Hemorrhoids are swollen veins in the lowest part of your rectum and anus. They are common and treatable. Most people can fix hemorrhoids at home with simple changes like more fiber, water, and less straining on the toilet. For stubborn cases, in-office procedures from a doctor offer fast relief. Here is what the evidence actually says about fixing them.
What Causes Hemorrhoids in the First Place?
Hemorrhoids happen when pressure builds up in the lower rectum. This pressure pushes the veins outward, making them swell and sometimes bleed. The most common cause is chronic constipation. When you strain to pass hard stool, you force blood vessels to stretch and bulge.
Sitting on the toilet for too long also raises pressure. The American Society of Colon and Rectal Surgeons reports that spending more than 10 minutes on the toilet increases your risk. Pregnancy is another major cause. The growing uterus presses on these veins, and hormonal changes relax the vein walls. About 35% of pregnant women get hemorrhoids, especially in the third trimester.
Other causes include lifting heavy objects repeatedly, being overweight, and aging. The tissues that support these veins weaken naturally as you get older. A low-fiber diet is the most fixable cause. The average American eats about 15 grams of fiber daily, well below the recommended 25 to 38 grams. This directly leads to harder stools and more straining.
How To Fix Hemorrhoids With Simple Home Changes
Most hemorrhoids get better on their own within a week. The goal is to reduce pressure and let the veins shrink back. Increasing fiber is the most proven step. A 2022 analysis in the World Journal of Gastroenterology looked at seven studies and found that fiber supplements reduced hemorrhoid symptoms by about 50% compared to placebo.
Start with food sources first. Oatmeal, beans, lentils, apples, and broccoli are good options. If you cannot get enough from food, a psyllium husk supplement like Metamucil works. Drink plenty of water when you increase fiber. Without enough water, fiber can make constipation worse. Aim for eight to ten cups of water daily.
Change how you use the toilet. Do not strain. Do not sit longer than needed. If you feel the urge to go, go right away. Holding it in dries out the stool. Use a small footstool to raise your knees above your hips. This straightens the angle of your rectum and makes passing stool easier. The National Institute of Diabetes and Digestive and Kidney Diseases recommends this position for reducing strain.
What Over-the-Counter Treatments Actually Work
Drugstore creams and suppositories are popular, but their evidence is mixed. Products containing hydrocortisone reduce inflammation and itching. They work best for short-term use, usually no more than seven days. Longer use can thin the skin around your anus and make symptoms worse.
Products with witch hazel have some research behind them. Witch hazel contains tannins that shrink swelling. A small study in the Journal of Inflammation found that witch hazel reduced skin inflammation by about 27% in lab tests. It is gentle enough for daily use. Wipes soaked in witch hazel are a common option.
Pain relievers like acetaminophen or ibuprofen help with discomfort but do not treat the hemorrhoid itself. Stool softeners like docusate sodium are not as effective as fiber. A 2019 review in American Family Physician stated that fiber works better than stool softeners for preventing constipation. Save your money and buy fiber instead.
| Treatment | What It Does | Evidence Level |
|---|---|---|
| Fiber supplements | Softens stool, reduces straining | Strong – multiple studies show 50% symptom reduction |
| Hydrocortisone cream | Reduces swelling and itching | Moderate – effective short-term, skin thinning with long use |
| Witch hazel | Shrinks swelling, soothes skin | Moderate – small studies show benefit, low risk |
| Sitz bath | Warm water soaks relax muscles | Weak – widely recommended, limited direct evidence |
| Stool softeners | Moisten stool | Weak – less effective than fiber for prevention |
What About Sitz Baths and Cold Packs
Warm water soaks, called sitz baths, are a standard recommendation. You sit in a few inches of warm water for 10 to 15 minutes, two to three times daily. The warmth relaxes the anal sphincter muscle, which reduces pain. It also cleans the area gently.
The evidence for sitz baths is not as strong as people assume. A 2017 review in Techniques in Coloproctology found that sitz baths improved patient comfort but did not shrink hemorrhoids faster than other methods. Still, there is little downside. Just pat dry afterward. Rubbing with a towel can irritate the skin further.
Cold packs work differently. They numb the area and reduce swelling by constricting blood vessels. Wrap an ice pack in a thin cloth and apply for 10 minutes at a time. Do not put ice directly on the skin. This can cause frostbite. Cold works best in the first 48 hours when swelling is worst. Warm soaks are better after that for muscle relaxation.
When Home Remedies Are Not Enough
Some people do not get relief from home treatments. If hemorrhoids last longer than two weeks despite fiber, water, and over-the-counter products, it is time to see a doctor. Bleeding also needs a medical check. Hemorrhoids are a common cause of rectal bleeding, but so are colon polyps and other conditions. A doctor needs to rule out more serious problems.
Doctors offer several in-office procedures. Rubber band ligation is the most common. A small rubber band is placed around the base of the hemorrhoid. This cuts off blood flow, and the hemorrhoid falls off in about a week. The American College of Gastroenterology reports success rates of 80% to 90% for this procedure. It works best for internal hemorrhoids.
Sclerotherapy involves injecting a chemical solution into the hemorrhoid. This shrinks the vein. It is less painful than banding but has slightly lower success rates. Infrared coagulation uses heat to cut off blood flow. It works well for small to medium internal hemorrhoids. For severe external hemorrhoids, surgical removal called hemorrhoidectomy is the most effective option. Recovery takes one to two weeks and can be painful. A newer option called stapled hemorrhoidopexy has less pain but a higher chance of hemorrhoids coming back.
Common Misconceptions About Hemorrhoid Treatment
A common myth is that spicy food causes hemorrhoids. Research does not support this. A study in Diseases of the Colon and Rectum gave spicy meals to people with hemorrhoids and found no increase in symptoms. Spicy food can make the burning sensation worse if you already have a flare-up, but it does not cause the condition.
Another myth is that hemorrhoids always require surgery. This is not true. The National Institutes of Health states that 90% of people with hemorrhoids improve with diet and lifestyle changes alone. Surgery is reserved for the worst cases. Many people put off seeing a doctor because they fear surgery, but most never need it.
Some people believe that hemorrhoids are a sign of poor hygiene. This is false. Hemorrhoids have nothing to do with cleanliness. Overwashing the area can actually make irritation worse by stripping natural oils. Gentle cleaning with water and patting dry is all that is needed.
- Spicy food does not cause hemorrhoids but can irritate existing ones.
- Most people never need surgery for hemorrhoids.
- Hemorrhoids are not caused by poor hygiene.
- Sitting on cold surfaces does not cause hemorrhoids.
Frequently Asked Questions
How long does it take for hemorrhoids to go away?
Most hemorrhoids improve within 3 to 7 days with home care. Larger or more severe hemorrhoids can take 2 to 3 weeks to fully resolve.
Can hemorrhoids heal on their own without treatment?
Yes, many mild hemorrhoids shrink and heal without any treatment. Eating more fiber and drinking water helps speed up natural healing.
Is it safe to pop a hemorrhoid at home?
No, never pop a hemorrhoid. This can cause infection, severe bleeding, and intense pain. Let them shrink naturally or see a doctor for safe removal.
Do hemorrhoids come back after they heal?
Yes, hemorrhoids can return if the underlying causes like constipation or straining are not addressed. Long-term fiber intake and good toilet habits reduce the risk.
