Best way to get rid of hemorrhoids

Hemorrhoids often get better without surgery or even procedures your doctor can do in the office. Start with over-the-counter products and lifestyle changes. (If you're pregnant, you should talk to your doctor before you try any medicine or change your diet.)

Hemorrhoid Home Care

Try these tips to soothe the pain and itching of hemorrhoids.

• Warm Bath or Sitz Bath. It’s a time-honored therapy: Sit in about 3 inches of warm (not hot) water for 15 minutes or so, several times a day. This helps reduce swelling in the area and relaxes your clenching sphincter muscle. It's especially good after pooping.
• Ointments. Put a little petroleum jelly just inside your anus to make pooping hurt less. Don't force it! Or use over-the-counter creams or ointments made for hemorrhoid symptoms. A 1% hydrocortisone cream on the skin outside the anus (not inside) can relieve itching, too. But don't use it for longer than a week unless your doctor says it's OK.
• Witch Hazel. Dab witch hazel on irritated hemorrhoids. It’s a natural anti-inflammatory that can work against swelling and itching.
• Soothing Wipes. After you poop, clean yourself gently with a baby wipe, a wet cloth, or a medicated pad.
• Cold Compress. Try putting a simple cold pack on the tender area for a few minutes to numb it and bring down the swelling.
• Loose Clothing. Weaning loose clothing in a breathable fabric like cotton may help with discomfort.
• High-Fiber Diet. It's the best thing for hemorrhoids: A diet rich in high-fiber foods and with few processed foods. Eat mostly vegetables, fruit, nuts, and whole grains to avoid constipation.
• Stool Softeners. If you can't get enough fiber from food, your doctor may want you to take a fiber supplement or stool softener. Don't take laxatives, because they can cause diarrhea that could irritate hemorrhoids.
• Keep Hydrated. Drink seven to eight glasses of water each day, at least a half-gallon total. If you're very active or you live in a hot climate, you may need even more.

Even if your doctor prescribes medication or suggests surgery, you'll probably need to change your diet. Introduce new foods slowly to avoid gas.

Hemorrhoid Medications

Pain relievers, including acetaminophen, ibuprofen, and aspirin, may help with your hemorrhoid symptoms. You can also choose from a variety of over-the-counter creams, ointments, suppositories, and medicated pads. They contain medicines like lidocaine to numb the area, or hydrocortisone or witch hazel, to reduce swelling and itching.

Medical Procedures for Hemorrhoids

If your symptoms are severe or aren't getting better after a couple of weeks, your doctor may suggest a procedure to shrink or remove the hemorrhoids. Many can be performed in their office.

Injection. Your doctor can inject an internal hemorrhoid with a solution to create a scar and close off the hemorrhoid. The shot hurts only a little.

Rubber band ligation. This procedure is often done on prolapsed hemorrhoids, internal hemorrhoids that can be seen or felt outside. Using a special tool, the doctor puts a tiny rubber band around the hemorrhoid, which shuts off its blood supply almost instantly. Within a week, the hemorrhoid will dry up, shrink, and fall off.

Coagulation or cauterization. With an electric probe, a laser beam, or an infrared light, your doctor will make a tiny burn to remove tissue and painlessly seal the end of the hemorrhoid, causing it to close off and shrink. This works best for prolapsed hemorrhoids.

Surgery. For large internal hemorrhoids or extremely uncomfortable external hemorrhoids, your doctor may recommend surgery.

• Hemorrhoidectomy. The most effective technique is to completely remove the hemorrhoids. But recovery is painful and can take several weeks.
• Hemorrhoid stapling. This technique cuts blood flow to internal hemorrhoids and moves prolapsed tissue back in place. Recovery is easier, but there’s a greater chance of the hemorrhoids coming back.

Newer procedures use less invasive techniques to identify and cut off the blood supply to the problem tissues.

Medical treatments are effective, but unless you change your diet and lifestyle, hemorrhoids may come back.

What Are Hemorrhoids?

Hemorrhoids are swollen veins in the lowest part of your rectum and anus. Sometimes, the walls of these blood vessels stretch so thin that the veins bulge and get irritated, especially when you poop. Hemorrhoids are also called piles.

Hemorrhoids are one of the most common causes of rectal bleeding. They often go away on their own. Treatments can also help.

Symptoms of Hemorrhoids

Internal hemorrhoids

Internal hemorrhoids are so far inside your rectum that you can't usually see or feel them. They don't generally hurt because you have few pain-sensing nerves there. Symptoms of internal hemorrhoids include:

• Blood on your poop, on toilet paper after you wipe, or in the toilet bowl
• Tissue that bulges outside your anal opening (prolapse). This may hurt, often when you poop. You might be able to see prolapsed hemorrhoids as moist bumps that are pinker than the surrounding area. These usually go back inside on their own. Even if they don't, they can often be gently pushed back into place.

