Most hemorrhoids can be treated at home with a combination of dietary changes, warm soaks, and over-the-counter products. Mild cases often improve within a week. The right approach depends on whether you’re dealing with internal or external hemorrhoids and how severe your symptoms are.
Internal vs. External: Why It Matters
Hemorrhoids fall into two categories, and each calls for a slightly different strategy. Internal hemorrhoids form inside the rectum, where you can’t see or feel them. Their main symptom is bright red blood on toilet paper or in the bowl after a bowel movement. They’re graded on a scale of I to IV based on whether they bulge out of the anus (prolapse) and how far. Grade I stays inside. Grade II slides out during straining but goes back on its own. Grade III has to be pushed back in manually. Grade IV stays out permanently.
External hemorrhoids sit under the skin around the anus. You’ll notice them as hard, tender lumps that itch or ache, especially when sitting. They sometimes develop a blood clot (thrombosis), which causes sudden, intense pain and a firm bluish lump at the anal opening. If that happens within the first 48 hours, a doctor can remove the clot in a quick office procedure for fast relief. After 48 hours, the pain typically starts fading on its own, and conservative care is the better path.
Home Treatments That Work
Sitz Baths
A sitz bath is one of the most effective things you can do right now. Fill your bathtub or a basin that fits over your toilet seat with a few inches of warm water, around 104°F (40°C). Soak for 15 to 20 minutes. Doing this three to four times a day can significantly reduce pain, itching, and swelling. Pat the area dry afterward rather than rubbing. No soap, salts, or additives are necessary.
Over-the-Counter Products
Hemorrhoid creams and ointments containing phenylephrine work by temporarily shrinking swollen tissue and relieving burning. Products with a numbing agent (like lidocaine or pramoxine) can take the edge off pain. Witch hazel pads are a gentler option for cleaning the area and soothing irritation. These products manage symptoms while your body heals, but they aren’t a long-term fix. If you’re still relying on them after a week with no improvement, it’s time to see a doctor.
Stool Softeners
Hard stools are the enemy of healing hemorrhoids. Over-the-counter stool softeners and osmotic laxatives (the kind that draw water into the bowel to keep things soft) can make bowel movements far less painful while you recover. The goal is stools that pass easily without straining.
Diet Changes That Prevent Flare-Ups
Fiber is the single most important dietary factor. It bulks up stool and keeps it soft so you don’t have to strain, which is what causes hemorrhoids to swell in the first place. The recommended intake is 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.
Some of the highest-fiber foods you can add:
- Beans: Half a cup of navy beans has 9.6 grams, pinto beans 7.7 grams
- Vegetables: A cup of green peas has 8.8 grams, sweet potato 6.3 grams, winter squash 5.7 grams
- Fruits: A cup of raspberries has 8.0 grams, a medium pear 5.5 grams, a medium apple 4.8 grams
- Grains: Half a cup of high-fiber bran cereal packs 14 grams on its own
If your current diet is low in fiber, increase your intake gradually over a week or two. Adding too much too fast causes bloating and gas. Drink plenty of water alongside the fiber, since fiber absorbs water to do its job. Without enough fluid, it can actually make constipation worse.
Flavonoid Supplements
A class of plant-based supplements known as flavonoids has shown real benefit for hemorrhoid symptoms. These compounds strengthen blood vessel walls and reduce inflammation. A meta-analysis of 11 studies found that flavonoid treatment significantly reduced bleeding and discharge, and patients reported meaningful overall improvement. Pain also trended lower, though the effect wasn’t as strong. These supplements are available over the counter in many countries and can be a useful addition to other treatments during an acute flare-up.
Office Procedures for Persistent Hemorrhoids
When home care isn’t enough, doctors can treat grade I through III internal hemorrhoids with minimally invasive procedures done right in the office, usually without anesthesia.
Rubber band ligation is the most common. A tiny rubber band is placed around the base of the hemorrhoid, cutting off its blood supply. The tissue shrinks and falls off within a few days. Success rates are high: about 96% for grade I, 94% for grade II, and 88% for grade III. Recurrence rates are relatively low, around 10% overall, though grade III hemorrhoids recur more often (about 17%) compared to grade I (under 4%). The procedure can cause a feeling of pressure or mild discomfort for a day or two.
Injection sclerotherapy is another option, where a chemical solution is injected into the hemorrhoid tissue to shrink it. Infrared coagulation uses heat to achieve a similar result. Both work best on smaller, lower-grade hemorrhoids.
Surgery for Advanced Cases
Surgery enters the picture for grade III and IV internal hemorrhoids that haven’t responded to less invasive treatment, and for complicated cases involving blood clots or strangulation. There are two main approaches.
Traditional hemorrhoidectomy, where the hemorrhoid tissue is surgically removed, remains the gold standard. It has the highest cure rate and the lowest chance of recurrence. The trade-off is a more painful recovery, typically lasting two to four weeks before you’re back to normal activities.
Stapled hemorrhoidopexy is an alternative that repositions the tissue rather than removing it. Recovery is less painful than traditional surgery. However, a systematic review of randomized trials found that the stapled approach carries roughly 3.6 times the odds of recurrence compared to conventional hemorrhoidectomy. For this reason, it tends to be reserved for specific situations, such as circumferential prolapse, and should be performed by an experienced surgeon.
A third option, Doppler-guided artery ligation, uses ultrasound to locate and tie off the blood vessels feeding the hemorrhoids. It’s effective for grade II and III hemorrhoids and offers a middle ground between office procedures and full surgery in terms of both invasiveness and recovery.
Habits That Keep Hemorrhoids From Coming Back
Treatment handles the current problem. Prevention keeps it from cycling back. The most impactful habits are straightforward: maintain a high-fiber diet, stay well hydrated, and avoid straining during bowel movements. Don’t sit on the toilet longer than necessary. Scrolling your phone for 15 minutes while bearing down is a recipe for recurrence. When you feel the urge to go, go. Delaying bowel movements leads to harder stools and more straining. Regular physical activity also helps by keeping your digestive system moving and reducing pressure on the veins in your lower rectum.
If you notice rectal bleeding, don’t assume it’s hemorrhoids, especially if the blood is dark rather than bright red, or if it’s your first episode. Rectal bleeding can signal other conditions that need evaluation. Similarly, if home treatment hasn’t improved your symptoms within a week, getting examined will help rule out other causes and open up more effective treatment options.