Most hemorrhoids resolve without surgery. Increasing your fiber intake alone reduces persistent symptoms by 53% compared to doing nothing, and with consistent home care, symptoms often clear up within a week. Surgery is typically reserved for the most advanced cases or hemorrhoids that keep coming back despite other treatments. For the majority of people, a combination of dietary changes, topical treatments, and simple habit adjustments is enough.
Start With Fiber and Fluids
The single most effective thing you can do for hemorrhoids is soften your stools so they pass without straining. That means fiber. Current dietary guidelines recommend 14 grams of fiber per 1,000 calories you eat, which works out to about 28 grams a day on a standard 2,000-calorie diet. Most people fall well short of that number.
You can get there through food (beans, whole grains, fruits, vegetables, nuts) or through a fiber supplement like psyllium husk. A Cochrane review of roughly 380 patients found that increasing fiber intake significantly reduces both bleeding and prolapse. Pair it with plenty of water, since fiber without adequate fluids can make constipation worse. This isn’t a quick fix you try for a day or two. Consistent daily fiber intake is what makes the difference, and it also helps prevent future flare-ups.
Sitz Baths for Pain and Swelling
A sitz bath is exactly what it sounds like: sitting in a few inches of warm water to soak the affected area. Fill a bathtub or use a basin that fits over your toilet seat. Keep the water around 104°F (40°C), soak for 15 to 20 minutes, and repeat three to four times a day when symptoms are active. The warm water improves blood flow to the area and relaxes the muscles around the anus, which eases pain, itching, and swelling. Pat dry gently afterward rather than rubbing.
Over-the-Counter Creams and Suppositories
Topical treatments won’t cure hemorrhoids, but they can make a noticeable difference in day-to-day comfort. The two most common active ingredients work in different ways.
Phenylephrine (0.25%) is a vasoconstrictor. It narrows blood vessels in the area, which reduces swelling and relieves pain and itching. It’s available as both a cream and a suppository, and you can use it up to four times daily, especially after bowel movements.
Hydrocortisone (1%) is a mild steroid that dials down inflammation. It’s effective for itching, swelling, and irritation, but it shouldn’t be used for more than seven days at a stretch. Prolonged use can thin the skin and actually make things worse. If you’re still having symptoms after a week of these treatments, that’s a signal to talk to your doctor rather than keep applying cream.
Oral Flavonoid Supplements
Flavonoid supplements, sometimes sold under names like diosmin or hesperidin, strengthen blood vessel walls and reduce inflammation in hemorrhoidal tissue. Clinical guidelines now suggest them as an option for reducing bleeding, itching, and discharge. In one study, 80% of patients taking a flavonoid supplement had their bleeding stop within three days, and over 90% saw it resolve within a week. Pain scores on a 10-point scale dropped from around 5 to 2 over the same period. These supplements are available without a prescription in most countries and are generally well tolerated.
Change How You Use the Toilet
Two bathroom habits make hemorrhoids significantly worse: straining during bowel movements and sitting on the toilet for extended periods. Both increase pressure on the veins around the anus. Put the phone down, and if nothing is happening after a few minutes, get up and come back later.
Your body position matters too. On a standard toilet, the angle between your rectum and anal canal sits around 80 to 90 degrees, which means your body has to work harder to push stool through. Using a small footstool to elevate your feet opens that angle to about 100 to 110 degrees, straightening the passage. Research consistently shows this reduces straining. In one study, using a footstool cut the average time to complete a bowel movement roughly in half (about 56 seconds versus 113 seconds) and participants reported noticeably less effort. A $15 stool in front of your toilet is one of the simplest changes you can make.
Office Procedures That Don’t Require Surgery
If home treatment hasn’t worked after a week or two, several in-office procedures can treat hemorrhoids without a trip to the operating room. These are typically done in a doctor’s office with little to no anesthesia and minimal downtime.
Rubber Band Ligation
This is the most common office-based procedure. Your 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. It’s the most effective non-surgical option in terms of long-term results, meaning fewer patients need additional treatments afterward. The trade-off is that it can cause moderate pain for a day or two. For grade III hemorrhoids (those that prolapse and need to be pushed back in), recurrence rates are higher than with surgery, around 48% over 12 months compared to about 6% with a surgical approach. But many people prefer trying banding first and repeating it if needed rather than jumping straight to an operation.
Infrared Coagulation
A device applies brief pulses of infrared light to the hemorrhoid, causing the tissue to scar and shrink. It works about as well as rubber band ligation in the short term, with similar rates of symptom relief at 12 months. The key advantage is less pain and fewer complications. When all factors are weighed, some specialists consider it the best overall non-surgical option, particularly for smaller hemorrhoids.
Injection Sclerotherapy
A chemical solution is injected directly into the hemorrhoid, triggering inflammation that causes it to shrivel. It’s quick, generally painless, and works well for bleeding hemorrhoids. It’s less durable than banding, so recurrence is more likely, but it’s a reasonable first step for mild to moderate symptoms.
When Surgery Becomes the Better Option
Conservative and office-based treatments work well for grade I and II hemorrhoids (those that bleed but don’t prolapse, or prolapse but retract on their own). Grade III hemorrhoids that must be manually pushed back in can sometimes be managed with rubber band ligation, though the recurrence rate is substantial. Grade IV hemorrhoids, which prolapse and can’t be pushed back, almost always require surgical removal. The same goes for any grade that keeps coming back despite repeated non-surgical treatment.
Rectal bleeding can also be a symptom of other conditions, including colorectal cancer. If your bleeding doesn’t stop with treatment, if you notice a change in stool shape or bowel habits, or if you’re over 45 and haven’t had a screening colonoscopy, those are reasons to get evaluated rather than continuing to self-treat at home.