Most hemorrhoids can be treated at home with a combination of dietary changes, warm soaks, and over-the-counter remedies. The American Society of Colon and Rectal Surgeons lists dietary and behavioral changes as the primary first-line therapy, and many people see improvement within a week. For hemorrhoids that persist or worsen, office-based procedures and surgery offer more definitive solutions.
Start With Fiber and Hydration
The single most effective long-term strategy for hemorrhoids is softening your stool so it passes without straining. That means fiber. The recommended daily intake is about 14 grams per 1,000 calories you eat, which works out to roughly 28 grams a day on a standard 2,000-calorie diet. Most people fall well short of that number.
Good sources include beans, lentils, whole grains, berries, broccoli, and pears. If you can’t hit your target through food alone, a fiber supplement works too, but increase your intake gradually over a week or two. Adding too much fiber at once causes gas and bloating. Pair the fiber with plenty of water and other liquids like fruit juice or clear soups, which help the fiber do its job.
Sitz Baths for Quick Relief
A sitz bath is one of the simplest ways to reduce pain, itching, and swelling. Fill your bathtub or a basin that fits over your toilet seat with a few inches of warm water, around 104°F (40°C). Soak the area for 15 to 20 minutes. You can do this three to four times a day when symptoms are active. Pat the area dry afterward rather than rubbing. Many people notice meaningful relief within the first day or two of consistent soaking.
Over-the-Counter Topical Treatments
Several products at the pharmacy can help manage discomfort while your hemorrhoids heal. Witch hazel wipes or pads work as a natural astringent, meaning they tighten and shrink swollen tissue. You apply them directly to the outside of the affected area. Hydrocortisone creams reduce inflammation and itching, though they shouldn’t be used for more than a week at a time because they can thin the skin. Numbing agents containing lidocaine or pramoxine provide temporary pain relief.
These treatments manage symptoms rather than eliminating the hemorrhoid itself. They’re most useful as a bridge while dietary and behavioral changes take effect.
Change Your Bathroom Habits
How you use the toilet matters as much as what you eat. Straining during bowel movements is one of the primary forces that causes hemorrhoids to swell, so the goal is to make every trip as effortless as possible.
Go when you feel the urge rather than waiting. Sitting on the toilet for long stretches, including scrolling your phone, increases pressure on the rectal veins. Limit yourself to a few minutes. If nothing happens, get up and come back later.
A footstool placed under your feet while you sit on the toilet can also help. Raising your knees toward a squatting position relaxes the muscle that normally kinks around the rectum, straightens the pathway, and allows the colon to empty more completely with less straining. This is the principle behind products like the Squatty Potty, but any sturdy stool about 6 to 9 inches high works.
When Home Treatment Isn’t Enough
If your hemorrhoids haven’t improved after a week of consistent home care, or if they keep coming back, it’s time to talk to a doctor. Several office-based procedures can resolve hemorrhoids that don’t respond to conservative measures.
Rubber Band Ligation
This is the most common in-office procedure for internal hemorrhoids. A doctor places a small rubber band around the base of the hemorrhoid, cutting off its blood supply. The tissue shrivels and falls off on its own, usually within about a week. Studies find it’s effective 70% to 80% of the time. You can typically return to normal activities the same day, though you should avoid heavy lifting for at least two weeks. Some people experience mild pressure or discomfort for a day or two afterward.
Other Office Procedures
Infrared coagulation uses heat to shrink internal hemorrhoids, and sclerotherapy involves injecting a chemical solution that causes the tissue to collapse. Both are less invasive alternatives to banding, though they tend to have slightly lower success rates and may require repeat treatments.
Surgery for Severe Hemorrhoids
Most people never need surgery. A hemorrhoidectomy is reserved for hemorrhoids that are more complicated than average: those that have prolapsed and won’t stay inside the anal canal, hemorrhoids where the blood supply has been pinched off (strangulation), or hemorrhoids where the blood inside has clotted (thrombosis).
Doctors classify internal hemorrhoids by grade. Grade II hemorrhoids briefly emerge during a bowel movement and then retract on their own. Grade III hemorrhoids come out and need to be pushed back in manually. Grade IV hemorrhoids stay outside permanently. Grades III and IV are the ones most likely to require surgical removal, especially if they cause ongoing bleeding or pain.
Recovery from a hemorrhoidectomy is more significant than from office procedures. The most intense pain typically comes with your first bowel movement after surgery, then starts improving after about three days and continues to get better over the following two weeks. The payoff is that surgery resolves hemorrhoids more definitively than any other approach.
Preventing Hemorrhoids From Returning
Getting rid of a hemorrhoid is only half the challenge. The same habits that caused the first one will cause another if nothing changes. A high-fiber diet with adequate fluids is the foundation of prevention, just as it is for treatment. Regular physical activity helps keep your digestive system moving. Avoid sitting for extended periods, whether on the toilet or at a desk, and take standing or walking breaks throughout the day.
If you lift heavy weights at the gym, use proper breathing technique and avoid holding your breath, which spikes abdominal pressure. The same applies to heavy lifting at work or home.
Rectal Bleeding Isn’t Always Hemorrhoids
Small amounts of bright red blood on toilet paper or in the bowl are the hallmark of hemorrhoids, but rectal bleeding can also signal other conditions, including colorectal or anal cancer. If your bleeding is accompanied by changes in bowel habits, changes in stool color or consistency, or if it doesn’t improve with a week of home care, get it evaluated. Large amounts of rectal bleeding, lightheadedness, dizziness, or faintness call for emergency care.