Hemorrhoids are a common condition involving swollen veins in the lower rectum and anus. They can cause uncomfortable symptoms like itching, pain, and bleeding. Many people experience hemorrhoids, and a common question is whether they can resolve without specific medical intervention.
What Are Internal Hemorrhoids?
Internal hemorrhoids are swollen blood vessels inside the rectum, above the dentate line. Unlike external hemorrhoids, they typically cause little pain because the rectal lining has fewer pain-sensing nerve endings. These vessels are a normal part of human anatomy, acting as cushions that aid continence and protect sphincter muscles during bowel movements. When they become swollen and irritated from increased pressure, they become symptomatic.
Do They Resolve Without Intervention?
Mild internal hemorrhoids often resolve on their own, usually within a few days to a week. This natural resolution occurs as swelling subsides and any trapped blood drains, allowing the hemorrhoid to shrink.
However, spontaneous resolution depends on the hemorrhoid’s size and whether aggravating factors are addressed. While minor cases may clear up, larger or more irritated internal hemorrhoids might not fully disappear without intervention. Persistent or worsening symptoms suggest self-care alone may be insufficient.
Home Strategies for Relief
Several home strategies can alleviate symptoms and support the natural healing of internal hemorrhoids. Increasing dietary fiber intake softens stools and prevents straining during bowel movements, a common trigger. Aim for 25 to 38 grams of fiber daily from fruits, vegetables, and whole grains.
Staying well-hydrated also contributes to softer stools, making them easier to pass and reducing pressure. Warm sitz baths, soaking the anal area in warm water for 15-20 minutes multiple times daily, can soothe discomfort, reduce swelling, and relax muscles. Over-the-counter creams, ointments, or suppositories with witch hazel or hydrocortisone offer temporary relief from itching and pain.
When to Consult a Doctor
While many hemorrhoids improve with home care, certain signs indicate the need for medical evaluation. Persistent rectal bleeding, especially if heavy or non-stopping, warrants prompt attention to rule out more serious conditions. Severe pain, a prolapsed hemorrhoid that remains outside the anus, or symptoms that worsen or do not improve after a week of consistent home treatment are also reasons to seek professional medical advice. A healthcare provider can accurately diagnose the condition and determine its cause.
Professional Treatment Options
If internal hemorrhoids do not respond to home care or are severe, various professional treatments are available. Non-surgical office procedures are often the first medical intervention. Rubber band ligation places an elastic band around the hemorrhoid’s base, cutting off its blood supply, causing it to shrink and fall off within a week. Sclerotherapy injects a chemical solution into the hemorrhoid to induce scarring and shrinkage.
Other minimally invasive techniques include infrared photocoagulation or electrocoagulation, which use heat or electric current to shrink the hemorrhoid by cutting off its blood supply. For very large, severe, or recurrent hemorrhoids unresponsive to less invasive methods, surgical removal (hemorrhoidectomy) may be recommended. This procedure excises the swollen veins and is typically reserved for advanced cases.