, performed in a doctor’s office. Attempting to drain or “pop” a hemorrhoid at home is extremely dangerous, as it can lead to severe bleeding and infection in an area naturally high in bacteria.

 

When the Problem is a Prolapsed Hemorrhoid

 

A prolapsed hemorrhoid is a condition where a swollen internal hemorrhoid bulges out of the anus. This is the “bulge” or “lump” an individual might feel, especially after a bowel movement. Doctors classify the severity of this condition using a grading system (from Grade 1 to 4) to determine the best course of treatment.

In mild cases, it may be possible to gently push the hemorrhoid back into the anus. However, if the hemorrhoid does not easily return to its place, or if it causes persistent pain, bleeding, or discomfort, it requires medical treatment. In more severe cases, the blood supply to the prolapsed hemorrhoid can be cut off (a complication called strangulation), leading to severe pain and requiring immediate medical attention.

 

When the Problem is Chronic or Recurring

 

Sometimes, the issue isn’t a single hemorrhoid but a continuous cycle of them coming back. Recurrent hemorrhoids are the result of underlying lifestyle factors that consistently put pressure on the rectal veins. This is a frequent reason why a hemorrhoid won’t go away, as the root causes are not being addressed. This is often why a hemorrhoid won’t go away for years.

The primary reasons for recurring hemorrhoids include:

• Chronic constipation or diarrhea: Both conditions can cause excessive straining.
• Straining during bowel movements: This puts direct pressure on the anal veins.
• Prolonged sitting: Sitting for long hours, especially on the toilet, increases pressure in the pelvic region.
• Heavy lifting: This activity increases intra-abdominal pressure and can cause hemorrhoidal veins to swell.
• Low-fiber diet: A lack of fiber leads to hard stools and the need for more straining.
• Pregnancy: The pressure from the uterus can lead to hemorrhoids, and sometimes a hemorrhoid won’t go away after pregnancy without addressing these factors.

Understanding these root causes helps an individual realize that successful treatment isn’t just about fixing the current symptom but about correcting these underlying factors to break the cycle of recurrence.

 

Section 2: The Critical Decision Point: When to See a Doctor

One of the biggest concerns when a hemorrhoid won’t go away is deciding when to see a doctor. The primary motivation for seeking medical advice isn’t just treatment—it’s eliminating uncertainty and fear. The worry that symptoms like bleeding or a persistent lump could be a sign of a more serious condition is an understandable, underlying anxiety. This section, therefore, serves as a clear guide for taking the necessary step toward a definitive diagnosis. The key message is: “Don’t guess, get a diagnosis.” A professional evaluation not only brings peace of mind but also ensures you are on the correct treatment path.

 

Stop Waiting and See a Doctor If You Experience the Following

 

• The One-Week Rule: If a hemorrhoid won’t go away and symptoms like pain, discomfort, or itching do not improve after one week of consistent home care, it’s time to consult a doctor. Persistent symptoms indicate that home remedies alone are not sufficient.
• Any Rectal Bleeding: Although bleeding is a common symptom of hemorrhoids, it can also be a sign of more serious conditions like colorectal or anal cancer. For this reason, any bleeding, even if minor, should always be evaluated by a doctor to get an accurate diagnosis and rule out any dangerous conditions.
• Severe or Worsening Pain: If the pain is severe, makes it difficult to sit or walk, or is gradually getting worse instead of better, this is a warning sign. Severe pain can indicate a complication like a thrombosed or strangulated hemorrhoid that requires medical intervention.
• A Lump or Bulge That Doesn’t Go Away: Referring to the conditions mentioned in Section 1, if there is a noticeable lump that cannot be gently pushed back in, is very painful, or is a new development, it should be examined by a doctor. This is true even if a hemorrhoid won’t go away but no pain is present, as a persistent lump needs a professional diagnosis.
• Signs of Infection: If the anal area becomes increasingly red, warm, or swollen, or if there is pus, discharge, or a fever, this could be a sign of an infection. An infection in this area can be serious and requires prompt medical care.

 

Section 3: Your Doctor’s Toolkit: A Comprehensive Guide to Medical Treatments

When a hemorrhoid won’t go away with home remedies, doctors have a range of procedures to provide lasting relief. The choice of chronic hemorrhoid treatment depends on the severity, type, and grade of the hemorrhoid. Understanding these options is a complex process, often involving a trade-off between pain and recovery time on one hand, and long-term effectiveness and risk of recurrence on the other. This section is designed to decode these options and help you have an informed conversation with your doctor. The treatments are ordered from least to most invasive.

 

3.1 Minimally Invasive In-Office Procedures (For Grades I-III)

 

These procedures are typically performed in a doctor’s office without general anesthesia and are suitable for internal hemorrhoids that cause bleeding or prolapse.

