Medications can ease pain and discomfort while hemorrhoids heal. In addition, certain lifestyle measures can help you feel better and even prevent the recurrence of hemorrhoids.
Try the following approaches to reduce the pain and itching from hemorrhoids:
- Avoid pressure on the area (for example, sit on an inflatable ring)
- Wear cotton undergarments
- Avoid toilet tissue with perfumes or colors
- Try not to scratch the area
- Sit in a warm bath (or use a sitz bath -- ask your doctor) for 10 to 15 minutes, 1 to 2 times per day
- Avoid straining during bowel movements
- Limit the amount of time you sit on the toilet
There are also dietary and other lifestyle steps you can take to prevent or treat constipation, which will help you avoid hemorrhoids.
- Over-the-counter corticosteroid creams, ointments, or pads can help reduce pain and swelling. Hemorrhoid creams with lidocaine (also available over the counter) can reduce pain.
- Stool softeners help reduce straining during bowel movements and prevent hard stools.
- Bulk laxatives help prevent hard stools and constipation.
Surgery and Other Procedures
For cases that do not respond to home treatments, your doctor may recommend other procedures:
- Rubber band ligation. A tiny rubber band is placed around an internal hemorrhoid, which cuts off the blood supply and causes the hemorrhoid to fall off.
- Sclerotherapy. Used to treat varicose veins, in this procedure a chemical solution is injected into the vein, which causes the hemorrhoid to collapse.
- Doppler guided hemorrhoidal artery ligation. A relatively new procedure to help safely treat hemorrhoids.
- Surgery. If other options fail, your doctor may recommend a hemorrhoidectomy.
- Diode laser. This laser surgery requires less operation time, less pain and bleeding, and speeds healing time.
Nutrition and Dietary Supplements
- Psyllium and other forms of fiber may help soften stool and reduce the pain associated with hemorrhoids. Increase fiber intake to 25 to 30 grams per day, and drink 6 to 8 glasses of water per day. People with inflammatory bowel disease should check with their doctor to see if psyllium is appropriate for their condition.
- Probiotics, or "friendly" bacteria, such as lactobacillus and bifidus, can help prevent and treat hemorrhoids. People who are extremely immunocompromised should speak to their physician before taking probiotics.
- Drinking more water can greatly decrease constipation and straining during bowel movements, which can help prevent hemorrhoids.
The use of herbs is a time-honored approach to strengthening the body and treating disease. Herbs, however, can trigger side effects and can interact with other herbs, supplements, or medications. For these reasons, you should take herbs only under the supervision of a health care provider.
Witch hazel (Hamamelis virginiana), applied topically or used as a sitz bath, may temporarily shrink hemorrhoids and relive symptoms. Many "pads" used to treat hemorrhoids contain witch hazel.
Other herbs that are often suggested for hemorrhoids include:
- Goldenrod (Solidago virgaurea), used topically in traditional herbal medicine to reduce inflammation of hemorrhoids.
- Gotu kola (Centella asiatica), used for venous insufficiency or varicose veins. Gotu kola can interact with sedative medications. People with a history of liver disease should use Gotu kola with caution.
- Yarrow (Achillea millefolium), popular in European folk medicine, this herb has traditionally been used to treat wounds and bleeding hemorrhoids. Yarrow can interact with lithium and blood-thinning medications. People with allergies to ragweed should use yarrow with caution.
Scientific evidence to support the use of these herbs is lacking, but professional herbalists may prescribe them in appropriate circumstances.
Although few studies have examined the effectiveness of specific homeopathic therapies, professional homeopaths may consider the following remedies for the treatment of hemorrhoids based on their knowledge and experience. Before prescribing a remedy, homeopaths take into account a person's constitutional type, includes their physical, emotional, and psychological makeup. An experienced homeopath assesses all of these factors when determining the most appropriate treatment for each individual. A homeopath might select the following remedies to treat someone with hemorrhoids.
- Aesculus. For burning hemorrhoids with a sensation of a lump in the anus that feels worse when walking.
- Aloe. For a sensation of pulsation in the rectum with large, external hemorrhoids.
- Collinsonia. For chronic, itchy hemorrhoids with constipation
- Hamamelis. For large bleeding hemorrhoids with a raw feeling
Alonso-Coello P, Guyatt G, Heels-Ansdell D, Johanson JF, Lopez-Yarto M, Mills E, Zhou Q. Laxatives for the treatment of hemorrhoids. Cochrane Database Syst Rev. 2005 Oct 19;(4):CD004649. Review.
Alonso-Coello P, Zhou Q, Martinez-Zapata MJ, Mills E, Heels-Ansdell D, Johanson JF, Guyatt G. Meta-analysis of flavonoids for the treatment of haemorrhoids. Br J Surg. 2006 Aug;93(8):909-20. Review.
Altomare DF, Giannini I. Pharmacological treatment of hemorrhods: a narrative review. Expert Opin Pharmacother . 2013;14(17):2343-9.
