Hemorrhoids are swollen and enlarged veins located either inside the lower rectum or under the skin around the anus. They are similar to varicose veins and can cause discomfort, itching, and bleeding. Internal hemorrhoids develop within the rectum and are typically painless unless they prolapse. External hemorrhoids form closer to the anal opening and often cause noticeable pain due to the presence of many nerve endings in that area. This common condition often leads people to search for quick, self-administered remedies.
DIY Hemorrhoid Ligation Is Never Safe
The idea of self-ligation, or attempting to tie off a hemorrhoid at home using non-sterile items like thread, string, or common rubber bands, is dangerous and should never be attempted. This action introduces a risk of complications that far outweigh any perceived benefit. The unsterile nature of household items and the environment significantly increase the risk of a localized infection.
An infection in the anal area can rapidly progress into sepsis, a systemic condition requiring immediate hospital treatment. Furthermore, any attempt to restrict blood flow without specialized medical training can lead to tissue necrosis, or gangrene, where the tissue dies and may require extensive surgical debridement. Uncontrolled bleeding is another major risk because a person cannot accurately identify or safely cauterize the blood vessels involved.
The sensitive nerves and tissues in the anal canal can also suffer irreparable damage from improper self-treatment. Attempting to tie off an external hemorrhoid, which is below the dentate line and rich in pain receptors, would result in prolonged pain. Improper removal or damage can also lead to an anal stricture, a painful narrowing of the anal canal that makes future bowel movements difficult. The sophisticated tools and sterile environment necessary for safe ligation cannot be replicated outside of a medical setting.
Professional Rubber Band Ligation
The medical procedure that involves “tying off” a hemorrhoid is called Rubber Band Ligation (RBL). It is a safe, minimally invasive treatment performed by a qualified physician, such as a gastroenterologist or proctologist. This procedure is designed for treating internal hemorrhoids that have not responded to conservative home treatments. The goal is to cut off the blood supply to the tissue, causing the hemorrhoid to shrink and fall off within a few days to a week.
The physician first inserts a thin, lighted tube called an anoscope into the anal canal to visualize the internal hemorrhoid. A specialized ligator tool is then passed through the anoscope and used to grasp the tissue. The small rubber band is carefully placed approximately one to two centimeters above the dentate line, which is an area that lacks pain receptors.
By placing the band in this precise location, the procedure is relatively painless, though some patients may feel a sensation of fullness or mild discomfort. The specialized rubber band is then released around the base of the hemorrhoid, which starves the tissue of blood flow. The dead tissue and the band naturally detach and pass out of the body during a bowel movement.
Effective Non-Surgical Home Care and OTC Treatments
Hemorrhoid symptoms can often be managed and relieved using conservative, non-surgical methods at home or with over-the-counter (OTC) treatments. A primary focus should be on dietary and lifestyle modifications to ensure soft, regular bowel movements and prevent straining. This includes increasing daily fiber intake, aiming for 20 to 35 grams a day through high-fiber foods or a fiber supplement like psyllium, and drinking plenty of water.
Topical treatments can provide immediate symptom relief for itching and pain. OTC creams, ointments, and suppositories often contain ingredients such as:
- Witch hazel, which acts as an astringent to soothe irritation.
- Hydrocortisone, a mild steroid that reduces inflammation.
- Numbing agents like lidocaine to temporarily dull pain.
Hydrocortisone should not be used for more than a week without a doctor’s guidance, as prolonged use can thin the skin.
Soaking the affected area in warm water several times a day is an effective remedy. A sitz bath involves sitting in a few inches of warm water for about 15 minutes, two to three times daily, and especially after a bowel movement. This practice helps to cleanse the area, relax the anal sphincter muscle, and reduce swelling. Additionally, oral pain relievers like ibuprofen or acetaminophen can help manage discomfort, and stool softeners such as docusate sodium can make bowel movements easier and less painful.
When to Seek Emergency Medical Attention
While many hemorrhoid symptoms resolve with home care within a week, certain signs require immediate medical evaluation. Seek emergency attention if you experience heavy rectal bleeding, especially if accompanied by signs of blood loss like feeling lightheaded, dizzy, or faint.
Signs of infection require urgent care, including high fever, chills, or local swelling and discharge around the anus. Persistent pain that does not improve with OTC pain relievers could signal a thrombosed hemorrhoid, where a blood clot has formed. A hemorrhoid that is prolapsed and cannot be gently pushed back inside, or one that causes an inability to pass stool, warrants immediate professional assessment.