• Rubber Band Ligation: This is the most common in-office treatment for internal hemorrhoids. In this simple process, a doctor places a small rubber band at the base of the hemorrhoid. The band cuts off blood flow, causing the hemorrhoid to shrink and fall off within a week. This procedure is used for internal hemorrhoids.
• Sclerotherapy: In this procedure, a chemical solution is injected into the hemorrhoid tissue. This solution causes scar tissue to form, shrinking the hemorrhoid. It is often considered an alternative to rubber band ligation.
• Coagulation (Infrared/Electrocoagulation): These methods use infrared light, heat, or an electric current to create scar tissue on small, bleeding internal hemorrhoids. This cuts off the blood supply and causes the hemorrhoid to shrivel.
• Hemorrhoidal Artery Ligation (THD/DGHAL): This is a more advanced, minimally invasive surgical option where a Doppler ultrasound is used to precisely locate the arteries feeding the hemorrhoid. These arteries are then stitched closed, causing the hemorrhoid to shrink. This procedure is effective for Grade II and III hemorrhoids and has a faster recovery compared to traditional surgery.

 

3.2 Surgical Solutions for Lasting Relief (For Severe Grades III-IV or Recurring Cases)

 

For a large, external, or recurrent hemorrhoid that won’t go away and has not responded to other treatments, surgery may be the best option for achieving permanent relief.

• Hemorrhoidectomy (Surgical Removal): This is considered the “gold standard” and most effective treatment for severe or recurring hemorrhoids, with the lowest rate of recurrence. It is reserved for cases where other treatments have failed. However, this effectiveness comes with a trade-off: a hemorrhoidectomy has a longer and more painful recovery, which can last from 2 to 6 weeks, but it offers a permanent solution.
• Stapled Hemorrhoidopexy: In this procedure, a circular stapling device is used to remove a ring of excess rectal mucosal tissue above the hemorrhoids. This pulls the hemorrhoids back into their normal position and cuts off their blood supply. The advantage is less post-operative pain and a quicker return to normal activities compared to a hemorrhoidectomy. However, this procedure is associated with a significantly higher risk of long-term recurrence and prolapse.

 

Section 4: Featured Feature – “Treatment Options at a Glance” Table

 

To help you better understand the complex treatment options explained in the previous section, this table summarizes the key information in a visual, comparable format. This tool allows you to quickly assess the pros and cons of each method based on the factors that matter most to your decision—such as pain, recovery time, and risk of recurrence.

This table is based on comparative data from authoritative sources and serves as a decision-making guide. Using it, you can clearly see why a hemorrhoidectomy, despite its high pain level, is considered a definitive solution due to its very low recurrence risk, while rubber band ligation, with less pain, carries a moderate risk of recurrence. This information equips you for a more productive conversation with your doctor.

 

Section 5: Breaking the Cycle: A Proactive Plan to Prevent Recurrence

The most critical part of ensuring a hemorrhoid won’t go away only to come back again is prevention. Medical treatments fix the current problem, but only lifestyle changes can stop the cycle. This section provides a practical, evidence-based plan to control the underlying factors and prevent the recurrence of hemorrhoids.

 

Dietary Foundations

 

• Fiber is Non-Negotiable: A daily intake of 25 to 35 grams of fiber is essential for softening stool and preventing straining. You can find a helpful list of high-fiber foods from the Mayo Clinic to guide your choices, which include fruits, vegetables, whole grains, and legumes.
• Hydration is Key: Drinking plenty of water helps fiber work effectively and keeps stool soft.

 

Behavioral & Toilet Habits

 

• Don’t Strain: This is the primary trigger for hemorrhoids. Let bowel movements happen naturally.
• Limit Your Toilet Time: Avoid sitting on the toilet for long periods, which increases pressure on the rectal veins. A key piece of advice is: “Don’t take your phone to the bathroom”.
• Go When You Feel the Urge: Postponing a bowel movement can lead to harder stools and constipation.
• Use a Footstool: Placing your feet on a small stool while using the toilet improves your posture and makes passing stool easier.

 

Lifestyle Integration

 

• Stay Active: Regular exercise helps promote regular bowel movements.
• Avoid Prolonged Sitting: If your job requires sitting, get up and walk around frequently. Using a specialized Seat Cushion can help distribute pressure and provide comfort during long periods of sitting.
• Lift Smart: Avoid frequent heavy lifting, which increases intra-abdominal pressure. A high-quality Seat Cushion can also provide support and reduce strain when you do have to sit after strenuous activity.

 

Conclusion: Taking Control & Your Next Steps

 

In the end, it’s important to remember that when a Hemorrhoid won’t go away, there are often specific medical causes, including blood clots (thrombosis) or tissue protrusion (prolapse). There is a clear threshold for when to see a doctor, and ignoring it can lead to prolonged discomfort. Fortunately, a full spectrum of effective medical treatments, from minimally invasive procedures to definitive surgeries, is available. However, the key to permanent relief lies in prevention and breaking the cycle of recurrence through lifestyle modifications.

This is not a path of suffering, but one of empowerment. You now have the information needed to have an intelligent conversation with your doctor and make informed decisions. For more in-depth information on related topics, you can explore our Knowledge Center.

The final call to action is clear: if you have a Hemorrhoid that won’t go away after more than a week of home care, or if you are experiencing bleeding or severe pain, your next step is to schedule an appointment with a healthcare professional. A definitive diagnosis is the first and most important step toward lasting recovery. And for daily comfort and prevention, consider how a Seat Cushion can fit into your lifestyle.