Bleeding and blood clots
The straining and irritation when passing stool is difficult can cause painless bleeding [5] when defecating. It is usually minor with tiny amounts of bright red blood on the toilet paper or in the toilet. The bleeding usually shouldn’t last for more than ten minutes; however, it may occur at intervals when defecating. Excessive bleeding from the anus might be a sign of a more serious condition that requires immediate medical attention.
Blood may pool in the external hemorrhoid, forming a clot. This condition is called a thrombosed [6] hemorrhoid and is usually accompanied by soreness, inflammation, and a hard lump on the skin around the anus. Although a thrombosed hemorrhoid isn’t life-threatening, it may cause severe pain. In some cases, the clot may also need to be lanced and drained to provide relief.
Fecal Leakage
The passage of solid stool is easy to control than a loose one. Piles cause the anus to enlarge and prevent it from closing, which may allow loose (watery) feces to leak out [7]. This type of bowel incontinence is accidental and may not qualify as a medical emergency. The situation tends to correct itself when the pile is treated, and the anal and rectal veins return to their normal sizes. Piles can also cause mucus to leak out, irritating the sensitive skin of the anus.
References:
[1] https://www.healthline.com/health/home-remedies-for-hemorrhoids
[2] https://www.healthline.com/health/why-do-hemorrhoids-itch#:~:text=When%20an%20internal%20hemorrhoid%20prolapses,and%20thus%20the%20itching%2C%20greater.
[3] https://www.mayoclinic.org/diseases-conditions/hemorrhoids/symptoms-causes/syc-20360268#:~:text=Hemorrhoids%20are%20swollen%20veins%20in,rectum%2C%20similar%20to%20varicose%20veins.
[4] https://www.health.harvard.edu/diseases-and-conditions/hemorrhoids_and_what_to_do_about_them#:~:text=If%20a%20blood%20clot%20forms,even%20when%20they%20produce%20bleeding.
[5] https://www.healthline.com/health/bleeding-hemorrhoid#:~:text=Straining%20or%20passing%20a%20particularly,too%20full%2C%20resulting%20in%20bleeding.
[6] https://www.medicalnewstoday.com/articles/326040#:~:text=Sometimes%2C%20a%20blood%20clot%20can,to%20be%20dark%20and%20clotted.
[7] https://www.mayoclinic.org/diseases-conditions/fecal-incontinence/symptoms-causes/syc-20351397#:~:text=Hemorrhoids.,rectum%20stretches%20to%20accommodate%20stool.