Treatment for Hemorrhoids

A wide variety of treatment options exist for hemorrhoids, depending on the type of hemorrhoid and the severity of your symptoms.

Avoiding constipation is often the key to preventing and treating hemorrhoids. And simple diet and lifestyle changes may help reduce hemorrhoid symptoms.

Eating a high-fiber diet can help make stools softer and easier to pass, reducing the urge to strain during bowel movements. Fiber is found in fruits, vegetables, whole grains, beans, nuts, and seeds.

The Academy of Nutrition and Dietetics recommends that adult women eat at least 25 grams of fiber each day, and that adult men eat at least 38 grams. (1) When adding fiber to your diet, go slow to avoid problems with excess gas.

If you’re having a hard time getting enough fiber in your diet, you can also take a fiber supplement.

RELATED: 11 High-Fiber Foods to Add to Your Diet

Hemorrhoid Remedies You Can Try on Your Own at Home

There are several steps you can take at home to ease the discomfort caused by hemorrhoids:

• Take a sitz bath two to three times daily for 15 to 20 minutes. Sit in warm water, covering just your hips and buttocks. This can help reduce itching and irritation. You can take a sitz bath in a few inches of warm (not scalding hot) water in a regular tub, but small tubs that fit over toilet seats are also available for this purpose at pharmacies. Following a sitz bath, gently pat the area dry to avoid further irritation. (2)
• Use ice packs on the area to relieve swelling and pain.
• Don’t push too hard or strain while passing a bowel movement.
• Clean your anus after each bowel movement by gently patting (rather than wiping) with moistened pads, such as baby wipes. Using hard, dry toilet paper, which may contain fragrance, can cause further irritation.
• Keep the area clean by bathing or showering daily with warm water. After bathing, gently pat the area dry. You can even use a hair dryer to dry the area. (2)
• Sit on cushions rather than hard surfaces to help lessen the swelling of hemorrhoids and keep new ones from forming.
• Take over-the-counter (OTC) pain relievers, such as acetaminophen, ibuprofen, or aspirin as needed. (3)

RELATED: 6 Easy Ways to Prevent Hemorrhoids

Hemorrhoid Medication: When, Why, and Which Ones to Use

A number of OTC creams, ointments, and pads that contain hydrocortisone or witch hazel are available to help relieve pain, swelling, and itching caused by hemorrhoids. According to the National Institute of Diabetes and Digestive and Kidney Diseases, doctors recommend using over-the-counter products for a week. If symptoms persist beyond a week, follow up with your doctor. (3)

Creams and suppositories containing hydrocortisone can cause the skin to weaken and thin, so they should not be used for more than a week. If any of these creams cause a rash or dry skin around the area, contact your healthcare provider. (2)

A fiber supplement, such as psyllium (Metamucil), or a stool softener, such as methylcellulose (Citrucel), can help prevent constipation.

Avoid laxatives, which can lead to diarrhea and worsen hemorrhoid symptoms.

Medical Procedures for Hemorrhoids That Won’t Go Away

If hemorrhoids don’t go away with home treatments, medical procedures may be necessary.

If you visit your doctor with painful external hemorrhoids — those located around the outside of the anus that are visible from the outside — your doctor may offer to excise them (cut them off) during the office visit. You will be given a shot with a local anesthetic to numb the area before the procedure.

Doctor’s office procedures for internal hemorrhoids — those located inside the rectum — may include:

Rubber Band Ligation This is the most commonly performed hemorrhoid procedure in the United States. (2) In this procedure, which can be used for grades 1, 2, and 3 internal hemorrhoids (grading is based on the appearance of hemorrhoids and their degree of prolapse, or how much they protrude through the anus), the doctor places a small rubber band around the base of the hemorrhoid, which can be done when your doctor performs an anoscopy examination to better visualize the hemorrhoids. The rubber band cuts off the hemorrhoid’s blood supply.

The procedure typically causes the hemorrhoid to shrink and fall off within about a week, though several short visits to your doctor may be necessary to completely get rid of the hemorrhoid. Minor bleeding and a feeling of pressure may occur, but this can usually be alleviated with OTC pain relievers. This procedure is not associated with significant recovery time. (4)

Sclerotherapy In this quick, often painless procedure, the doctor injects a chemical into the hemorrhoidal blood vessel, causing scar tissue to form in order to shrink the hemorrhoid. (3) The principle behind this is the same as rubber band ligation, though it’s not always as effective. This procedure can be used in patients taking blood thinners, for whom rubber band ligation may not be recommended. (4)

Infrared Coagulation In this office-based procedure, the doctor uses an intense beam of infrared light to shrink the hemorrhoid. Heat from the light causes the formation of scar tissue, cutting off the blood supply to the hemorrhoid. (3) This procedure is generally quick and painless, with few complications, but can take several sessions to work completely. (4)

RELATED: 4 Signs Your Hemorrhoids Warrant a Doctor’s Visit

When Hemorrhoid Surgery May Be Necessary

Very few people — fewer than 10 percent of all adults who see a doctor because of symptomatic hemorrhoids — will require a surgical operation. (4)

Surgery to remove hemorrhoids is called a hemorrhoidectomy.

Your doctor may recommend a hemorrhoidectomy if:

• You have large external hemorrhoids
• You have both internal and external hemorrhoids
• An internal hemorrhoid has prolapsed (popped out through the anus)
• You have excessive bleeding

In a hemorrhoidectomy, the doctor makes a small incision to remove the hemorrhoid and surrounding tissue before closing the wound with stitches.

A hemorrhoidectomy is performed in an operating room and can be done under general anesthesia, in which you are unconscious and unable to feel pain.

It can also be done with a spinal anesthetic block while you are awake (similar to an epidural injection given during childbirth), or with a combination of relaxing and sedating drugs given intravenously (IV) and a local anesthetic injected around the anus.

Hemorrhoidectomy is associated with postoperative pain, but the procedure is successful for 95 percent of cases. (2)

More recently, another option aimed at avoiding the postoperative pain of a hemorrhoidectomy has become available, called a stapled hemorrhoidopexy. A circular stapling device pulls the hemorrhoidal tissue upward and to its normal position, stapling it in place. The staples eventually fall out over time. (4)

According to a study published in the journal Techniques in Coloproctology, in the long term, patient satisfaction, resolution of symptoms, quality of life, and functional outcome appeared similar among patients after stapled hemorrhoidopexy and hemorrhoidectomy. (5) But other sources note that stapling has been associated with a greater risk of recurrence and rectal prolapse. (6)

Pain is to be expected following hemorrhoid surgery, and it may take two to four weeks before you’re back to your normal self. Your doctor will likely prescribe you pain medication, and sitting in a sitz bath two to three times a day for 10 to 15 minutes can also help. You may experience some bleeding with bowel movements for a few weeks after surgery. If the bleeding doesn’t stop after the bowel movement, call your surgeon. (4)

There are many options for the treatment of hemorrhoids. It’s best to discuss the benefits and risks of each of these with your doctor in order to come up with the treatment plan that is best for your particular case.

Additional reporting by Deborah Shapiro.