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Hemorrhoids are a condition where the veins in the lower rectum and anus become swollen and inflamed. It's a common condition, with about 50% of adults in the U.S. facing hemorrhoids at least once before the age of 50. The condition arises due to increased pressure on the veins in the lower rectum and anus, causing them to swell. The most common symptoms include painless bleeding during bowel movements, rectal or anal pain, itching, and/or soft lumps near the anus. There are various home remedies and medical treatments to manage hemorrhoids and their pain.
Steps
Home Treatment for Hemorrhoids
Identify the Type of Hemorrhoid. Hemorrhoids can be either internal or external. Pain is usually associated with external hemorrhoids. However, it is advisable to visit a doctor for an accurate diagnosis.
- Internal hemorrhoids develop in the lower rectum and generally do not cause pain as the rectum lacks pain receptors. You may not realize you have internal hemorrhoids until you notice blood in your stool or observe hemorrhoids protruding from the anus.
- Painful symptoms are often a sign of external hemorrhoids, which develop under the skin around the anus. If a blood clot forms in the hemorrhoid, it is called a “thrombosed hemorrhoid,” and the pain is often described as severe and sudden. The patient may see or feel a lump around the anus. The blood clot usually dissolves over time, leaving excess skin protruding from the anus.
Sitz Bath. The Sitz bath therapy (or sitting bath) can provide immediate relief for pain and itching caused by hemorrhoids. Soak the anal area in warm water for about 10-20 minutes, 2-3 times a day, especially after bowel movements. Small plastic basins, which fit over a toilet, are often available at pharmacies. Alternatively, you can fill a bathtub with warm water until it covers your hips.
- Gently pat the anal area dry with a towel or use a hair dryer to ensure it is completely dry after the bath.
Apply Cold Compress to the Anus. A cold compress can help reduce swelling and pain from hemorrhoids. You can use a water-filled condom or an ice pack wrapped in a soft cloth to apply cold to the anal area for 5-10 minutes, 3-4 times a day.
- After using the cold compress, gently dry the area with a towel or use a hair dryer to avoid moisture.
Try Over-the-Counter Topical Medications. Many over-the-counter medications are available at pharmacies that specifically help alleviate pain and discomfort caused by hemorrhoids. Some products to look for include:
- Use Tucks medicated pads, which can be applied up to 6 times a day to the irritated hemorrhoid area to relieve pain and itching. These pads contain witch hazel, known for its soothing and anti-inflammatory properties.
- Preparation H cream acts as a topical anesthetic, helping to constrict blood vessels and protect the skin effectively in hemorrhoid treatment. It blocks pain signals from the nerve endings in the anal area and helps reduce swelling and inflammation.
- Creams or suppositories containing hydrocortisone, a strong anti-inflammatory steroid, can be useful for treating hemorrhoids. However, hydrocortisone should only be used for a maximum of 7 days to avoid thinning the skin around the anus.
- Pramoxine, available in both prescription and over-the-counter forms, is another topical anesthetic used for hemorrhoid treatment.
Take Pain Relievers. Over-the-counter pain relievers like acetaminophen (Tylenol), ibuprofen (Advil), or aspirin can help reduce discomfort caused by hemorrhoids.
- Acetaminophen can be taken at 650-1000 mg every 4-6 hours, not exceeding 4 grams in 24 hours.
- Ibuprofen can be taken at 800 mg, up to 4 times a day.
- Aspirin can be taken at 325-650 mg every 4 hours as needed, not exceeding 4 grams in 24 hours.
Take Stool Softeners. Stool softeners can be helpful if you have constipation due to hemorrhoids. Over-the-counter stool softeners like docusate (Colace) can keep stools soft, reduce constipation, and ease anal strain. You can take 100-300 mg of docusate daily, for up to 7 days.
Receive medical treatment
Consult a doctor. Hemorrhoids sometimes improve with home treatment and may not require medical intervention. However, you should see a doctor if symptoms do not improve after a week of home care. The doctor can discuss stronger prescription medications or recommend surgery.
- Seek medical attention immediately if the hemorrhoids cause pain.
- The doctor may suggest changes to your diet and lifestyle before recommending medication or surgery. These changes could include increasing fiber intake and regular exercise.
Inquire about stronger anesthetic medications. If surgery is not deemed necessary, the doctor may prescribe stronger anesthetics such as lidocaine (Xylocaine) to alleviate pain, itching, and discomfort caused by hemorrhoids.
Discuss rubber band ligation with your doctor. This is the most common procedure for treating hemorrhoids. The doctor will place a small elastic band around the base of an internal hemorrhoid to cut off its blood supply. When blood flow is halted, the hemorrhoid shrinks and dries up within a week.
Talk to your doctor about sclerotherapy for hemorrhoids. The doctor will inject a chemical solution into the hemorrhoid to create scar tissue and shrink the affected area. This method is less effective than rubber band ligation.
