Hemorrhoids Treatment

Medically Reviewed by Zilpah Sheikh, MD on November 30, 2023
4 min read

Hemorrhoids almost always get better on their own. You can usually get relief from the itching, swelling, and pain with some simple lifestyle changes that help keep you from getting constipated, such as eating more fiber and drinking more water.

Hemorrhoids can be uncomfortable, but they don't usually cause serious medical problems. However, you should see your doctor if:

  • You bleed a lot
  • You have symptoms that make it hard to sleep or go about your daily life
  • Your symptoms aren't getting better after about a week of at-home treatment

To soothe the pain and itching of hemorrhoids, try these tips:

  • Eat more fiber. A high-fiber diet is one of the best ways to treat your hemorrhoids. A diet that includes a lot of high-fiber foods can help keep your poop softer and easier to pass. If you have to strain to poop, it puts pressure on the veins in your anus and rectum. This can cause the veins to swell, which leads to hemorrhoids. The 2020-2025 Dietary Guidelines for Americans recommends that you eat 14 grams of fiber a day for every 1,000 calories you eat. So, if you eat 2,000 calories a day, you should eat about 28 grams of fiber a day. Fortunately, foods high in fiber are also foods that doctors and dieticians recommend for good health anyway, such as grains, fruits, vegetables, and beans.
  • Take fiber supplements if you can't get enough fiber from food. Doctors recommend fiber supplements with psyllium (Metamucil) or methylcellulose (Citrucel). Don't take laxatives, because they can cause diarrhea, which may irritate your hemorrhoids.
  • Stay hydrated. This is another way you can help prevent constipation and the need to strain when you poop. The U.S. National Academies of Sciences, Engineering, and Medicine recommends adults drink 12-16 cups of water (96-128 oz) every day. You may need to drink more if you're very active, live in a hot area, are pregnant or nursing, or are sick.
  • Use soothing wipes to clean yourself after you poop. You can try using wet baby wipes, wet toilet paper, or a washcloth. Whatever you choose, don't rub roughly. To avoid irritating your hemorrhoids, gently pat to clean yourself.
  • Apply ointments, creams, or lotions made for hemorrhoids.
  • Sit in a warm bath (sometimes called a sitz bath). It’s a time-honored therapy: Sit in about 3 inches of warm (not hot) water for 15-20 minutes several times a day. This helps relax your clenching sphincter muscle, which increases blood flow and helps reduce itching and irritation. You can take a sitz bath in your bathtub, or buy a small plastic tub that fits over your toilet.
  • Take nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or naproxen, to help ease the pain and inflammation of your hemorrhoids.
  • Apply a cold compress. A simple cold pack on the tender area for a few minutes can help numb it and bring down the swelling.

If your symptoms are serious or aren't getting better after 1-2 weeks, your doctor may suggest a procedure to help ease your symptoms. Most of these procedures are done on internal hemorrhoids and work to close off the blood supply, which shrinks and removes them. Many can be performed in your doctor's office or an outpatient center.

Procedures your doctor may suggest include:

Sclerotherapy. During this procedure, your doctor injects your hemorrhoid with a solution that closes off the blood supply.

Rubber band ligation. This procedure is often done on prolapsed (those that have pushed outside your anus) internal hemorrhoids. The doctor puts a special rubber band around the base of the hemorrhoid, which shuts off its blood supply. The hemorrhoid will then shrink and fall off, usually within a week.

Infrared photocoagulation. In this procedure, your doctor uses a tool to direct infrared light at your hemorrhoid. The heat from the light closes off its blood supply.

Electrocauterization. With an electric probe, your doctor makes a tiny burn to remove tissue and seal the end of the hemorrhoid, causing it to close off and shrink. This procedure seems to work best for prolapsed hemorrhoids.

These treatments are usually effective, but unless you change your diet and lifestyle, your hemorrhoids may come back.

You may be able to soothe the itching, pain, and swelling of your external hemorrhoids with creams, ointments, or suppositories (medicine you put in your rectum) made for hemorrhoids. These products usually contain medicines such as lidocaine to numb the area, or hydrocortisone or witch hazel, to reduce swelling and itching. But don't use these for longer than a week unless your doctor says it's okay. Go see your doctor if you have used these and you still have symptoms or you have side effects such as a rash or dry skin around your anus.

Most people don't need surgery to remove hemorrhoids. However, if other approaches haven't helped or if you have large hemorrhoids, your doctor may recommend surgery, using one of the following procedures:

  • Hemorrhoidectomy (hemorrhoid removal). This is the most effective way to treat large external or prolapsing internal hemorrhoids or those that keep coming back. Most of the time, hemorrhoids removed this way don't come back. The operation itself is usually simple, but your recovery can take 2-8 weeks. Most people who have had hemorrhoidectomy say that their pain is gone after about 2 weeks, but it can take 6-8 weeks before you can return to hard exercise or physical work. Some surgeons may use an electrothermal device to do this surgery, a method that results in quicker healing and lesser pain for some people.
  • Hemorrhoidopexy (hemorrhoid stapling). This is usually only used for internal hemorrhoids. It cuts off blood flow to your hemorrhoids and also moves prolapsed tissue back in place. Your recovery will likely be faster and less painful than with hemorrhoidectomy. However, there’s also a higher chance of your hemorrhoids coming back or getting rectal prolapse (when part of your rectum pushes out of your anus).