Belcaro G, Cesarone MR, Errichi B, Di Renzo A, Grossi MG, Ricci A, Dugall M, Cornelli U, Cacchio M, Rohdewald P. Pycnogenol treatment of acute hemorrhoidal episodes. Phytother Res. 2010;24(3):438-44.
Belcaro G, Gizzi G, Pellegrini L, et al. Pycnogenol in postpartum symptomatic hemorrhoids. Minerva Ginecol. 2014;66(1):77-84.
El Nakeeb A., et al. Rubber band ligation for 750 cases of symptomatic hemorrhoids out of 2200 cases. World J Gastroenterol. 2008;14(42):6525-30.
Eshghi F, Hosseinimehr SJ, Rahmani N, Khademloo M, Norozi MS, Hojati O. Effects of Aloe vera cream on posthemorrhoidectomy pain and wound healing: results of a randomized, blind, placebo-control study. J Altern Complement Med. 2010;16(6):647-50.
Feldman: Sleisenger & Foredtran's Gastrointestinal and Liver Disease. 8th ed. Philadelphia, PA: Elsevier Saunders; 2008.
Ferri: Ferri's Clinical Advisor 2016. 1st ed. Philadelphia, PA: Elsevier Inc. 2016.
Gan T, Liu YD, Wang Y, Yang J. Traditional Chinese Medicine herbs for stopping bleeding from hemorrhoids. [Review] Cochrane Database Syst Rev. 2010;(10:CD006791.
Goldstein L. Ask the midwife. Prevention and care of hemorrhoids, including homeopathic remedies. Birth Gaz. 2000;16(2):13-16.
Hawkins M, Billingham R, Bastawrous A. Hemorrhoid management in patients with radiation proctitis. Int J Colorectal Dis. 2012; 27(12):1673-7.
Ho Y, Tan M, Seow-Choen F. Micronized purified flavonidic fraction compared favorably with rubber band ligation and fiber alone in the management of bleeding hemorrhoids. Dis Colon Rectum. 2000;43:66-69.
Jahanshahi A, Mashhadizadeh E. Sarmast MH. Diode laser treatment of symptomatic hemorrhoid: a short term clinical result of a mini invasive treatment, and one year follow up. Pol Przegl Chir. 2012;84(7):329-32.
Jiang ZM, Cao JD. The impact of micronized purified flavonoid fraction on the treatment of acute haemorrhoidal episodes. Curr Med Res Opin. 2006 Jun;22(6):1141-7.
Kaidar-Person O, Person B, Wexner S. Hemorrhoidal Disease: A Comprehensive Review. Journal of the American College of Surgeons. 2007;204(1).
Kantsevoy SV, Bitner M. Nonsurgical treatment of actively bleeding internal hemorrhoids with a novel endoscopic device (with video). Gastrointest Endosc. 2013;78(4):649-52.
Lyseng-Williamson KA, Perry CM. Micronised purified flavonoid fraction: a review of its use in chronic venous insufficiency, venous ulcers, and haemorrhoids. Drugs. 2003;63(1):71-100.
MacKay D. Hemorrhoids and varicose veins: a review of treatment options. Altern Med Rev. 2001;6(2):126-40.
Melton G. Bope & Kellerman: Conn's Current Therapy 2013. 1st ed. Philadelphia, PA: Elsevier Saunders; 2012.
Misra MC, Parshad R. Randomized clinical trial of micronized flavonoids in the early control of bleeding from acute internal haemorrhoids. Br J Surg. 2000;87(7):868-72.
Panpimanmas S, Sithipongsri S, Sukdanon C, Manmee C. Experimental comparative study of the efficacy and side effects of Cissus quadrangularis L. (Vitaceae) to Daflon (Servier) and placebo in the treatment of acute hemorrhoids. J Med Assoc Thai. 2010;93(12):1360-7.
Rakinic J, Poola VP. Hemorrhoids and fistulas: new solutions to old problems. Curr Probl Surg. 2014;51(3):98-137.
Riss S, Weiser FA, Schwameis K, Mittlböck M, Stift A. Haemorrhoids, constipation and faecal incontinence: is there any relationship? Colorectal Dis. 2011;13(8):e227-33. doi: 10.1111/j.1463-1318.2011.02632.x.
Riss S, Weiser FA, Schwameis K, et al. The prevalence of hemorrhoids in adults. Int J Colorectal Dis. 2012;27(2):215-20.
Srivastava JK, Shankar E, Gupta S. Chamomile: A herbal medicine of the past with bright future. Mol Med Report . 2010;3(6):895-901.
Staroselsky A, Nava-Ocampo AA, Vohra S, Koren G. Hemorrhoids in pregnancy. Can Fam Physician. 2008;54(2):189-90.
Vazquez JC. Constipation, haemorrhoids, and heartburn in pregnancy. Clin Evid (Online). 2010;pii:1411.
Zindel J, Inglin R, Brugger L. Necessary and unnecessary treatment options for hemorrhoids. Ther Umsch. 2014;71(12):737-51.
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- 2013 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.