- Some doctors do not recommend sclerotherapy because studies show it is only effective for a short time, and most patients experience a recurrence of hemorrhoids.
Research on coagulation methods. Coagulation techniques utilize lasers, infrared light, or heat. This procedure helps stop bleeding in small hemorrhoids and causes them to shrink. Compared to rubber band ligation, coagulation has a higher recurrence rate of hemorrhoids.
- This technique is typically applied to small hemorrhoidal tissue (where rubber band ligation isn't feasible) or combined with rubber band ligation, offering a success rate of up to 97%.
- Patients generally require a short recovery time (1-2 weeks) after the procedure.
Exploring hemorrhoid removal. This procedure, known as hemorrhoidectomy, involves surgically removing internal or external hemorrhoids. It is considered the most effective treatment for severe or recurring hemorrhoids, with a cure rate of 95% and a low complication rate.
- Hemorrhoidectomy is typically performed for thrombosed internal hemorrhoids, combined internal and external hemorrhoids, or rectal conditions requiring surgery. The procedure is more painful, and recovery time is longer than with other methods.
- The recovery period after a hemorrhoidectomy typically spans 2-3 weeks, with a follow-up visit.
Consideration of hemorrhoidectomy with clamps. In clamp hemorrhoidectomy, the doctor uses a clamp device to grasp bleeding or prolapsed hemorrhoids, securing them in their natural position. This method restricts blood flow to the hemorrhoids, helping them shrink.
- Compared to traditional hemorrhoidectomy, clamp hemorrhoidectomy has a higher risk of recurrence and rectal prolapse (where the rectum protrudes from the anus). However, it significantly reduces postoperative pain compared to conventional surgery.
Prevention of hemorrhoids
Increasing fiber intake in the diet. Boosting fiber consumption can help prevent constipation, a major cause of hemorrhoids. Fiber is abundant in fruits, vegetables, and whole grains. It softens stool and reduces straining during bowel movements, which is a primary cause of hemorrhoids.
- The recommended fiber intake is around 20-35 g per day, depending on age and gender. Women under 51 need 25 g of fiber daily, while women over 51 need 21 g. Men under 51 need 38 g daily, while men over 51 require 30 g of fiber.
- Additionally, fiber supplements like psyllium husk (Metamucil, Citrucel) can be added to your diet.
- Increase fiber intake gradually to prevent bloating.
- If increasing fiber doesn't alleviate constipation, consider using stool softeners like Colace for short-term relief.
Drink plenty of water. Staying hydrated is crucial for preventing constipation. Aim for 6-8 glasses of water, each 240 ml, per day. Water softens stool and helps ensure smooth bowel movements. This is especially important for those increasing their fiber intake, as not drinking enough water while consuming more fiber can worsen or lead to constipation.
Exercise regularly. Regular physical activity promotes bowel movement regularity and helps prevent constipation. Additionally, it aids in weight loss, which in turn reduces pressure on the lower rectum and anus, preventing hemorrhoids.
- Try to exercise for at least 30 minutes, five times a week. You can break this into shorter sessions, like 15 minutes twice a day or 10 minutes twice a day if that's easier for you.
- Engage in activities that you enjoy to stay motivated. You can go for a walk after meals, cycle to work, or join an aerobic class a few times a week.
Go to the bathroom when you feel the urge. Delaying bowel movements can worsen constipation and trigger hemorrhoids. Stay near a restroom when you feel the need to go so you can respond promptly.
- If after sitting on the toilet for 5 minutes you still can't have a bowel movement, stand up and return later. Prolonged sitting on the toilet can aggravate hemorrhoid symptoms.
Avoid sitting for prolonged periods. Sitting for extended times increases pressure on the lower rectal veins and anus, contributing to hemorrhoid development. If your job requires prolonged sitting, make sure to stand up and move around, even briefly, during breaks.
Warning
- This article offers information regarding hemorrhoids but is not intended as medical advice. Always consult with a doctor to determine the best treatment for your condition.
- Individuals who experience rectal bleeding while taking blood-thinning medications such as warfarin (Coumadin), clopidogrel (Plavix), enoxaparin (Lovenox), rivaroxaban (Xarelto), dabigatran (Pradaxa), or apixaban (Eliquis) should seek immediate medical assessment.
- Hemorrhoids do not cause abdominal pain, so if rectal bleeding is accompanied by stomach pain, urgent medical care is needed.
- If rectal bleeding is accompanied by dizziness, mild headaches, or fainting, it is important to seek emergency medical care. These symptoms may indicate significant blood loss and could require a blood transfusion.
- If internal hemorrhoids cannot be pushed back into the rectum, immediate medical attention is necessary.
- Severe pain caused by thrombosed hemorrhoids requires urgent medical examination, and if indicated, clot dissolution may be necessary.
