A Complete Guide to Hemorrhoids: At-Home & Medical Options
A Complete Guide to Hemorrhoids: At-Home & Medical Options
Few medical issues are as common (or annoying!) as hemorrhoids. Also known as piles, hemorrhoids are swollen veins created by extra pressure around your lower rectum and anus. Thankfully, there are plenty of ways to get rid of them for good—and we’re here to help you get started. Read on for plenty of expert-backed remedies, OTC treatments, and prevention strategies that you can try at home, along with some medical procedures you can consider for persistent hemorrhoids.
Things You Should Know
  • Treat hemorrhoids at home with a sitz bath or cold compress, or visit a drugstore for pain relievers and OTC hemorrhoid creams, ointments, and suppositories.
  • Prevent hemorrhoids with good hygiene, a clean diet, and exercise. Use the bathroom when you feel the urge and avoid straining when you go.
  • Many hemorrhoid cases go away within a week. If your symptoms don’t improve after a week of OTC treatments, meet with your doctor.
  • Discuss nonsurgical and surgical treatments with your doctor if your at-home treatment hasn’t seemed to help.

Home Remedies and OTC Treatments

Apply topical OTC medications to shrink your hemorrhoids. Different hemorrhoid creams, suppositories, and ointments made with cortisone can help ease some of your itchiness, pain, and overall discomfort—all while helping your hemorrhoids shrink in the process. Check the instructions on the box for guidance on how to apply the product (as well as how often it can be applied). Look for products with labels like Hemorrhoidal Cream, Hemorrhoidal Ointment, Hemorrhoidal Suppositories, and Anorectal Cream. Preparation H is a common brand that sells these types of products. Other topical medications contain steroids, anesthetics, astringents, and antiseptics. Check the "Drug Facts” section on the package to see which active ingredients are in the product, as well as what they do. Your doctor can also prescribe an ointment or cream for your hemorrhoids. Warning: Don’t use over-the-counter hydrocortisone topicals for longer than 1 week unless otherwise directed by your doctor.

Take a sitz bath for 15 minutes. Pour a little bit of warm water (around 104 °F (40 °C)) into your bathtub so it’s 3 to 4 in (7.6 to 10.2 cm) full. Sit down in the shallow water for 15 minutes, giving yourself the bath around 2-3 times each day. A brief sitz bath helps ease the pain and discomfort—plus, the warm temperature helps shrink the hemorrhoids. You can also use a special sitz bath seat that’s designed to go over your toilet seat. Never use hot water for your sitz baths, as this can make your hemorrhoids even more swollen.

Apply a cold compress for 15-20 minutes at a time. Wrap an ice pack or cold compress with a cloth and place it beneath your anus for 15-20 minutes—the cool temperature provides relief while also shrinking the hemorrhoid. Feel free to use ice once per hour, or follow your doctor’s recommendation if they give you one.

Wipe with flushable wet wipes after using the restroom. Once you’re finished on the toilet, wipe yourself down with a flushable wet ripe rather than a dry sheet of toilet paper (which can irritate your hemorrhoids even more). Steer clear of baby wipes, since these can block up your toilet. Ointments and rectal wipes made with zinc oxide can also provide some relief when you’re wiping. Some people also like to treat their hemorrhoids with Tucks pads.

Manage any pain or discomfort with OTC pain relievers. OTC painkillers like acetaminophen (Tylenol), ibuprofen (Advil), naproxen (Aleve), and aspirin (Bayer) can help your hemorrhoids feel a little less sore and uncomfortable. Always check the dosage info on the bottle before you take any medication, and be sure to only take the recommended amount of medication per day. Acetaminophen dosage (for adults): 325 mg once every 4-6 hours; up to 1000 mg per day Ibuprofen dosage (for adults): 200-400 mg once every 4-6 hours; up to 3200 mg per day Naproxen dosage (for adults): 550 mg once every 12 hours (or 550 mg and then 275 mg once every 6-8 hours); up to 1375 mg on the first day and 1100 mg on the following days Aspirin dosage (for adults): 300 to 650 mg once every 4 to 6 hours; up to 4 g per day

Practice good hygiene around your anal area. One of the best things you can do to care for hemorrhoids is keeping your anal area clean. Bathe or shower daily, and clean the skin in and around the anus with water and fragrance-free soap.

