Hemorrhoids are a common condition involving swollen, inflamed veins located in the lower rectum and around the anus. These vascular cushions become symptomatic when they enlarge, often due to increased pressure from straining during bowel movements or prolonged sitting. Most minor cases of hemorrhoids will shrink or resolve on their own, especially when supported by simple, conservative care. This natural process involves the body reducing the inflammation and pressure that caused the veins to swell.
The Timeframe for Natural Shrinkage
The duration it takes for hemorrhoids to shrink depends heavily on their size and type. Small, non-thrombosed hemorrhoids often begin to feel better within two to seven days as the acute swelling subsides. The actual reduction in size of the swollen tissue can take a full week or more, provided the underlying issue of straining is avoided.
A different timeline applies to a thrombosed external hemorrhoid, which involves a blood clot forming within the vein. Severe, acute pain typically peaks within the first 48 to 72 hours, then gradually eases as the body begins to reabsorb the clot. The hard lump itself may take between one to four weeks or longer to completely flatten and disappear.
Self-Care Strategies to Induce Shrinking
Active self-care is highly effective at accelerating the shrinkage process by addressing the primary causes of swelling. Dietary changes are fundamental, focusing on increasing fiber intake to ensure softer, bulkier stools that pass easily. Soluble fiber softens stool, while insoluble fiber adds bulk and speeds up transit time, both of which reduce the need to strain.
Proper hydration is necessary for fiber to work correctly, as sufficient fluid prevents intestinal blockage and helps maintain stool consistency. Avoiding prolonged sitting on the toilet and heeding the urge to defecate promptly also helps prevent excessive pressure from building up in the rectal veins.
Topical applications can offer both symptom relief and active reduction of inflammation. A warm water sitz bath, performed several times a day for about 15 minutes, works by relaxing the anal sphincter muscle. This relaxation promotes better blood circulation in the anal tissues, which helps drain the engorged veins and reduces local swelling.
Over-the-counter products use specific compounds to target the swollen tissue. Preparations containing witch hazel function as astringents, causing a temporary tightening and drying of the tissue which can reduce swelling and irritation. Topical corticosteroids, such as hydrocortisone creams, work as anti-inflammatory agents by suppressing the body’s inflammatory response and directly reducing the swelling and associated itching.
Clinical Procedures for Persistent Hemorrhoids
When self-care measures fail to shrink the hemorrhoids or when the condition is more severe, medical intervention becomes necessary. Non-surgical office procedures offer targeted ways to reduce or eliminate the swollen tissue by cutting off the blood supply.
Rubber band ligation is a common technique for internal hemorrhoids, where a specialized device places a small elastic band around the base of the hemorrhoid. This band halts the flow of blood, causing the hemorrhoid to wither and fall off, typically within a week.
Another option is sclerotherapy, which involves injecting a chemical solution directly into the hemorrhoid tissue. This solution causes scar tissue to form, which shrinks the hemorrhoid by collapsing the blood vessel walls.
Infrared coagulation uses a device that directs a burst of infrared light onto the hemorrhoid. The heat creates scar tissue, which cuts off the blood supply and causes the hemorrhoid to shrivel and retract.
These procedures are typically reserved for Grade I or II internal hemorrhoids. A surgical hemorrhoidectomy is the final option for large, severely prolapsed, or non-responsive Grade III and IV cases. Any instance of severe pain, excessive bleeding, or symptoms that persist beyond seven days of home treatment should prompt an immediate consultation with a healthcare provider.