As embarrassing as this health issue may feel, the truth is, it’s incredibly common. More than half of us will develop hemorrhoids at some point in our lives, usually after age 30, according to the American Society of Colon and Rectal Surgeons. (Even Napoleon had hemorrhoids—it’s said the distracting pain of the emperor’s hemorrhoids contributed to his defeat at Waterloo.) Though the condition becomes more prevalent as people age, it’s also associated with pregnancy and childbirth, chronic constipation, and chronic diarrhea. Heredity is a factor, but hemorrhoids can also be caused by—and remedied by—such things as diet and toilet habits. Luckily, most hemorrhoids improve dramatically with simple measures. Here are the hemorrhoid treatment methods our experts suggest.
Add fiber to your diet
The American Gastroenterological Association suggests that drinking water and eating enough fiber are the two biggest ways to treat hemorrhoid flare-ups. “Fiber has a consistent beneficial effect,” says Janelle Gurguis-Blake, MD. Increased fiber in your diet can cause stools to soften and makes them easier to pass, reducing the pressure on your hemorrhoids. Boost fiber either by eating high-fiber foods or by taking a fiber supplement (such as Metamucil, Citrucel, or FiberCon), or both. Just make sure that you also drink plenty of fluids. High-fiber foods include broccoli, beans, wheat and oat bran, whole grains, and fruit. (Try these 6 tasty ways to get more fiber in your diet.)
…But add it slowly
Fiber can cause bloating or gas, so increase your daily amount slowly. Aim for 25 to 30 grams each day. As you increase your fiber, be sure to drink more water.
Make it easier to 💩
Once you’ve increased the fiber and fluids in your diet, your stools should become softer and pass with less effort. You may help your bowels move even more smoothly by lubing up with a dab of petroleum jelly, says Edmund Leff, MD. Using a cotton swab or just your finger, apply the jelly about 1/2 inch into the rectum.
Get some exercise
Experts agree that you can keep your bowels moving with moderate aerobic exercise, such as 30 minutes of brisk walking each day.
Go when you gotta go
When the urge hits, head to the bathroom immediately; don’t wait for a more convenient time. The stool can back up, which can result in increased pressure and straining.
Quit bringing your phone into the bathroom
A British survey found that 40% of us read on the toilet. Not a good idea if you have hemorrhoids. Prolonged sitting on the toilet causes the blood to pool and enlarge the vessels. (And besides, bringing your phone or other reading material into the loo is a little gross, isn’t it?)
Clean yourself gently
It’s extremely important to clean yourself properly and gently, says Leff. Toilet paper can be scratchy, and even contain chemical irritants. Buy only unscented white toilet paper, and dampen it under the faucet before each wipe, or use premoistened alcohol-free wipes.
Sit in a sitz
Most experts recommend a 20-minute sitz bath after each bowel movement (plus 2 or 3 additional times a day) to cleanse the anal area and relieve pain and irritation, says J. Byron Gathright Jr, MD. Sit in a bathtub filled with 3 to 4 inches of warm water, or buy a plastic tub that holds the water and fits over your toilet seat.
Dry yourself with extra care
After a sitz bath, pat the anal area dry; don’t rub or wipe hard. You can also dry the area with a hair dryer set on the cool setting.
Stop scratching down there
Hemorrhoids can itch, and scratching can relieve it. But don’t give in to the urge to scratch. You can damage the walls of these delicate veins and make matters much worse for yourself, says Leff.
Lay off lifting for a bit
Heavy lifting and strenuous exercise can act much like straining on the toilet, says Leff. If you’re prone to hemorrhoids, get a friend to help or hire someone to move that piano or dresser.
Treat yourself with an OTC hemorrhoid cream
There are many hemorrhoid creams and suppositories on the market, and while they generally will not make your problem disappear, most are designed as local painkillers and can relieve some of the discomfort, says Gathright. Limit their use to 1 week; they can cause the skin to get too thin. Choose a hemorrhoid cream like Preparation H over a suppository, says Leff. Suppositories are absolutely useless for external hemorrhoids. Even for internal hemorrhoids, they tend to float too far up the rectum to do much good, he says.
