Hemorrhoids are swollen, irritated veins in the anus or lower rectum. Internal hemorrhoids are located in the rectum; external hemorrhoids form beneath the skin surrounding the anus and usually cause more discomfort than the internal variety. Blood clots that develop inside hemorrhoids typically cause pressure and severe pain. Several factors may contribute to the formation of hemorrhoids, including constipation and straining during bowel movements. Many women experience hemorrhoids during pregnancy due to increased pressure within the abdomen. Sitting or standing for long periods may also promote hemorrhoid formation. The incidence of hemorrhoids increases with age, perhaps due to loss of elasticity in the skin and tissue that support the affected veins.
Home Treatment
Step 1
Use a sitz bath to reduce itching and inflammation. This small bathing seat fits over the toilet and is available from your doctor or pharmacy. Alternatively, you can fill the bathtub with a few inches of water. Soak your buttocks in warm water for 10 to 20 minutes and repeat this treatment several times each day, including after each bowel movement. After a sitz bath, pat your anal area dry with a towel and do not rub.
Step 2
Apply ice or an over-the-counter hemorrhoid cream containing lidocaine or another topical anesthetic to numb the area and reduce itching and irritation. Creams or suppositories containing hydrocortisone may also be used, but do not apply these for more than one week. Side effects including skin damage may develop.
Step 3
Witch hazel can be applied to the anal area with cotton balls to alleviate itchiness. Presoaked pads are also available at most pharmacies. Witch hazel is a safe choice for long-term use.
Step 4
Clean the anal area daily by bathing in warm water. Do not apply soap if it irritates the area further. After a bowel movement, a moist fragrance-free wipe may be gentler on hemorrhoids than dry toilet paper.
Step 5
Wear cotton underpants to reduce itchiness. Sit on a cushion to relieve pressure on the anal area and prevent the formation of new hemorrhoids.
Lifestyle Changes
Step 1
Boost the amount of fiber in your diet by adding more fruit, vegetables and whole grains, such as wheat and oat bran. A fiber supplement may also be helpful. Increase your consumption of water along with the added fiber. Aim for eight full glasses of fluids daily. These measures will help keep your stools soft and may reduce hemorrhoid formation. Many people experience increased gas or bloating as they add high-fiber foods, so you should make this change gradually. Slowly increase your fiber intake to 25 to 30 grams per day.
Step 2
Perform daily exercise to stimulate bowel function and prevent constipation. Being active reduces the pressure on your anal and rectal veins and helps you maintain a healthy weight. Carrying extra body weight increases your risk of hemorrhoid formation.
Step 3
Don't delay when you feel the urge to have a bowel movement. Talk with your doctor about whether stool softeners are an appropriate treatment for you.
Hemorrhoid Removal
Step 1
If your hemorrhoids do not respond to home treatment, your doctor may recommend a minimally-invasive procedure to reduce or remove them. These are typically performed in a surgeon's office or at a hospital as an outpatient procedure.
Step 2
Rubber band ligation is a common procedure for treating hemorrhoids. A small elastic band positioned around the hemorrhoid causes it to shrink. Over a period of several weeks, this procedure may be repeated two to four times. Infared or laser coagulation are other procedures that similarly reduce the size of a hemorrhoid.
Step 3
Surgical hemorrhoidectomy is an operation to remove a hemorrhoid. It may be recommended for patients with intense pain or bleeding from large, protruding, external hemorrhoids. The procedure is also used for patients who have internal hemorrhoids that are not eliminated by rubber band ligation.
Tips and Warnings
- Over-the-counter pain relievers, such as acetaminophen, aspirin or ibuprofen can help relieve discomfort associated with hemorrhoids. Consult your doctor if you are unsure if these medications are safe for you. Make sure your health care providers are aware of any other medications you are taking.
- Schedule an appointment with your doctor if hemorrhoids do not respond to home treatment within a few days. You should also see your doctor if you have rectal bleeding accompanying hemorrhoids. Seek emergency medical care if you experience sudden, severe pain, heavy loss of blood or bleeding accompanied by faintness or dizziness.
Things You'll Need
- Sitz bath
- Witch hazel
- Over-the-counter hemorrhoid cream
- Ice
- Cushion
