Most hemorrhoid flare-ups respond well to simple home treatments, and symptoms typically disappear within a few days. The key is reducing swelling, keeping stools soft, and avoiding anything that increases pressure on the area. Here’s what works.
Start With a Warm Sitz Bath
Soaking in warm water is one of the fastest ways to ease pain, itching, and swelling. Fill your bathtub or a plastic sitz basin (available at most pharmacies) with 3 to 4 inches of warm water, around 104°F (40°C). Sit in it for 15 to 20 minutes. You can do this three to four times a day during an active flare-up. Plain warm water is all you need. Pat the area dry gently afterward rather than rubbing.
Choose the Right Over-the-Counter Products
Hemorrhoid creams and suppositories contain different active ingredients that do different things, so it helps to know what you’re reaching for. Products with hydrocortisone reduce inflammation and itching. Creams containing phenylephrine temporarily shrink swollen tissue by constricting blood vessels. Products with a local anesthetic like pramoxine numb the area to relieve pain, soreness, and burning. Witch hazel pads cool and soothe irritated skin.
You can combine approaches. For example, use a numbing cream before a bowel movement and witch hazel pads for cleanup afterward. Hydrocortisone products shouldn’t be used for more than about a week at a time, as prolonged use can thin the skin.
For pain that the topical products don’t cover, acetaminophen or ibuprofen can help. Ibuprofen has the added benefit of reducing inflammation.
Soften Your Stools Immediately
Straining during bowel movements is what makes flare-ups worse and what likely triggered this one. Softening your stools takes the pressure off. The fastest way to do this is to dramatically increase your water intake and add fiber-rich foods to every meal. The general recommendation is about 28 grams of fiber per day for someone eating a 2,000-calorie diet. Good sources include beans, lentils, berries, broccoli, oats, and whole wheat bread. Add fiber gradually over several days, because jumping from a low-fiber diet to a high-fiber one all at once can cause gas and bloating.
A fiber supplement with psyllium husk can bridge the gap while you adjust your diet. If your stools are already hard and you need relief now, an over-the-counter stool softener can help in the short term, though research suggests the effect is modest.
Change How You Sit on the Toilet
Your posture on the toilet matters more than you might think. When you sit in a standard position, the muscle that wraps around your rectum creates a natural kink that makes evacuation harder. Raising your knees above your hips straightens that angle from roughly 80 degrees to 100 or 110 degrees, which lets stool pass with less effort.
A simple footstool in front of the toilet does the job. One study found that using a footstool cut the average time to complete a bowel movement nearly in half (about 56 seconds versus 113 seconds sitting normally) and roughly halved the amount of straining participants reported. If you don’t have a footstool, leaning your upper body forward and resting your elbows on your knees (sometimes called “The Thinker” position) can produce a similar effect.
Two other toilet habits to adopt during a flare-up: don’t sit on the toilet longer than necessary (scrolling your phone while sitting adds constant pressure to hemorrhoidal tissue), and go when you first feel the urge rather than holding it, which can make stool harder and more difficult to pass.
How Long a Flare-Up Typically Lasts
With consistent home treatment, most flare-ups involving swelling, irritation, and mild discomfort clear up within a few days. If a blood clot has formed inside an external hemorrhoid (a thrombosed hemorrhoid, which feels like a firm, painful lump), the pain is usually worst in the first 48 to 72 hours and then gradually improves over days to weeks as the clot is reabsorbed.
If you’re in severe pain from a thrombosed hemorrhoid within the first day or two, a doctor can perform a quick in-office procedure to remove the clot. This provides almost immediate relief. After that initial window, the clot is already starting to resolve on its own, so the procedure becomes less beneficial.
When Home Treatment Isn’t Enough
If your flare-ups keep returning or don’t respond to home care after a week or two, there are minimally invasive office procedures that can address the underlying problem. The most common is rubber band ligation, where a small band is placed around the base of an internal hemorrhoid to cut off its blood supply. It’s done in a doctor’s office without anesthesia and takes just a few minutes. Pooled data across multiple studies show it controls prolapse in about 93% of cases and bleeding in about 89%. About one in four people experience some pain afterward, and any post-procedure bleeding typically happens 10 to 14 days later as the tissue separates.
Injection-based treatment (sclerotherapy) is another option, though it’s generally less effective, with symptom control around 62% compared to 78% for banding. Patient satisfaction rates reflect the difference: roughly 78% for banding versus 47% for sclerotherapy. Recurrence rates at three months are similar, around 10 to 15% for both.
Surgical removal is reserved for large or severe hemorrhoids that don’t respond to these less invasive approaches.
Habits That Prevent the Next Flare-Up
Once you’ve gotten through the acute phase, the same strategies that helped you heal are the ones that keep flare-ups from coming back. Keep fiber intake consistently high rather than only reaching for it during a crisis. Stay well hydrated. Use the footstool every time. Avoid sitting for prolonged stretches, whether on the toilet or at a desk, and build in movement throughout your day. Regular physical activity keeps your digestive system moving, which keeps stools soft and reduces the need to strain.
If you notice rectal bleeding that’s darker in color, bleeding that doesn’t stop, or a significant change in your bowel habits alongside hemorrhoid symptoms, those warrant a medical evaluation to rule out other conditions.