About half of all adults will deal with hemorrhoids by age 50, and most flare-ups can be managed at home with a few straightforward changes. Small hemorrhoids often clear up on their own within a few days. Larger or more persistent ones may take a week or longer, but the combination of better bathroom habits, dietary adjustments, and targeted relief measures can speed things along and prevent them from coming back.
Know What You’re Dealing With
Hemorrhoids fall into two main categories depending on where they form. Internal hemorrhoids sit inside the rectum, where you typically can’t see or feel them. The most common sign is painless bleeding: small amounts of bright red blood on toilet paper or in the bowl. Sometimes an internal hemorrhoid pushes through the anal opening (a prolapsed hemorrhoid), which can cause pain and irritation.
External hemorrhoids form under the skin around the anus. These are the ones you can feel, and they tend to cause itching, swelling, and discomfort. If blood pools inside an external hemorrhoid and forms a clot, called a thrombosed hemorrhoid, the pain can become severe. You’ll notice a hard, discolored lump near the anus along with significant swelling.
Start With Sitz Baths
A sitz bath is one of the simplest and most effective first steps. Fill a basin or your bathtub with a few inches of warm water and sit in it for about 10 minutes. Clinical studies typically have patients do this twice daily plus after each bowel movement. The warm water increases blood flow to the area, relaxes the muscles around the anus, and reduces swelling. You can add chamomile or witch hazel to the water if you like, though plain warm water works well on its own.
Pat the area dry gently afterward rather than rubbing. Keeping the skin clean and dry between baths helps prevent additional irritation.
Fix Your Fiber Intake
Straining during bowel movements is one of the primary causes of hemorrhoids and the main reason they keep flaring up. The single most impactful change you can make is getting enough fiber. The general targets are 25 grams per day for women and 38 grams per day for men, and most people fall well short of that.
Fiber works by binding water to form a softer, bulkier stool that passes more easily. A meta-analysis in The American Journal of Gastroenterology found that people who supplemented with psyllium fiber had a 50% lower risk of bleeding from hemorrhoid symptoms compared to those who didn’t. Psyllium (sold as Metamucil and similar products) is one of the most studied options, but methylcellulose supplements work on the same principle. If you’re not used to much fiber, increase your intake gradually over a week or two to avoid gas and bloating, and drink plenty of water alongside it.
Good food sources include beans, lentils, oats, berries, broccoli, and whole grains. Spreading fiber-rich foods across your meals is easier on your digestive system than loading it all into one sitting.
Change How You Sit on the Toilet
Your posture on the toilet has a real effect on how hard you have to strain. When you sit on a standard toilet, the angle between your rectum and anal canal is roughly 80 to 90 degrees, which creates a partial kink. In a squatting position, that angle opens to about 100 to 110 degrees, straightening the path and allowing stool to pass with less effort. Research comparing the two positions consistently finds that squatting requires less abdominal pressure and leads to more complete bowel evacuation.
You don’t need to replace your toilet. A small footstool (6 to 9 inches tall) placed in front of the toilet lets you raise your knees above your hips, mimicking a squat. This one change can noticeably reduce straining. Also, avoid sitting on the toilet longer than necessary. Scrolling your phone for 15 minutes while bearing down on the seat puts sustained pressure on the veins around the anus.
Over-the-Counter Relief Options
Several products can help manage symptoms while your hemorrhoids heal. Witch hazel pads or liquid, applied directly to the area, act as a mild astringent that can reduce itching and swelling. Zinc-based creams and ointments create a protective barrier on irritated skin. Aloe vera can soothe the area as well.
For more significant inflammation, steroid creams containing hydrocortisone bring down swelling quickly. However, these should only be used for short stretches, typically no more than a week at a time. Prolonged use can thin the skin and make the problem worse. Pain relievers like ibuprofen can help with discomfort and inflammation during a flare-up.
When Home Care Isn’t Enough
If your symptoms haven’t improved after about a week of consistent home treatment, it’s worth getting evaluated. Persistent or worsening hemorrhoids may need a procedure.
The most common in-office treatment is rubber band ligation, where a small band is placed around the base of an internal hemorrhoid to cut off its blood supply. The hemorrhoid shrivels and falls off within about a week. Studies find this procedure is 70% to 80% effective, and most people return to normal activities the same day or within a day or two. It’s done without general anesthesia and is far less involved than surgical removal.
Other office-based options include treatments that use heat or chemical solutions to shrink the hemorrhoid tissue. Surgery is reserved for large or severe cases that haven’t responded to less invasive approaches.
Preventing Future Flare-Ups
Once you’ve had hemorrhoids, you’re more likely to get them again. Prevention comes down to keeping your stools soft and avoiding pressure on the veins around your anus. The fiber and hydration changes described above are the foundation. Beyond that, a few habits make a measurable difference:
- Go when you feel the urge. Delaying bowel movements lets stool dry out and harden, forcing you to strain more later.
- Stay active. Regular movement helps keep your digestive system functioning and reduces the time stool sits in the colon absorbing water.
- Avoid prolonged sitting. If your job keeps you in a chair, stand and move around periodically. Sitting for hours puts continuous pressure on the rectal veins.
- Don’t strain or hold your breath. If a bowel movement isn’t coming easily, get up and try again later rather than pushing through it.
Bleeding That Needs Attention
Bright red blood on the toilet paper after a bowel movement is the hallmark of hemorrhoids, but rectal bleeding can also signal other conditions. Heavy bleeding, large blood clots in your stool, or dark/black stool (which can indicate bleeding higher up in the digestive tract, such as a stomach ulcer) all warrant prompt medical evaluation. The same goes for rectal bleeding accompanied by unexplained weight loss or a change in bowel habits that persists for weeks. These symptoms don’t necessarily mean something serious is wrong, but they need to be checked to rule out conditions like colorectal polyps or cancer.