Most hemorrhoids improve within a week using simple at-home measures: warm soaks, over-the-counter creams, more fiber, and better bathroom habits. About half of all adults develop hemorrhoids by age 50, so this is one of the most common health issues people deal with. The good news is that the vast majority of cases resolve without medical procedures.
Know What You’re Dealing With
Hemorrhoids are swollen veins in and around the anus and lower rectum. There are two types, and they feel quite different. Internal hemorrhoids sit inside the rectum where you can’t see or feel them. Their main calling card is painless bleeding, usually bright red blood on toilet paper or in the bowl. Sometimes an internal hemorrhoid pushes out through the anal opening (called prolapse), which causes pain and irritation.
External hemorrhoids form under the skin around the anus. These are the ones you can feel. They cause itching, swelling, discomfort, and sometimes bleeding. If blood pools inside an external hemorrhoid and forms a clot, it becomes a thrombosed hemorrhoid, producing severe pain, swelling, and a hard, discolored lump you can see and feel near the anus.
Sitz Baths: Your Best First Move
A sitz bath is simply sitting in a few inches of warm water, and it’s one of the most effective things you can do for immediate relief. Fill a bathtub with just enough water to cover your hips, or use a plastic sitz bath basin that fits over your toilet seat. Aim for a water temperature around 104°F (40°C), warm but not hot enough to burn. Soak for 15 to 20 minutes at a time, up to three or four times a day if your symptoms are significant. The warm water increases blood flow to the area, relaxes the surrounding muscles, and reduces swelling.
Pat the area dry gently afterward rather than rubbing. You can follow up with an over-the-counter cream or ointment for additional relief.
Over-the-Counter Products That Help
Hemorrhoid creams and ointments work by targeting specific symptoms. Products containing phenylephrine (like Preparation H) shrink swollen blood vessels in the area, which reduces inflammation and swelling. Hydrocortisone creams calm itching and irritation. Witch hazel pads or wipes have a natural astringent effect that soothes the skin and reduces minor swelling.
These products are meant for short-term use. Hydrocortisone creams in particular can thin the skin if used for more than a week or so. If you’re still reaching for the cream after seven days with no improvement, it’s time to talk to a doctor rather than keep self-treating.
Eat More Fiber, Drink More Water
Fiber is the single most important long-term strategy for both treating and preventing hemorrhoids. It softens stool and adds bulk, which means less straining during bowel movements. Current dietary guidelines recommend 14 grams of fiber for every 1,000 calories you eat daily. For most adults, that works out to roughly 25 to 35 grams per day, and most people fall well short of that.
Good sources include beans, lentils, whole grains, fruits with skin, vegetables, and nuts. If your current diet is low in fiber, increase your intake gradually over a week or two to avoid bloating and gas. A fiber supplement can fill gaps, but whole foods are preferable because they bring other nutrients along. Pair the fiber with plenty of water. Fiber without adequate fluid can actually make constipation worse.
Fix Your Bathroom Habits
How you use the toilet matters more than most people realize. Sitting on the toilet for long stretches is a known risk factor for hemorrhoids because the position puts sustained pressure on the rectal veins. Leave your phone outside the bathroom. Go when you feel the urge, do what you need to do, and get up.
Straining is the other big problem. If you’re pushing hard to have a bowel movement, that’s a sign your stool is too firm (see the fiber section above) or your positioning isn’t ideal. A toilet stool that elevates your feet, like a Squatty Potty, straightens the angle between your rectum and anal canal. This mimics a squatting position, makes bowel movements easier, and reduces the pressure that aggravates hemorrhoids. Sitting upright rather than hunching forward also helps.
When Home Treatment Isn’t Enough
With consistent home care, hemorrhoid symptoms often resolve within a week. When they don’t, or when hemorrhoids keep coming back, doctors can offer in-office procedures that don’t require general anesthesia or a hospital visit.
Rubber band ligation is the most common option for internal hemorrhoids that bleed or prolapse. A doctor places a tiny rubber band around the base of the hemorrhoid, cutting off its blood supply. The hemorrhoid shrinks and falls off within about a week. The procedure is 70% to 80% effective, and recovery involves avoiding heavy lifting for two weeks, eating high-fiber foods, staying hydrated, and not straining on the toilet.
For thrombosed external hemorrhoids caught within 72 hours of when symptoms start, a doctor can make a small incision to remove the clot. This provides near-immediate relief from the intense pain.
When Surgery Becomes Necessary
Surgery is reserved for hemorrhoids that don’t respond to conservative treatment and office procedures. Large prolapsing hemorrhoids or those with a significant external component are the most common candidates for surgical removal. The general principle is straightforward: all patients start with diet changes and home remedies, move to office procedures if those fail, and consider surgery only as a last step.
Several surgical approaches exist, ranging from traditional excision to newer techniques that use staples or target the arteries feeding the hemorrhoid. Recovery from surgery takes longer than office procedures, typically two to four weeks before returning to normal activity, and the first few bowel movements after surgery can be uncomfortable. But for people with severe or recurring hemorrhoids that haven’t responded to anything else, surgery offers the most definitive results.
Signs That Need Medical Attention
Rectal bleeding is the symptom that causes the most anxiety, and while hemorrhoids are the most common cause, bleeding can also signal other conditions. Certain red flags warrant a full evaluation: unexplained weight loss, abdominal pain, fever, or signs of anemia like unusual fatigue or lightheadedness alongside rectal bleeding. Adults over 40 with rectal bleeding, or younger adults with a personal or family history of colorectal cancer or inflammatory bowel disease, should have a colonoscopy or similar evaluation.
Rare but serious complications of hemorrhoids include abscess, massive bleeding, and infection. If you develop a fever, notice dramatically increased bleeding, or experience pain that’s getting worse rather than better over several days, seek medical care promptly.