The risks of hemorrhoidal disease are continued symptoms, anemia-producing bleeding, and thrombosed hemorrhoids that undergo necrosis. Risks of treatment include bleeding and infection. Local pain is a common side effect of local treatment. Pain after banding and injection typically lasts 24-36 hours, and continued pain requires medical attention. Excessive pain after treatment is due to sphincter spasm, and may render urination difficult.
Urinary retention is an occasional symptom of occult sepsis.
Pain after open hemorrhoidectomy is significant and generally requires narcotics for relief. The fear of a bowel movement because of pain may lead to fecal impaction in a few patients. Co-morbid conditions such as diabetes, HIV and heart disease increase the risks of local treatment, but do not alter the type of complications. There may be subtle changes in continence of gas or liquid stool following local treatment or surgery, but they are rarely socially significant. Injury to the anal sphincter muscle is a recognized risk, but is extremely rare in experienced hands.