Hemorrhoids Treatment Overview

When to see a healthcare provider

Hemorrhoids usually go away within 1–2 weeks. If they don’t go away, or they keep coming back, you may want to talk to your doctor.

Also call your doctor if you have frequent bleeding, trouble sitting, pain, or other medical conditions (like you’re on a blood thinner or have other digestive disorders). You may be referred to a gastroenterologist (a digestive disease specialist) or a colorectal or general surgeon.

Getting diagnosed

Hemorrhoids can sometimes be diagnosed based on your symptoms, but a doctor may want to examine your anus and rectal area.

What to expect from your visit

• For the majority of people with hemorrhoids, lifestyle, diet, and managing constipation will help control hemorrhoids.
• Your doctor may prescribe nitroglycerin ointment, which causes blood vessels to contract, reducing bleeding.
• If you have serious complications, like anemia from blood loss, or weight loss, do not be surprised if your doctor wants to do a colonoscopy.
• If managing constipation, making lifestyle changes, and trying OTC or topical medications do not help after a month or two, you may be referred to a gastroenterologist or a colorectal surgeon.
• In more serious cases, you may need an in-office procedure to “band” your hemorrhoids. A rubber band ligation is when the hemorrhoid is tied off at its base with rubber bands, cutting the blood flow to the blood vessel and shrinking the hemorrhoid.
• In rare cases where the hemorrhoids still do not go away and are causing severe issues with your health or quality of life, a colorectal surgeon may recommend a hemorrhoidectomy, which is a surgery to remove the hemorrhoids.

Prescription hemorrhoid medications

• Nitroglycerin ointment

What kind of doctor treats hemorrhoids?

• A primary care provider can diagnose and treat most hemorrhoid issues.
• A gastroenterologist is a digestive disease specialist. Some do in-office banding procedures for hemorrhoids
• A colorectal surgeon is a surgeon of the colon and rectum who can perform in-office banding. They can also do hemorrhoidectomies.

How to treat hemorrhoids at home

You can often treat the symptoms of hemorrhoids—itching or pain around your anus—at home. Hemorrhoid treatment includes using hemorrhoid creams or suppositories to bring down swelling, and making certain changes to reduce straining on your anus. For example, constipation can make hemorrhoids worse. So changing what you eat to help constipation can help hemorrhoids too.

It can take anywhere from a few days to over a week for the swelling to go down and the symptoms to go away.

What's good for hemorrhoids?

• Hemorrhoid creams or suppositories, like Preparation H, can reduce itching and pain, and help shrink the hemorrhoids.
• You can try soaking daily in a warm bath or a sitz bath (a warm, shallow bath that fits over your toilet).
• A stool softener can help reduce straining. This can help prevent hemorrhoids and makes it less painful to pass stool when you do have them.
• Laxatives can help if you are not having regular bowel movements.
• Wear loose-fitting clothing to avoid irritating hemorrhoids.
• Try not to linger on the toilet (i.e., no reading!). This puts extra pressure on the blood vessels around your anus.
• Avoid lifting heavy objects, which puts a strain on your abdomen.

OTC hemorrhoid medications

• Hemorrhoid creams or suppositories, like Preparation H
• Fiber supplements, like Benefiber and Metamucil
• Laxatives, like stool softeners (Colace, Surfak)

Tips for preventing hemorrhoids

There are a few changes to your diet and lifestyle that can help prevent constipation. If these don’t help within 1–2 months, consider talking to your doctor.

• Make sure you are getting enough fiber. The goal is 20–30 grams a day. High-fiber foods include bananas, oranges, apples, berries, dark green leafy vegetables, beans, and legumes.
• If you don’t get enough fiber from your regular diet, take fiber supplements.
• Drink more water. It’s recommended that you drink about 6–8 cups a day.
• It’s also important to exercise regularly, which can help keep your bowel moving and consistent.