Hemorrhoids are swollen veins that develop inside or outside the rectum, causing pain, itching, or bleeding. People can treat hemorrhoids at home and ease symptoms using oral or topical medications.
Home treatment usually helps to resolve a person’s hemorrhoids. However, surgery may be an option in severe cases.
This article discusses the different treatment options for hemorrhoids and their associated side effects and risks. It also considers the outlook for people living with hemorrhoids.
- following a high fiber diet that is rich in whole fruits and vegetables
- avoiding processed foods that tend to be low in fiber and nutritional value
- taking fiber supplements, such as psyllium
- avoiding straining during bowel movements
- avoiding sitting on the toilet for a long time
According to the University of California San Francisco, foods rich in fiber can soften the stools and lead to regular bowel movements. It is important to note that a person should drink plenty of water when increasing their fiber intake. Fiber draws water into the bowel, so adequate water intake is necessary to prevent dehydration.
A doctor or pharmacist may recommend taking an over-the-counter (OTC) nonsteroidal anti-inflammatory drug (NSAID) to relieve hemorrhoid pain. These medications also help alleviate inflammation and swelling. Examples include:
Possible side effects
The United Kingdom’s National Health Service (NHS) notes that NSAIDs can cause the following side effects:
Factors that can increase the risk of side effects include:
- taking prolonged high doses of NSAIDs
- being older
- having a chronic underlying health condition
Although rare, NSAIDs can also cause issues with the liver, kidneys, or circulatory system. A
A person can ask their pharmacist for an OTC cream or ointment to help treat and soothe hemorrhoids. Examples include:
- Anesthetic: Topical anesthetic creams provide an instant numbing effect when a person applies them to the skin. Examples include lidocaine-based cream (LMX5 or Recticare) and dibucaine (Nupercainal).
- Hydrocortisone: This cream contains 1% hydrocortisone, a corticosteroid that helps to relieve swelling and itching. People can apply the cream up to four times per day, ideally at the same times each day.
- Glyceryl trinitrate: This ointment widens blood vessels around the anal area to help improve blood circulation. People typically use this to help treat pain from anal fissures, which are small tears in the lining of the anus. People may also use the ointment to alleviate pain from acute hemorrhoid inflammation or hemorrhoid surgery.
- Petroleum jelly: People can apply petroleum jelly to their anal area to reduce itching. The American Academy of Dermatology Association (AAD) explains that petroleum jelly helps with the following:
- keeping the skin moist
- assisting scar healing
- preventing further skin damage or tears
Possible side effects
Below are some potential side effects of the above creams and ointments.
Common side effects of lidocaine skin cream include itching or tingling on the application site. The skin may also appear paler than usual, with redness or mild swelling.
A person should speak with a doctor or pharmacist if the side effect does not disappear.
People should consult a doctor if they develop one or more of the following side effects when using hydrocortisone cream:
- white or red bumps
- unwanted hair growth
Glyceryl trinitrate ointments
According to a 2021 study, headaches are the most common side effect of glyceryl trinitrate ointments, affecting around
Anyone who experiences headaches after using a glyceryl trinitrate ointment should consider reducing the dose for several days. The NHS advises applying a pea-sized amount of ointment five or six times per day rather than a larger amount twice per day.
Petroleum jelly is an emollient, meaning it creates a physical barrier on the skin that helps trap moisture.
Some people may experience one or more of the following side effects when using emollients:
- a burning or stinging sensation that persists for several days
- folliculitis, which is the medical term for blocked or inflamed hair follicles
- boils resulting from folliculitis
Healthcare professionals may recommend in-office procedures to treat larger hemorrhoids. These usually take place in a hospital or a surgeon’s office.
Examples of in-office procedures include:
- Rubber band ligation (RBL): This involves tying a rubber band around the hemorrhoid. Doing so prevents blood flow to the hemorrhoid, causing it to shrink. Treatment consists of 2–4 sessions across 6–8 weeks.
- Sclerotherapy: This involves injecting a hardening agent into the hemorrhoid to destroy its blood vessels. The lack of blood supply then causes the hemorrhoid to shrink.
- Infrared coagulation: This involves using a small probe to deliver infrared light to the blood vessels supplying the hemorrhoid. The light damages the vessels, causing the hemorrhoid to shrink and recede.
Possible side effects
Below are some potential side effects of the above in-office procedures.
Rubber band ligation
Complications from RBL are rare. However, some people may experience the following:
- a feeling of tightness
- mild pain
According to a 2019 study, people who undergo sclerotherapy may experience the following:
- an increased risk of infection
Surgery may be necessary for people with chronic painful hemorrhoids that do not respond to home remedies, OTC medications, or in-office procedures.
- Hemorrhoidectomy: Doctors usually recommend this surgery for individuals with protruding or internal hemorrhoids that persist despite RBL. Hemorrhoidectomy involves surgically removing the hemorrhoid with a scalpel.
- Hemorrhoid stapling: This surgery may be an appropriate option for people with anal bleeding or prolapsed internal hemorrhoids. It involves using a stapling device to remove an internal hemorrhoid or staple a prolapsing hemorrhoid back inside the anus.
Possible side effects and risks
A person should seek immediate medical care if they experience any of the following symptoms after hemorrhoid surgery:
- increased pain or swelling in the area
- increased warmth or redness in the area
- red streaks leading from the area
- pus drainage from the surgical site
- inability to pass stools or gas
- signs of deep vein thrombosis, such as:
- pain in the calf, back of the knee, thigh, or groin
- redness and swelling in the leg or groin
In many cases, hemorrhoids will resolve following appropriate home care. If hemorrhoids persist, a person should contact their doctor for further advice.
People who undergo surgical treatment for hemorrhoids should follow the doctor’s instructions regarding postsurgical care. These may include:
- drinking plenty of water
- following a high fiber diet
- taking pain medications
- blood clots
A person should inform a doctor if symptoms worsen or if they notice blood in their stool.
Hemorrhoids are swollen veins that develop inside or outside of the rectum. Symptoms may include pain, itching, or bleeding from the anus.
The treatment for hemorrhoids depends on the type and severity. Conservative treatment options include dietary changes, OTC medications, and in-office procedures. Surgery may be necessary for severe hemorrhoids that do not respond to conservative treatment.
In most cases, hemorrhoids resolve with appropriate home treatment. When surgery is necessary, the results are typically long lasting. A person can talk with a doctor regarding suitable treatment options.