Most hemorrhoids improve within a few weeks using a combination of dietary changes, simple home treatments, and over-the-counter products. The key is softening your stool so you stop straining, calming the irritated tissue, and changing the habits that caused the problem. For more stubborn cases, quick in-office procedures can resolve symptoms without major surgery.
What’s Actually Happening
Hemorrhoids are cushions of blood vessels and connective tissue that everyone has in and around the anal canal. They only become a problem when those cushions swell, stretch, or slip out of place. Internal hemorrhoids form inside the rectum and tend to cause painless bleeding. External hemorrhoids develop under the skin around the anus and can become intensely painful when a blood clot forms inside them.
Internal hemorrhoids are graded by severity. Grade I hemorrhoids bleed but don’t protrude. Grade II hemorrhoids bulge out during a bowel movement but slide back on their own. Grade III hemorrhoids protrude and need to be pushed back in manually, often causing itching and moisture. Grade IV hemorrhoids stay out permanently and develop chronic irritation. Knowing where you fall on this scale helps determine whether home treatment is enough or whether you need professional help.
Start With Fiber and Water
The single most effective long-term strategy is preventing hard, dry stools. Current dietary guidelines recommend about 14 grams of fiber per 1,000 calories you eat, which works out to roughly 28 grams a day on a standard 2,000-calorie diet. Most people fall well short of that. Good sources include beans, lentils, oats, berries, broccoli, and whole grains.
If you can’t reach that target through food alone, a bulk-forming fiber supplement (psyllium, methylcellulose, or wheat dextrin) can fill the gap. These work by absorbing water and forming a soft, bulky stool that passes without straining. Start with a small dose and increase gradually, because adding too much fiber too fast causes gas and bloating. Drink at least eight glasses of water a day alongside any fiber supplement, or it can make constipation worse.
A stool softener like docusate sodium is another option. It works differently from fiber: rather than adding bulk, it draws moisture into the stool so it’s easier to pass. Some people use both a softener and a fiber supplement during a flare-up, then taper down to fiber alone for maintenance.
Home Treatments That Reduce Pain and Swelling
Sitz baths are one of the most reliable ways to calm hemorrhoid symptoms. Fill a basin or shallow bathtub with warm water (around 104°F or 40°C) and soak for 15 to 20 minutes. You can do this three to four times a day during a painful episode. The warmth increases blood flow to the area, relaxes the surrounding muscles, and eases itching. Pat dry gently afterward rather than rubbing.
Ice packs wrapped in a cloth can also reduce swelling when applied for 10 to 15 minutes at a time. Some people alternate between warm soaks and cold packs for the best relief. Witch hazel pads, applied directly to the area, have an astringent effect that helps with irritation and minor bleeding.
Over-the-Counter Products
Hemorrhoid creams and suppositories contain different active ingredients depending on the symptom they target. Products with phenylephrine work by constricting blood vessels in the tissue, which temporarily shrinks swelling and reduces irritation. Hydrocortisone-based creams reduce inflammation and itching but shouldn’t be used for more than about a week at a time, because prolonged use can thin the skin.
For itching specifically, avoid scratching (which worsens the cycle) and keep the area clean and dry. Unscented, alcohol-free wipes are gentler than dry toilet paper. If itching is your main complaint, a barrier cream containing zinc oxide can protect irritated skin between bowel movements.
Change Your Bathroom Habits
Spending too long on the toilet is one of the most overlooked causes of hemorrhoid trouble. Whether you’re straining from constipation or just scrolling your phone, sitting on a toilet seat puts direct pressure on the veins in your rectum. Try to keep your time on the toilet to five to ten minutes. If nothing is happening, get up and try again later.
Go when you feel the urge rather than delaying. Waiting causes stool to dry out in the rectum, making it harder to pass. Elevating your feet on a small stool while sitting on the toilet straightens the angle of your rectum and lets stool pass with less effort. Avoid bearing down forcefully. If you need to strain, you probably need more fiber or fluid in your diet.
Dealing With Hemorrhoids During Pregnancy
Pregnancy increases pressure on pelvic veins and frequently triggers or worsens hemorrhoids. The approach is largely the same as for anyone else: eat a high-fiber diet, drink plenty of water, and use sitz baths (warm, not hot) a few times a day. Ice packs and witch hazel pads are considered safe during pregnancy. Getting up and moving throughout the day helps take pressure off the pelvic veins, and keeping weight gain within the range your provider recommends reduces the load on those vessels further.
Over-the-counter creams and suppositories may also be appropriate, but it’s worth confirming with your provider which specific products are safe during your pregnancy, since some active ingredients carry more caution than others.
When Home Treatment Isn’t Enough
If symptoms persist beyond two to three weeks of consistent home care, or if you have Grade II or III hemorrhoids that keep prolapsing, an in-office procedure can provide faster, more durable relief. The most common option is rubber band ligation, where a tiny band is placed around the base of an internal hemorrhoid to cut off its blood supply. The banded tissue shrinks and falls off within a few days.
Rubber band ligation is 70% to 80% effective, and recovery is quick. Most people return to normal activities immediately, though you should avoid heavy lifting for at least two weeks. There’s some pressure and mild discomfort for a day or two, but it rarely requires time off work. Other in-office options include infrared coagulation and injection therapy, which work on a similar principle of shrinking the hemorrhoid tissue.
Surgical Options for Severe Cases
Grade IV hemorrhoids, large external hemorrhoids, and cases that don’t respond to banding sometimes require surgery. Traditional surgical removal (hemorrhoidectomy) is the most thorough approach. It has a higher success rate and lower recurrence than less invasive alternatives, but recovery involves more pain and a longer time away from normal activities.
A stapled procedure is an alternative that repositions prolapsed tissue rather than removing it entirely. Patients experience less postoperative pain, shorter hospital stays, and a faster return to daily life. The tradeoff is durability: long-term data from a large meta-analysis of randomized trials found a significantly higher rate of prolapse recurrence with the stapled approach, and patients were nearly twice as likely to need additional treatment compared to those who had a traditional hemorrhoidectomy. Your surgeon can help weigh these tradeoffs based on the severity and anatomy of your specific case.
When Bleeding Needs Further Evaluation
Bright red blood on toilet paper or in the bowl is the hallmark of hemorrhoid bleeding, and it usually looks alarming relative to how minor it actually is. But not all rectal bleeding comes from hemorrhoids. Dark red or maroon blood can indicate bleeding higher in the colon or small intestine. Black, tarry stools often point to bleeding in the stomach.
Get evaluated if rectal bleeding is heavy, frequent, lasts longer than a week, or if you don’t have an obvious explanation for it. Unexplained rectal bleeding sometimes warrants a colonoscopy to rule out other conditions, including colorectal polyps or cancer. Sudden severe bleeding, or bleeding accompanied by lightheadedness or feeling faint, is a reason to go to the emergency room.