External hemorrhoids

External hemorrhoids are under the skin around your anus, where there are many more pain-sensing nerves. Symptoms of external hemorrhoids include:

• Pain
• Bleeding
• Itching
• Swelling

Thrombosed hemorrhoids

A blood clot can turn an external hemorrhoid purple or blue. This is called a thrombosis or a thrombosed hemorrhoid. You may notice symptoms like:

• Severe pain
• Itching
• Bleeding

When to call your doctor

Hemorrhoids are rarely dangerous. If the symptoms don’t go away in a week or if you have bleeding, see your doctor to make sure you don’t have a more serious condition.

Causes and Risk Factors of Hemorrhoids

You may be more likely to get hemorrhoids if other family members, like your parents, had them.

Pressure building up in your lower rectum can affect blood flow and make the veins there swell. That may happen from:

• Pushing during bowel movements
• Straining when you do something that's physically hard, like lifting something heavy
• Extra weight, like obesity
• Pregnancy, when your growing uterus presses on your veins
• A diet low in fiber
• Anal sex

People who stand or sit for long stretches of time are at greater risk, too.

You may get them when you have constipation or diarrhea that doesn't clear up. Coughing, sneezing, and vomiting could make them worse.

Hemorrhoids Diagnosis

Your doctor will ask about your medical history and symptoms. They’ll probably need to do one or both of these examinations:

• Physical exam. Your doctor will look at your anus and rectum to check for lumps, swelling, irritation, or other problems.
• Digital rectal exam. Your doctor will put on gloves, apply lubrication, and insert a finger into your rectum to check muscle tone and feel for tenderness, lumps, or other problems.

To diagnose internal hemorrhoids or rule out other conditions, you might need a more thorough test, including:

• Anoscopy. Your doctor uses a short plastic tube called an anoscope to look into your anal canal.
• Sigmoidoscopy. Your doctor looks into your lower colon with a flexible lighted tube called a sigmoidoscope. They can also use the tube to take a bit of tissue for tests.
• Colonoscopy. Your doctor looks at all of your large intestine with a long, flexible tube called a colonoscope. They can also take tissue samples or treat other problems they find.

Hemorrhoids Treatment

Hemorrhoid symptoms usually go away on their own. Your doctor’s treatment plan will depend on how severe your symptoms are.

• Home remedies. Simple lifestyle changes can often relieve mild hemorrhoid symptoms within 2 to 7 days. Add fiber to your diet with over-the counter supplements and foods like fruit, vegetables, and grains. Try not to strain during bowel movements; drinking more water can make it easier to go. Warm sitz baths for 20 minutes several times a day may also make you feel better. Ice packs can ease pain and swelling.
• Nonsurgical treatments. Over-the-counter creams and other medications ease pain, swelling, and itching.
• Surgical treatments. If you have large hemorrhoids, or if other treatments haven’t helped, you might need surgery. Your doctor can use chemicals, lasers, infrared light, or tiny rubber bands to get rid of them. If they’re especially large or keep coming back, your doctor might need to remove them with a sharp tool called a scalpel.

Hemorrhoids Complications

Rarely, hemorrhoids could lead to problems such as:

• Skin tags. When the clot in a thrombosed hemorrhoid dissolves, you may have a bit of skin left over, which could get irritated.
• Anemia. You might lose too much blood if you have a hemorrhoid that lasts a long time and bleeds a lot.
• Infection. Some external hemorrhoids have sores that get infected.
• Strangulated hemorrhoid. Muscles can block the blood flow to a prolapsed hemorrhoid. This may be very painful and need surgery.

Hemorrhoids Prevention

To prevent hemorrhoid flare-ups, try these steps:

• Eat fiber. It helps food pass through your system easier. A good way to get it is from plant foods: vegetables, fruits, whole grains, nuts, seeds, beans, and legumes. Aim for 20 to 35 grams of dietary fiber a day.
• Use fiber supplements. Over-the-counter supplements can help soften stool if you don’t get enough fiber from food. Start with a small amount, and slowly use more.
• Drink water. It will help you avoid hard stools and constipation, so you strain less during bowel movements. Fruits and vegetables, which have fiber, also have water in them.
• Exercise. Physical activity, like walking a half-hour every day, keeps your blood and your bowels moving.
• Don't wait to go. Use the toilet as soon as you feel the urge.
• Don’t strain during a bowel movement or sit on the toilet for long periods. This puts more pressure on your veins.
• Keep a healthy weight.