Work wonders with witch hazel
A dab of witch hazel (like Quinn’s, pictured above) applied to the rectum with a cotton ball is one of the very best remedies available for external hemorrhoids, especially if there’s bleeding, says Marvin Schuster, MD. Witch hazel causes the blood vessels to shrink and contract. While anything cold, even water, can help kill the pain of hemorrhoids, icy cold witch hazel provides even more relief. Chill a bottle of witch hazel in an ice bucket or the refrigerator. Then take a cotton ball, soak it in the witch hazel, and apply it against your hemorrhoids until it’s no longer cold, then repeat, suggests Schuster.
Eat more berries
These antioxidants, found primarily in dark berries, can help stop the thinning of veins, which can reduce the development of hemorrhoids. In a study of 120 people with frequent hemorrhoid flare-ups, those who received a twice-daily supplement of 500 milligrams of flavonoids had fewer and less severe hemorrhoid attacks. Another study, published in the British Journal of Surgery, looked at the effect of flavonoids on 100 patients facing surgery to fix their bleeding hemorrhoids. After 3 days of treatment with the flavonoids, bleeding stopped in 80% of the patients. Continued treatment prevented a relapse in nearly two-thirds of the patients.
Try stoneroot
Take two 375-milligram capsules twice a day with a full glass of water between meals for acute problems. Some people need to take a maintenance dose of two tablets daily indefinitely to control symptoms, says Deal. (But check with your doctor first.) “I keep them on hand for my hemorrhoid patients,” he says.
If you’re pregnant, lie on your left side
Pregnant women are particularly prone to hemorrhoids, in part because the uterus sits directly on the blood vessels that drain the hemorrhoidal veins, says Lewis R. Townsend, MD. A special hemorrhoid remedy if you are pregnant is to lie on your left side for about 20 minutes every 4 to 6 hours, he says. This helps decrease pressure on the main vein, draining the lower half of the body.
Give it a little shove
Sometimes the word hemorrhoid refers not to a swollen vein but to a downward displacement of the anal canal lining. If you have such a protruding hemorrhoid, try gently pushing it back into the anal canal, says Townsend. Hemorrhoids left hanging are prime candidates to develop into painful clots.
Buy a special pillow
Sitting on hard surfaces can exacerbate hemorrhoids; a doughnut-shaped cushion (like this one) can take pressure off painful hemorrhoids, says Townsend.
When To Call A Doctor About Hemorrhoids
If you’ve never had hemorrhoids, but all of a sudden you experience discomfort, it may well be related to something else. If discomfort is accompanied by itching and you’ve recently returned from a trip abroad, for example, you might have parasites. You will need medical treatment to get rid of them. Bleeding from the rectum always warrants a trip to the doctor, says Leff. “Hemorrhoids can never become cancer, but hemorrhoids can bleed and cancer can bleed.” At other times, an enlarged vein in your anus can clot, creating a big, blue, swollen, hard area that’s very painful. In most cases, your doctor can easily extract the clot.
Panel Of Advisors
Donato F. Altomare, MD, is a physician in the department of surgery at the medical school at the University of Bari in Italy. Grady Deal, DC, PhD, is a nutrition chiropractor in Koloa, Kauai, Hawaii. He is founder and director of Dr. Deal’s Hawaiian Wellness Holiday Health Spa in Koloa. J. Byron Gathright Jr, MD, is a chair emeritus of the department of colon and rectal surgery at the Ochsner Clinic Foundation and a clinical professor of surgery at Tulane University, both in New Orleans. He is also past president of the American Society of Colon and Rectal Surgeons. Janelle Gurguis-Blake, MD, is a family practitioner in Washington, DC. Edmund Leff, MD, is a semiretired colon and rectal surgeon in Phoenix and Scottsdale, Arizona. Marvin Schuster, MD, is the former director of the Marvin M. Schuster Center for Digestive and Motility Disorders at the Hopkins Bayview Medical Center, and former professor of medicine and psychiatry at Johns Hopkins University School of Medicine, both in Baltimore. Lewis R. Townsend, MD, practices obstetrics and gynecology at Contemporary Women’s Healthcare in Bethesda, Maryland, and Sibley Memorial Hospital in Washington, DC. He is former clinical instructor of obstetrics and gynecology at Georgetown University Hospital and former director of the Physicial’s Group at the Columbia Hospital for Women Medical Center, both in Washington, DC.
