Hemorrhoids, commonly referred to as piles, involve the swelling of veins in the lower rectum and anus. This swelling occurs when increased pressure causes the blood vessels in the anal canal to become enlarged and inflamed. While they cause discomfort, itching, and sometimes bleeding, hemorrhoids are a treatable issue. Managing this condition involves immediate symptom relief combined with long-term changes to prevent recurrence.
Immediate Relief: Home Remedies and Over-the-Counter Options
The immediate goal when dealing with an active flare-up is to reduce pain, swelling, and itching. A simple method is the sitz bath, which involves soaking the anal area in warm water for 10 to 15 minutes, two or three times a day. The warm water helps relax the anal sphincter muscles, reducing swelling and discomfort.
Over-the-counter topical treatments can be applied directly to the affected area. Creams or suppositories containing hydrocortisone reduce inflammation and itching, but should not be used for more than one week continuously without medical advice, as prolonged use can thin the skin. Products containing witch hazel, a natural astringent, can also be applied to temporarily relieve irritation and burning.
Ointments with a numbing agent, such as lidocaine, can temporarily block pain signals. For immediate swelling reduction, applying a cloth-covered ice pack or cold compress to the area for short periods helps constrict the blood vessels. For overall discomfort, taking an oral nonsteroidal anti-inflammatory drug (NSAID), such as ibuprofen, manages both pain and general inflammation.
Long-Term Fixes Through Lifestyle and Dietary Changes
Addressing the underlying cause of hemorrhoids—straining during bowel movements—is the most effective strategy for preventing future episodes. This requires focusing on dietary and lifestyle adjustments to ensure soft, regular stools. The most important change involves increasing daily fiber intake to a goal of 25 to 30 grams per day.
Dietary fiber works by adding bulk and holding water in the stool, making it easier to pass without excessive pressure. Good sources include soluble fiber (found in oats, beans, and certain fruits) and insoluble fiber (found in whole grains and vegetables). It is important to increase fiber intake gradually over several weeks to prevent uncomfortable side effects like bloating and gas.
Alongside fiber, adequate fluid intake is necessary for the fiber to function correctly and keep the stool soft. Aim to drink at least eight glasses of water or other non-caffeinated fluids throughout the day. Changing bathroom habits is also crucial; avoid sitting on the toilet for more than a few minutes and resist the urge to strain. Going to the bathroom as soon as you feel the urge prevents the stool from becoming harder to pass.
Regular physical activity, such as walking for 20 to 30 minutes most days of the week, also supports digestive health by stimulating the intestinal muscles. This movement helps prevent the sluggish bowel function that can lead to constipation and straining.
Professional Medical Treatment Options
If home remedies and lifestyle changes do not resolve symptoms after about a week, or if you experience persistent bleeding, severe pain, or a failure to respond to treatment, medical intervention may be necessary. A doctor may recommend one of several minimally invasive procedures, which are typically performed in an office setting.
One common procedure is rubber band ligation, where a small rubber band is placed around the base of an internal hemorrhoid to cut off its blood supply. The banded tissue then shrinks and falls off within a week. Sclerotherapy involves injecting a chemical solution into the hemorrhoid, causing the blood vessel to scar and shrink. Coagulation uses infrared light or heat to cause the hemorrhoid to harden and recede.
For more severe or persistent cases, surgical options may be discussed. A hemorrhoidectomy is the surgical removal of the excess tissue causing bleeding and pain. A stapled hemorrhoidopexy uses a circular stapling device to reposition the hemorrhoidal tissue and restrict its blood flow. While surgery has a longer recovery time, it is highly effective for large or recurring hemorrhoids.