Hemorrhoid Prevention Strategies

Avoid straining as much as possible during bowel movements. One of the most common causes of hemorrhoids is excessive straining while going to the bathroom, which can be caused by constipation, chronic diarrhea, and long periods of sitting on the toilet. Stick with short, 1-2 minute bathroom breaks without any straining to help prevent hemorrhoids from forming in the first place. Try elevating your feet slightly while sitting on the toilet. This may help your bowel movement be a little less strenuous. Constipation is a side effect of many over-the-counter and prescription drugs. Talk to your doctor about any medications you may be taking, and see if you can switch to something less likely to cause constipation.

Go to the bathroom as soon as you get the urge. Putting off a bowel movement or waiting for a "more convenient" time can cause constipation and painful bowel movements, which can cause hemorrhoids or aggravate existing ones. Instead, always head to the restroom as soon as you need to go. Try to get off the toilet as soon as you’re finished—the longer you sit, the worse your hemorrhoids can potentially get.

Switch to a fiber-rich diet. Stock up on foods that are rich in fiber, like whole grains, beans, raw veggies, fruits (both dried and raw), and whole-grain cereal. Fiber helps soften your stool, which prevents extra straining (and potential hemorrhoids) while you’re on the toilet. Try a fiber supplement. Fiber supplement sources include psyllium husk, wheat dextrin, and methylcellulose. Taking daily supplements can help ensure you get 20 to 30 grams (0.71 to 1.1 oz) of fiber every day. Always talk to your doctor before taking any new supplements.

Drink plenty of water each day. Aim to drink around 11.5 cups (2.7 L) of water each day if you’re a woman, and 15.5 cups (3.7 L) if you’re a man. When you don’t drink enough water, your body has trouble passing bowel movements. This can lead to straining, and eventually hemorrhoids. If you have certain medical conditions (like kidney or liver disease), drinking more water may not be the best option for you. In this case, talk to your doctor before changing your hydration habits.

Get 30 minutes of exercise every day. Set a daily exercise goal for 30 minutes each day (with a weekly goal of 150 minutes). Exercise helps with your body’s digestive process, and also helps keep constipation at bay. Any type of exercise is good! If you don’t have a set exercise routine in place, try going for an easy swim or a quick stroll around your neighborhood.

Medical Treatment Options

Visit your doctor if your hemorrhoids don’t go away in 1 week. Hemorrhoids often clear up within a week of home treatments, but some people still experience symptoms beyond this point. If you’re still experiencing hemorrhoids after 1 week (or if they’ve gotten even worse), meet with your doctor to discuss your treatment options. Hemorrhoids are nothing to be ashamed of—in fact, around 5% of the world population has dealt with them at one point or another. Your doctor won’t judge you or think it’s weird that you have hemorrhoids and will be happy to help you figure out an effective treatment plan. It’s always a good idea to see your doctor if you notice blood in your stool, since this symptom can be a sign of a more serious medical issue.

Discuss nonsurgical options with your doctor. Believe it or not, there are plenty of minimally invasive treatment options that don’t require surgery. These options are generally safe and effective, and can usually be done in an outpatient setting. A few common ones include: Rubber band ligation: Your doctor attaches a small rubber band to the base of the hemorrhoid, which prevents blood from flowing into it. In around 7-10 days, the hemorrhoid falls off. Sclerotherapy: Your doctor injects your hemorrhoid with a chemical solution that helps it shrink down. Coagulation: Your doctor carefully uses an infrared medical device to stop circulation to the hemorrhoid. The hemorrhoid dies, falls off, and is replaced by a scar.

Schedule a surgical procedure if your hemorrhoids are severe and persistent. If you have an especially large hemorrhoid (or multiple hemorrhoids), surgery (known as a hemorrhoidectomy or a hemorrhoidopexy) might be the best option. Talk to your doctor about the other treatments you’ve tried—they can help you decide if surgery is the best option for your hemorrhoids. Surgery is typically the best call if you have an external hemorrhoid that isn’t responding to home remedies and OTC treatments.

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