Treating and Preventing Hemorrhoids

Dr. Hsu says the best first step is to visit a drugstore to get some creams or suppositories that soothe inflamed rectal veins and speed healing. Look for treatments containing cortisone or lidocaine, which are especially helpful. 

Stool softeners also help reduce straining and constipation, but be sure to avoid laxatives. “Laxatives can cause diarrhea and further irritate swollen veins, which you definitely don’t want,” Dr. Hsu says. “If your hemorrhoids are especially itchy or you feel a burning sensation, use baby wipes instead of toilet paper and apply witch hazel to the area with a cotton swab.” 

For more aggressive hemorrhoids, use a sitz bath to relieve itching, irritation and pain. Fill a bathtub with a few inches of warm water and sit in the tub, with knees bent, for 15 to 20 minutes. If getting in a bathtub isn’t an option, purchase a plastic sitz bath kit, available at any drugstore, that fits over the toilet. For optimal relief, use a sitz bath several times per day. 

Prevention is the most effective treatment of all, Dr. Hsu says. Increase the amount of fiber in your diet through food or supplements to promote healthy stools and avoid straining. Drink enough water to keep stools soft and easy to pass. Probiotics, available in fermented foods and as over-the-counter supplements, may improve the good bacteria in the bowel, helping to regulate bowel movements and prevent straining. “And avoid sitting for long periods of time at a desk or driving for many hours each day because that can exacerbate hemorrhoids,” Dr. Hsu says.

When to See a Doctor

If over-the-counter medications and lifestyle changes don’t solve the problem, your doctor can prescribe stronger medications, from steroid products to more effective stool softeners, or a combination of medicines to treat your particular issues. 

For particularly stubborn and persistent hemorrhoids, you may need to resort to medical treatment, such as surgical intervention. 

“We often perform rubber-band ligation procedures, which use a tiny rubber band to tie off internal hemorrhoids, causing them to shrink and disappear,” Dr. Hsu says. “But if you have especially large hemorrhoids, sometimes a surgeon will do a hemorrhoidectomy to cut them out.” 

Most external hemorrhoids don’t bleed, so if you see blood in your stool or when you wipe and haven’t been diagnosed with an internal hemorrhoid, it’s time to see a doctor. 

“If there’s any sharp pain in the anal area that’s similar to how a paper cut feels, it’s likely due to an anal fissure,” which people often confuse for a hemorrhoid, he says. “An anal fissure is a little tear in the anal area that can heal up very quickly. Between bowel movements, patients with anal fissures can be symptom-free.” 

Anal fissures are easy to remedy, but rectal bleeding can also signal more serious ailments, such as colon cancer, Crohn’s disease and ulcerative colitis—so it’s important to see a doctor for a proper diagnosis. Make sure to get medical treatment right away if you lose a lot of blood from a hemorrhoid.