Hemorrhoids are a common condition involving swollen veins in the rectum and anus, causing discomfort such as itching, pain, and sometimes bleeding. Many individuals experience hemorrhoid flare-ups, often seeking relief through over-the-counter (OTC) treatments. Hemorrhoid ointments are a frequent first-line approach for managing these symptoms. This article explores how these ointments provide relief.
How Hemorrhoid Ointments Provide Relief
Over-the-counter hemorrhoid ointments work through a combination of active ingredients, each targeting specific symptoms. Local anesthetics, such as lidocaine or pramoxine, numb the affected area, reducing pain and itching. These compounds block nerve signals, temporarily desensitizing nerve endings in the skin around the anus.
Astringents like witch hazel and phenylephrine are common components in these ointments. Witch hazel helps shrink swollen tissues and reduce irritation by causing blood vessels to constrict. Phenylephrine, a decongestant, similarly narrows blood vessels, decreasing swelling. This action reduces the size of hemorrhoidal tissue and alleviates burning sensations.
Protectants, including petrolatum and mineral oil, form a physical barrier over irritated skin. This protective layer soothes the area, reduces friction, and prevents further irritation from stool passage, making bowel movements less painful. These ingredients also prevent dryness and provide lubrication. Some formulations may contain corticosteroids like hydrocortisone, which possess anti-inflammatory properties. Hydrocortisone reduces swelling, redness, and itching, though its use is recommended for short durations due to its potency.
Proper Application and Expected Timeline
Correct application of hemorrhoid ointment is important for achieving relief and minimizing irritation. Before applying, cleanse the affected area gently with mild soap and water, then pat it thoroughly dry with a soft cloth or tissue. Washing hands before and after application is also recommended to maintain hygiene and prevent the spread of bacteria. For external hemorrhoids, a small amount, roughly pea-sized, can be applied directly to the affected area with a clean finger, ensuring gentle massage into the tissue.
When internal hemorrhoids require treatment, many ointments come with an applicator tip. After attaching the applicator to the tube and lubricating its tip, it should be gently inserted approximately one to two inches into the rectum. Squeezing the tube then delivers the ointment inside. It is recommended to apply the ointment up to four times daily, particularly after bowel movements, in the morning, and before bedtime.
Relief from symptoms begins within a few days of consistent application. Many mild hemorrhoid symptoms may resolve within one to two weeks with home treatment. Over-the-counter ointments are intended for short-term use; if symptoms do not improve within seven days, or if they worsen, seek medical advice. Avoiding bowel movements for one to three hours after internal application can help ensure the ointment remains in place and maximizes its effect.
When to Seek Professional Guidance
While hemorrhoid ointments offer symptomatic relief, professional medical guidance becomes necessary in certain situations. If hemorrhoid symptoms, such as pain, itching, or discomfort, do not improve after seven days of consistent over-the-counter treatment, consult a doctor. Similarly, if symptoms worsen despite using the ointment, medical evaluation is warranted.
Any significant or continuous rectal bleeding, especially if the toilet water turns red or large blood clots are observed, requires immediate medical attention. While minor bleeding can be associated with hemorrhoids, it is important to rule out more serious underlying conditions. A painful lump around the anus, which might indicate a thrombosed external hemorrhoid (a blood clot within the hemorrhoid), requires medical intervention as ointments may not be sufficient.
Additional concerning symptoms that warrant a doctor’s visit include new symptoms like fever, severe anal pain, or changes in bowel habits accompanying hemorrhoid discomfort. If there is uncertainty regarding the diagnosis, or if symptoms are atypical for hemorrhoids, a healthcare provider can provide an accurate assessment and recommend appropriate treatment. Seeking professional guidance ensures proper diagnosis and management, preventing potential complications.
Beyond Ointments: Lifestyle and Other Approaches
Managing hemorrhoids often involves more than just topical ointments; lifestyle adjustments can significantly support relief and prevent recurrence. Increasing dietary fiber intake is a primary step, as fiber adds bulk to stool and helps it retain water, making bowel movements softer and easier to pass. Incorporating fruits, vegetables, and whole grains into the diet, aiming for 25-30 grams of fiber daily, can reduce straining, a primary cause of hemorrhoids.
Adequate hydration is equally important; drinking plenty of water throughout the day works synergistically with fiber to ensure smooth stool transit. Regular physical activity, even moderate exercise like walking for 20-30 minutes daily, promotes healthy bowel function and improves circulation, which can help prevent blood from pooling in rectal veins. These habits contribute to overall digestive health.
Practicing proper bathroom habits can also reduce pressure on the rectal area. This includes avoiding prolonged sitting on the toilet and heeding the urge to have a bowel movement promptly, rather than delaying it. Delaying can lead to harder stools and increased straining. Sitz baths, involving soaking the anal area in a few inches of lukewarm water for about 15-20 minutes, can provide soothing relief from pain and itching by increasing blood flow and relaxing the muscles. Gentle anal hygiene, using soft toilet paper or cleansing wipes, further helps to prevent irritation and maintain cleanliness.