The best thing for hemorrhoids depends on how severe they are, but for most people, the answer starts with fiber and simple home care. The majority of hemorrhoid flare-ups resolve within a week or two with changes you can make at home, no procedure required. When symptoms persist, a range of office-based and surgical options can provide longer-lasting relief.
Fiber Is the Single Most Effective Starting Point
Increasing your fiber intake softens stool and reduces the straining that causes hemorrhoids to swell in the first place. The current dietary guidelines recommend about 14 grams of fiber per 1,000 calories you eat, which works out to roughly 28 grams per day on a standard 2,000-calorie diet. Most Americans get about half that amount.
You can close the gap with high-fiber foods like beans, lentils, whole grains, berries, and vegetables, or with a fiber supplement like psyllium husk. If you’re not used to eating much fiber, increase your intake gradually over a week or two to avoid bloating and gas. Drink plenty of water alongside it. Fiber without adequate fluid can make constipation worse, not better. This isn’t just a treatment for an active flare-up. Consistent fiber intake is the most reliable way to prevent hemorrhoids from coming back.
Home Treatments That Ease Symptoms Fast
While fiber addresses the root cause, several home remedies help with the immediate discomfort of itching, swelling, and pain.
Sitz baths are one of the most effective options. You sit in a few inches of warm water (around 104°F or 40°C) for 15 to 20 minutes, up to three or four times a day. This relaxes the muscles around the anus, improves blood flow, and can significantly reduce pain and irritation. You can buy a small plastic basin that fits over your toilet seat, or simply use your bathtub. Pat the area dry afterward rather than rubbing.
Over-the-counter creams and ointments offer temporary relief. Most contain phenylephrine, which constricts blood vessels to temporarily shrink swollen tissue and ease burning. Products with hydrocortisone reduce inflammation, while those containing a local anesthetic numb the area. These are fine for short-term use during a flare-up, but hydrocortisone creams shouldn’t be used for more than a week at a time because they can thin the skin.
Cold packs applied to the area for 10 to 15 minutes can also reduce swelling. Wrap ice in a cloth rather than applying it directly to skin.
Habits That Make a Real Difference
How you use the bathroom matters more than most people realize. Sitting on the toilet for long stretches, scrolling your phone, puts continuous pressure on the veins around your rectum. Try to limit your time on the toilet to under 10 minutes per bowel movement, and ideally closer to one or two minutes of active effort. If nothing is happening, get up and come back later. Straining to force a bowel movement is one of the most common triggers for hemorrhoid flare-ups.
Staying physically active helps keep your bowel movements regular and reduces the time stool spends sitting in your colon, where it loses water and hardens. Even a daily 20- to 30-minute walk makes a difference. Avoid heavy lifting during a flare-up, since bearing down increases pressure on hemorrhoidal veins.
When Home Care Isn’t Enough
If your symptoms haven’t improved after about a week of consistent home treatment, or if you’re dealing with recurring flare-ups, it may be time for something more. Internal hemorrhoids that bleed or prolapse (bulge outside the anus) are typically treated first with rubber band ligation, the most commonly performed hemorrhoid procedure in the United States. A doctor places a small elastic band around the base of the hemorrhoid, cutting off its blood supply. The tissue shrinks and falls off within a few days. The procedure is done in an office without anesthesia and usually takes just a few minutes.
Rubber band ligation works well in the short term, but it does have a notable recurrence rate. A 2025 multicenter trial published in Diseases of the Colon & Rectum found that nearly 49% of patients with grade III hemorrhoids experienced recurrence within 12 months, compared to just 6% of those who had surgical removal. The procedure often needs to be repeated two to four times, spaced six to eight weeks apart, to fully eliminate a hemorrhoid. For many people, that tradeoff is worth it to avoid surgery.
Surgical Options for Severe Cases
When hemorrhoids are large, persistently symptomatic, or keep returning after banding, surgery becomes the most effective option. A traditional hemorrhoidectomy, where the hemorrhoid tissue and blood vessels are surgically removed, cures about 95% of cases. The downside is that recovery is genuinely painful, typically requiring one to two weeks off work and several weeks before you’re fully comfortable again. Pain management during recovery is a key part of the process.
A stapled procedure (stapled hemorrhoidopexy) is less painful in the first few weeks after surgery, with patients needing less pain medication during that window. However, return to normal activity at six weeks is about the same as with traditional surgery. Current guidelines from the American Society of Colon and Rectal Surgeons no longer recommend stapled hemorrhoidopexy as a first-line surgical treatment due to its lower long-term effectiveness and higher risk of complications. It’s generally reserved for prolapsing internal hemorrhoids when other approaches haven’t worked.
Another option, Doppler-guided hemorrhoidal artery ligation, uses ultrasound to locate and tie off the arteries feeding the hemorrhoid. It can be considered as an alternative to full surgical removal for internal hemorrhoids.
External vs. Internal Hemorrhoids
The best treatment partly depends on which type you have. Internal hemorrhoids form inside the rectum, where you can’t see or feel them unless they prolapse. Their main symptom is painless bleeding, usually bright red blood on toilet paper or in the bowl. These respond well to fiber, banding, and other office procedures.
External hemorrhoids develop under the skin around the anus and are often more painful, especially if a blood clot forms inside one (a thrombosed hemorrhoid). If the clot is recent and the pain is severe, a doctor can remove the clot or the entire hemorrhoid in a quick office procedure. If the clot has been there for more than two days and the pain is manageable, home treatments like sitz baths and over-the-counter pain relievers are usually sufficient while it resolves on its own over a week or two.
Supplements That May Help
A class of plant-based supplements called phlebotonics can support vein health and reduce hemorrhoid symptoms. The most studied is a combination of diosmin and hesperidin (sold under brand names like Daflon). These compounds strengthen blood vessel walls and improve circulation. A systematic review of 22 randomized trials covering over 2,300 patients found that this supplement reduced bleeding, pain, and swelling, particularly when used after hemorrhoid procedures. It also showed benefits when taken during acute flare-ups. These supplements are available over the counter in many countries, though they’re less commonly used in the United States than in Europe.
Rectal Bleeding Deserves Attention
Hemorrhoids are the most common cause of rectal bleeding, but they’re not the only one. Bright red blood on toilet paper after a bowel movement is typical of hemorrhoids. However, any rectal bleeding that persists, changes in character, or is accompanied by changes in bowel habits warrants a visit to your doctor. Conditions like colorectal polyps, inflammatory bowel disease, and colorectal cancer can produce similar symptoms. This is especially important if you’re over 45 or have a family history of colorectal cancer. Getting hemorrhoids properly diagnosed ensures you’re treating the right problem.