Hemorrhoids are a common medical condition involving swollen veins found either inside the rectum or beneath the skin around the anus. This engorgement of the vascular cushions occurs due to increased pressure, often from straining during bowel movements, pregnancy, or chronic constipation. While hemorrhoids are rarely dangerous, they can cause significant discomfort, including itching, pain, and bleeding, prompting many to seek immediate relief.
Expected Duration Based on Severity
The duration of a hemorrhoid largely depends on its type and severity, ranging from a few days to several weeks. Mild cases, often acute flare-ups triggered by temporary factors like short-term constipation, frequently resolve spontaneously within a few days to a week with basic home care. Small external hemorrhoids, which appear as tender lumps outside the anus, can take a few days to a few weeks to fully shrink.
Internal hemorrhoids, located inside the rectum, may remain asymptomatic or cause intermittent bright red bleeding. If symptomatic, especially if they are large or prolapse (protrude outside the anus), they are less likely to resolve completely without medical intervention and may become chronic.
A thrombosed hemorrhoid, which contains a blood clot, causes the most sudden and severe pain. The intense pain generally peaks and begins to subside within the first two to three days. However, the clot and the associated swelling can take two to three weeks or even longer to completely resolve. If symptoms persist beyond a week of dedicated self-care, the hemorrhoid should be evaluated by a healthcare provider.
Home Remedies for Symptom Relief
Immediate management focuses on reducing inflammation and easing the symptoms while the body heals the swollen tissue. Dietary and hydration changes are foundational because they address the primary cause: hard stools and straining. Ingesting adequate fiber, approximately 25 to 30 grams daily, adds bulk to the stool, and drinking plenty of water ensures this fiber absorbs moisture effectively.
This creates softer, easier-to-pass stools, which reduces the shearing action on the anal lining and minimizes pressure on the hemorrhoidal veins. Proper bathroom habits are also important, including avoiding prolonged sitting on the toilet and refusing to strain during a bowel movement. The goal is to facilitate passage without undue force that could worsen the swelling.
Sitz baths, which involve sitting in a few inches of warm water for 10 to 15 minutes, are a highly effective treatment for pain relief. The warmth increases blood flow to the affected area, promoting healing, and helps relax the anal sphincter muscle. This relaxation reduces painful spasms and pressure on the swollen veins.
Over-the-counter topical treatments also provide targeted relief. Astringents like witch hazel work by tightening and drying the tissue, which helps to reduce itching and irritation. Low-dose hydrocortisone creams, a type of topical steroid, work as an anti-inflammatory agent, directly reducing swelling and pain.
Warning Signs Requiring a Doctor’s Visit
While many hemorrhoid flare-ups can be managed at home, certain symptoms indicate a need for professional medical evaluation. Severe, unrelenting pain is a warning sign, often suggesting a thrombosed hemorrhoid that may require a minor procedure. Any significant or persistent rectal bleeding should prompt a doctor’s visit to rule out other, more serious gastrointestinal conditions.
It is concerning if the bleeding is heavy, or if it is accompanied by signs of blood loss, such as dizziness, lightheadedness, or fainting. Symptoms that fail to improve after seven days of diligent home treatment suggest that the hemorrhoid is not a simple, acute case and may require a medical procedure. Signs of infection, including a fever, chills, or increased swelling and redness around the anal area, also necessitate urgent care.
A prolapsed hemorrhoid that remains outside the anus and cannot be gently pushed back inside requires professional attention. Consulting a doctor confirms the diagnosis, ensuring that the appropriate treatment is initiated.
Medical Interventions and Procedures
If conservative measures are unsuccessful or if the hemorrhoid is more severe, a doctor may recommend one of several office-based treatments.
Rubber Band Ligation (RBL)
Rubber band ligation (RBL) is a common procedure for internal hemorrhoids where a small rubber band is placed around the base of the hemorrhoid. This action cuts off the blood supply to the tissue, causing the hemorrhoid to wither, shrink, and eventually fall off within about a week.
Sclerotherapy
Sclerotherapy involves injecting a chemical solution, known as a sclerosant, into the tissue around the hemorrhoid. This solution irritates the vessel walls, causing scarring and inflammation that closes off the blood vessel, leading to the hemorrhoid shrinking over the following weeks. This technique is often used for smaller, bleeding internal hemorrhoids and is usually painless.
Infrared Coagulation (IRC)
Infrared coagulation (IRC) uses a specialized probe to deliver a short burst of infrared light to the base of the internal hemorrhoid. The heat from the light coagulates the blood vessels, cutting off the blood supply. This process causes the hemorrhoid to scar and shrink, which helps anchor the surrounding tissue and prevents further prolapse.
Surgical Hemorrhoidectomy
For large, severe, or recurrent hemorrhoids, a surgical hemorrhoidectomy may be necessary. This procedure involves the physical removal of the hemorrhoidal tissue and is typically reserved for Grade 3 or Grade 4 hemorrhoids. Recovery from a hemorrhoidectomy is more extensive, often involving two to four weeks of pain, though most patients can return to normal activities within one to two weeks.