Treatment of Hemorrhoids

How can I treat my hemorrhoids?

You can most often treat your hemorrhoids at home by

• eating foods that are high in fiber
• taking a stool softener or a fiber supplement such as psyllium (Metamucil) or methylcellulose (Citrucel)
• drinking water or other nonalcoholic liquids each day as recommended by your health care professional
• not straining during bowel movements
• not sitting on the toilet for long periods of time
• taking over-the-counter pain relievers such as acetaminophen, ibuprofen, naproxen, or aspirin
• sitting in a tub of warm water, called a sitz bath, several times a day to help relieve pain

Applying over-the-counter hemorrhoid creams or ointments or using suppositories—a medicine you insert into your rectum—may relieve mild pain, swelling, and itching of external hemorrhoids. Most often, doctors recommend using over-the-counter products for 1 week. You should follow up with your doctor if the products

• do not relieve your symptoms after 1 week
• cause side effects such dry skin around your anus or a rash

Most prolapsed internal hemorrhoids go away without at-home treatment. However, severely prolapsed or bleeding internal hemorrhoids may need medical treatment.

How do doctors treat hemorrhoids?

Doctors treat hemorrhoids with procedures during an office visit or in an outpatient center or a hospital.

Office treatments include the following:

• Rubber band ligation. Rubber band ligation is a procedure that doctors use to treat bleeding or prolapsing internal hemorrhoids. A doctor places a special rubber band around the base of the hemorrhoid. The band cuts off the blood supply. The banded part of the hemorrhoid shrivels and falls off, most often within a week. Scar tissue forms in the remaining part of the hemorrhoid, often shrinking the hemorrhoid. Only a doctor should perform this procedure—you should never try this treatment yourself.
• Sclerotherapy. A doctor injects a solution into an internal hemorrhoid, which causes scar tissue to form. The scar tissue cuts off the blood supply, often shrinking the hemorrhoid.
• Infrared photocoagulation. A doctor uses a tool that directs infrared light at an internal hemorrhoid. Heat created by the infrared light causes scar tissue to form, which cuts off the blood supply, often shrinking the hemorrhoid.
• Electrocoagulation. A doctor uses a tool that sends an electric current into an internal hemorrhoid. The electric current causes scar tissue to form, which cuts off the blood supply, often shrinking the hemorrhoid.

Outpatient center or hospital treatments include the following:

• Hemorrhoidectomy. A doctor, most often a surgeon, may perform a hemorrhoidectomy to remove large external hemorrhoids and prolapsing internal hemorrhoids that do not respond to other treatments. Your doctor will give you anesthesia for this treatment.
• Hemorrhoid stapling. A doctor, most often a surgeon, may use a special stapling tool to remove internal hemorrhoid tissue and pull a prolapsing internal hemorrhoid back into the anus. Your doctor will give you anesthesia for this treatment.

Sometimes complications of hemorrhoids also require treatment.

How can I prevent hemorrhoids?

You can help prevent hemorrhoids by

• eating foods that are high in fiber
• drinking water or other nonalcoholic liquids each day as recommended by your health care professional
• not straining during bowel movements
• not sitting on the toilet for long periods of time
• avoiding regular heavy lifting