No one ever said that having swollen veins protruding from your rectum (aka hemorrhoids, or piles) would be a fun affair. External hemorrhoids, as they're called, leave you with symptoms like anal itching and pain.
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One option is to head to your local pharmacy and pick up over-the-counter hemorrhoid creams, but you might also prefer natural or home remedies. Here's what actually works — and what doesn't.
1. Soak in a Warm Tub
Especially when it comes to itching, sitting in warm water will help soothe external hemorrhoids, Jacqueline Wolf, MD, a gastroenterologist at Beth Israel Deaconess Medical Center in Boston, tells LIVESTRONG.com. The warm water boosts blood flow to the area and is naturally relaxing.
Take a full bath if you have time, or try a sitz bath, which is basically just sitting in a few inches of water. If you don't have a bathtub or can't get into it with ease, there are plastic sitz bath seats you can buy that attach to your toilet, available on Amazon.
Aim to soak for 10 to 15 minutes two to three times a day, per the Mayo Clinic.
What About an Epsom Salt Bath?
Epsom salts are rich in minerals like magnesium that are often praised for their muscle-relaxing properties. If you find the sensation of an Epsom salt soak in the bath to be particularly soothing, then go for it. You should know, however, that there’s no data to suggest the treatment will heal hemorrhoids or that it's more beneficial than a plain water bath or sitz bath, Dr. Wolf says.
2. Switch Your Toilet Paper Brand
Using perfumed, hard or scratchy TP only irritates hemorrhoids and can make the pain worse, Dr. Wolf says.
Instead, make sure you're wiping with unscented, soft paper. (If you get hemorrhoids often, now may be the time to switch.)
Try These Brands
3. Wipe With Balneol Lotion
After having a BM, it's especially important to keep the anal area clean when you have hemorrhoids, says Dr. Wolf.
Wiping with dry toilet paper can hurt, which is why many patients tell Dr. Wolf that they like Balneol lotion, which is a soothing, cleansing, mineral oil-based lotion that can be squeezed directly onto toilet paper before wiping, helping to ease hemorrhoid pain.
Balneol Hygienic Cleansing Lotion (Buy it: Amazon.com; Price: $13.89 for a 3-oz bottle)
4. Fill Up on Fiber
Your goal: Softer poops that don't require straining, which will allow hemorrhoids to heal.
High-fiber foods will help you out on that front by adding bulk to your stool. These include:
- Most fruits and veggies (raspberries, pears, squash and avocado are particularly fiber-rich)
- Legumes, including navy beans, kidney beans, lentils, split peas and pinto beans
- Flaxseeds and chia seeds
- Firm tofu
- Whole grains like spelt, buckwheat and oatmeal
The benefits are long-term, too: These foods decrease the risk of straining and thus may help you avoid hemorrhoids in the future. Just make sure you're also drinking plenty of water, too.
5. Dab on Some Witch Hazel
Try gently applying the botanical extract witch hazel, which acts as an astringent that may help shrink hemorrhoids, Dr. Wolf says.
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6. Consider Aloe
"Aloe hasn't been widely studied [when it comes to hemorrhoids], but it is anti-inflammatory and many people find that it does help with discomfort," Dr. Wolf says.
There is some limited evidence that a cream containing aloe vera may help encourage healing and reduce pain when used to treat anal fissures (a small tear in anal tissue), per July 2014 research in the European Review for Medical and Pharmacological Sciences. So it may be worth a shot.
What About Apple Cider Vinegar?
You may have heard that apple cider vinegar can offer instant relief for hemorrhoids, but there's no evidence to support this.
What's more: ACV could make things worse, per the Cleveland Clinic, because it's acidic and may burn your skin.
What About Tea Tree Oil?
Tea tree oil has anti-inflammatory properties, which is why some people believe it's useful to reduce hemorrhoid swelling and itching, but research is lacking on the safety of this remedy, so it's better to try a different method with more evidence behind it.
When to See a Doctor for Hemorrhoids
According to the National Institutes of Health, you should call your doctor if:
- You still experience pain and itching from hemorrhoids after one week of treating them at home
- You have bleeding from your rectum; this can be a sign of colorectal cancer or a GI disease like inflammatory bowel disorder
- National Institutes of Health: “Hemorrhoids”
- Mayo Clinic: “Hemorrhoids”
- Michigan Medicine. “magnesium sulfate (epsom salt)”
- Mayo Clinic: “Chart of high-fiber foods”
- European Review for Medical and Pharmacological Sciences: “Effects of Aloe vera cream on chronic anal fissure pain, wound healing and hemorrhaging upon defection: a prospective double blind clinical trial”
- Cleveland Clinic: "7 Best and Worst Home Remedies for Your Hemorrhoids"