Most hemorrhoid flare-ups go away within a week when you combine a few straightforward home treatments: more fiber, more water, warm soaks, and less time straining on the toilet. The key is reducing pressure on the swollen veins in your anal canal while giving the tissue time to heal. For hemorrhoids that don’t respond to these measures, office procedures and surgery offer highly effective options.
Fiber and Water: The Foundation
The single most important change you can make is eating more fiber. Fiber softens your stool and adds bulk, which means less straining during bowel movements. That reduction in straining takes pressure off the swollen veins and lets them shrink. The 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.
Good sources include beans, lentils, whole grains, fruits with skin, vegetables, and psyllium husk supplements. If your current fiber intake is low, increase it gradually over a week or two to avoid bloating and gas.
Fiber works significantly better when paired with enough water. A study on adults with chronic constipation found that those who combined 25 grams of daily fiber with 1.5 to 2 liters of fluid saw meaningfully greater improvements in stool frequency compared to those eating the same amount of fiber but drinking only about a liter a day. Aim for at least 1.5 to 2 liters of water daily, more if you’re active or in a warm climate.
Sitz Baths and Topical Treatments
A sitz bath is simply sitting in a few inches of warm water. You can buy a shallow basin that fits over your toilet seat or just use a clean bathtub. Soak for about 10 minutes, twice a day. Plain warm water is all you need; there’s no evidence that adding salts, baking soda, or other products improves results. The warmth increases blood flow to the area, relaxes the surrounding muscles, and eases itching, burning, and aching. For thrombosed hemorrhoids (the hard, painful type caused by a blood clot), sitz baths are especially helpful.
Over-the-counter creams and suppositories can provide additional relief. Products containing phenylephrine work by constricting the blood vessels in hemorrhoidal tissue, which temporarily reduces swelling and discomfort. Hydrocortisone creams calm inflammation by suppressing the immune response in the tissue, reducing itching and irritation. These products treat symptoms rather than the underlying cause, and hydrocortisone creams shouldn’t be used for more than about a week at a time, since prolonged use can thin the skin.
Toilet Habits That Speed Healing
How you use the toilet matters more than most people realize. Sitting on the toilet for extended periods is a recognized risk factor for hemorrhoids. When you sit there hunched over, especially scrolling your phone, you change the angle between your rectum and anus in a way that increases pressure on the veins. One survey found that 35% of people who use their phones on the toilet spend more than five minutes sitting there. Get in, do what you need to do, and get out.
Straining to push out a hard stool is one of the most common triggers for flare-ups. If you’re not ready to go, stand up and come back later. A toilet stool that elevates your feet (like a Squatty Potty) can help by straightening the angle between your rectum and anus, mimicking a natural squatting position. This makes bowel movements easier and reduces the amount of pressure on rectal veins.
Exercise: What Helps and What Hurts
Regular physical activity improves circulation and supports digestion, both of which help prevent and manage hemorrhoids. The best options are low-impact exercises. Walking boosts blood flow and keeps your digestive system moving. Swimming increases circulation and is gentle on the pelvic floor, though you should avoid it during a flare-up if you have active bleeding or severe pain. Yoga and other flexibility work can also help.
On the other hand, certain exercises build up intra-abdominal pressure and force more blood into the swollen veins in the anal canal, making things worse. Activities to avoid during a flare-up include heavy weight lifting, cycling, rowing, sit-ups, and squats. Once your symptoms resolve, you can reintroduce these gradually, but pay attention to how your body responds.
How Long Hemorrhoids Take to Heal
With consistent home treatment, hemorrhoid symptoms often resolve within a week. That means keeping up with the fiber, the water, the sitz baths, and the toilet habit changes simultaneously, not just trying one at a time. If you haven’t seen improvement after a week of home care, it’s time for a professional evaluation. Some hemorrhoids, particularly thrombosed external ones, can take two to three weeks to fully resolve on their own even with good home care, but the pain typically peaks in the first 48 to 72 hours and then steadily improves.
Office Procedures for Stubborn Hemorrhoids
When home treatments aren’t enough, several in-office procedures can eliminate hemorrhoids without full surgery. These are typically used for internal hemorrhoids that bleed or prolapse (bulge out during a bowel movement).
Rubber band ligation is the most common and effective office-based option. A small rubber band is placed around the base of the hemorrhoid, cutting off its blood supply. The tissue shrinks and falls off within a few days. In clinical studies, this approach controlled bleeding in 98% of patients and reduced prolapse in about 83%. Recurrence rates are low: roughly 3 to 4% at one year and 13 to 17% at five years. Compared to other in-office options like injection therapy and infrared coagulation, rubber band ligation is more effective and less likely to require follow-up treatment, though it can cause more discomfort in the short term.
Infrared coagulation uses focused infrared energy to create scar tissue at the base of the hemorrhoid. The scarring cuts off blood flow and anchors the tissue in place so it stops bulging. It’s less painful than banding but also somewhat less effective, particularly for larger hemorrhoids. Sclerotherapy involves injecting a chemical solution into the hemorrhoid to shrink it. Both of these are better suited for smaller, earlier-stage hemorrhoids.
When Surgery Becomes Necessary
Hemorrhoids are graded on a four-point scale based on how much they prolapse. Grade I hemorrhoids are swollen but stay inside the anal canal. Grade II hemorrhoids bulge out during a bowel movement but pull back in on their own. Grade III hemorrhoids prolapse and need to be pushed back in manually. Grade IV hemorrhoids are permanently prolapsed and can’t be pushed back in at all.
Surgical removal (hemorrhoidectomy) is reserved for large grade III and IV hemorrhoids, cases where non-surgical treatments have failed, hemorrhoids with a significant external component, and situations where internal hemorrhoids become trapped and cut off from blood supply. It remains the most effective treatment for advanced hemorrhoidal disease, though it involves a longer and more uncomfortable recovery than office-based procedures. Most people never reach this point. The vast majority of hemorrhoids respond to the combination of dietary changes, better toilet habits, and, if needed, one of the office procedures described above.