Chronic hemorrhoids, or piles, may cause iron deficiency anemia due to persistent blood loss. Symptoms may develop in severe cases of anemia. They can include tiredness, shortness of breath, and more.

If you have persistent blood loss due to hemorrhoids or another cause, it’s important to contact a doctor for an accurate diagnosis and a treatment plan.

Treatment for hemorrhoids and anemia can include addressing hemorrhoids directly and managing symptoms of anemia.

Read on to learn more about the link between hemorrhoids and anemia, the symptoms, how doctors diagnose anemia due to hemorrhoids, and more.

In rare cases, hemorrhoids can lead to anemia. This may happen over time if you have chronic, or long-term, hemorrhoids and don’t receive effective treatment.

A 2017 study looked at the reports of people who had colonoscopies for rectal bleeding and iron deficiency anemia or for screening if they had a family history of cancer. Around 22% of them had a colonoscopy because of iron deficiency anemia.

Around 43% of those with iron deficiency anemia received a diagnosis of internal hemorrhoids. This suggests that internal hemorrhoids could be a risk factor for iron deficiency anemia.

However, not everybody with hemorrhoids will develop iron deficiency anemia, and not all cases of anemia are due to hemorrhoids.

Symptoms of hemorrhoids can depend on whether you have internal or external hemorrhoids.

You may have internal hemorrhoids if you experience:

  • painless bleeding from the rectum
  • a prolapsed hemorrhoid, which is when a hemorrhoid falls through the opening of the anus
  • severe pain, which can happen if the hemorrhoid is completely prolapsed
  • a tender lump or lumps near the anus
  • anal itching
  • bleeding

It’s important to note that there are other causes of anal bleeding. It’s best to contact a doctor for a diagnosis if you experience bleeding or other symptoms with hemorrhoids.

Although chronic hemorrhoids may lead to iron deficiency anemia over time, you may not experience any symptoms of anemia if the condition is mild.

More severe cases of iron deficiency anemia may cause:

If you have chronic hemorrhoids and your doctor suspects anemia, they’ll likely order blood tests to check your:

If you don’t yet have a hemorrhoid diagnosis but you’re experiencing rectal bleeding, it’s important to let your doctor know. They may be able to confirm the diagnosis by taking a full medical history and doing a physical examination.

One test that can help confirm internal hemorrhoids is anoscopy. This involves using an anoscope to view the lining of the anus and lower rectum.

Other tests may also help confirm the diagnosis or rule out other possible causes.

Treatment for anemia due to hemorrhoids can include a combination of remedies for hemorrhoids and medications for anemia.

Anemia treatments can include:

To help manage hemorrhoids, your doctor may recommend:

  • consuming high fiber foods
  • drinking enough water each day
  • taking a stool softener
  • avoiding straining during bowel movements
  • taking a sitz bath multiple times per day to manage pain
  • using over-the-counter hemorrhoid creams for external hemorrhoids

Medical treatments that may help include:

  • rubber band ligation, particularly for internal hemorrhoids
  • infrared photocoagulation, which uses infrared light to create scar tissue and cut off blood flow
  • hemorrhoidectomy to remove the hemorrhoids
  • stapled hemorrhoidopexy, which involves using a stapling device to treat severe or prolapsed internal hemorrhoids

Your doctor can give you more information about the treatments they recommend based on your individual circumstances.

As iron deficiency is more likely to develop with untreated hemorrhoids, receiving treatment for hemorrhoids as early as possible may help.

Steps you can take to prevent hemorrhoids include:

  • consuming enough fiber
  • drinking plenty of fluids
  • avoiding constipation
  • avoiding straining during a bowel movement

Although treatment for chronic hemorrhoids is usually still necessary to help prevent or manage iron deficiency anemia, consuming iron-rich foods can help reduce the likelihood of developing anemia.

  • peas
  • beans
  • lean red meat
  • salmon
  • eggs
  • peas
  • tofu
  • dark green leafy vegetables
  • dried fruits
  • breads and cereals fortified with iron

Hemorrhoids aren’t the only cause of anal bleeding. Any chronic anal bleeding can lead to iron deficiency anemia.

It’s important to contact your doctor if you have frequent or persistent anal bleeding. They can help determine the cause.

Anal bleeding may be due to hemorrhoids or another condition, such as:

Blood loss due to chronic hemorrhoids can cause iron deficiency anemia. You may not experience any symptoms of anemia unless the condition is severe. In severe cases of anemia, symptoms can include shortness of breath, tiredness, chest pain, and more.

You may have internal hemorrhoids if you experience bleeding from the rectum or blood when wiping after a bowel movement. External hemorrhoids can cause itchiness, pain, and a tender lump near the anus.

It’s best to contact your doctor if you have concerns about hemorrhoids and anemia. They can order blood tests to confirm a diagnosis of iron deficiency anemia and advise on suitable treatments.

Treatment will likely focus on addressing the underlying cause, which may be hemorrhoids. Iron supplements and other treatments for anemia may also help.