Hemorrhoids are a common condition involving swollen veins in the lower rectum and anus, similar to varicose veins. This swelling is often a result of increased pressure in the area, typically due to straining during bowel movements, pregnancy, or prolonged sitting. While hemorrhoids can cause uncomfortable symptoms like itching, pain, and bleeding, they are a highly treatable issue. Most cases initially respond well to simple adjustments and over-the-counter products, but more persistent problems may require a professional medical procedure.
Immediate Relief Through Home Care
Simple actions provide immediate relief from pain and swelling. Soaking the affected area in warm water helps soothe irritation and relax the anal sphincter muscles. Use a sitz bath, sitting in shallow, warm water for 15 to 20 minutes, two or three times daily and after every bowel movement.
Applying a cold compress or ice pack reduces inflammation and numbs the area, offering temporary relief from acute pain. Always wrap the ice in a cloth and apply it for only 10 to 15 minutes at a time to prevent skin damage. Good hygiene is crucial; avoid harsh, dry toilet paper. Instead, use pre-moistened wipes or gently clean the area with warm water and mild, unscented soap after passing stool. Avoid sitting on the toilet for a long time, as this position increases pressure on the rectal veins.
Over-the-Counter Treatments for Symptom Management
Purchased products offer targeted relief using specific active ingredients. Topical creams and suppositories often contain hydrocortisone, a low-potency corticosteroid that reduces inflammation and swelling. Products containing hydrocortisone should not be used for more than seven days unless directed by a doctor, as prolonged use can thin the skin.
For local pain relief, look for products containing a local anesthetic like lidocaine, which temporarily blocks nerve signals to numb soreness and itching. Witch hazel is another popular ingredient, acting as a botanical astringent to cause tissue to contract, reducing swelling and alleviating burning discomfort. These topical treatments provide symptomatic management while the underlying issue heals.
Managing constipation is equally important, making fiber supplements a core component of treatment. Bulk-forming laxatives, such as psyllium husk, absorb water to create softer, bulkier stool that is easier to pass. This reduces the need to strain during a bowel movement, a major contributor to hemorrhoid irritation. Always take fiber supplements with plenty of water, as insufficient fluid intake can worsen constipation.
When to Seek Professional Medical Care
Most hemorrhoids resolve with home care, but certain symptoms require professional medical attention. Consult a healthcare provider if pain is severe or persistent and does not improve after a week of at-home management. Any instance of excessive or prolonged rectal bleeding also warrants an evaluation.
While bright red blood is often associated with hemorrhoids, dark red or tarry stool indicates bleeding higher in the digestive tract and requires an immediate medical visit. Seek care if you notice signs of infection, such as fever, increasing swelling, or unusual discharge. An intensely painful, bluish lump around the anus may indicate a thrombosed hemorrhoid, where a blood clot has formed, requiring prompt treatment.
Minimally Invasive Medical Procedures
For hemorrhoids unresponsive to conservative treatments, physicians perform simple, minimally invasive procedures in an office setting.
Rubber Band Ligation
The most common procedure is rubber band ligation, primarily used for internal hemorrhoids. This technique involves placing a small rubber band around the base of the hemorrhoid, cutting off its blood supply. The hemorrhoid then withers and falls off, typically within a week, leaving a small scar that helps prevent recurrence.
Sclerotherapy
Sclerotherapy involves injecting a chemical solution (sclerosant) into the tissue surrounding the internal hemorrhoid. This solution irritates the blood vessel walls, causing them to collapse and form scar tissue, shrinking the hemorrhoid. Sclerotherapy is reserved for smaller internal hemorrhoids and is often painless because the injection occurs in an area without pain-sensing nerves.
Infrared Coagulation (IRC)
Infrared coagulation (IRC) uses a small probe to apply a burst of infrared light, creating intense heat. This heat seals the blood vessels supplying the hemorrhoid, causing the tissue to coagulate and scar. The resulting scar tissue cuts off the blood flow, causing the hemorrhoid to shrink and gradually disappear. This quick, outpatient procedure is effective for small to medium-sized internal hemorrhoids and has minimal recovery time.
Preventing Future Occurrences
Long-term prevention focuses on maintaining soft stool and avoiding undue pressure on the rectal veins. A high-fiber diet, aiming for 20 to 30 grams daily from sources like whole grains, fruits, and vegetables, is foundational. Fiber increases stool bulk, easing passage and minimizing the need to strain during bowel movements.
Adequate hydration is equally important, as fiber needs water to work effectively. Drinking at least eight glasses of fluid daily helps keep the stool soft. Practice good toilet habits by avoiding straining and not sitting on the toilet for more than a few minutes. Regular physical activity helps stimulate bowel function, reducing the risk of constipation and the pressure that leads to hemorrhoids.