Hemorrhoids, also called piles, are swollen veins in the anus and rectum. They often develop when there is increased pressure on that area, such as during constipation or pregnancy. While common and often resolving without treatment, hemorrhoids can cause pain and itching.

Fortunately, a variety of treatments can ease symptoms and help prevent future flare-ups. Mild cases may improve with lifestyle changes or medication, while more severe hemorrhoids may require medical procedures.

Lifestyle

Hemorrhoids can often be managed at home through lifestyle modifications, which also help prevent recurrence.

bowel movement changes
Making it easier to pass stool reduces pressure on hemorrhoids. Increasing fiber intake—through fruits, vegetables, or supplements like psyllium or methylcellulose—helps keep stools soft and lowers the chance of bleeding. Staying well-hydrated also supports regular bowel movements and prevents constipation.

avoiding straining
Try not to strain during bowel movements, and avoid sitting on the toilet for more than a couple of minutes at a time.

sitz baths
Soaking in warm water for 10–15 minutes several times a day can help relax muscles, improve blood flow, and relieve pain.

staying active
Regular movement reduces pressure on the affected veins.

comfort measures
Applying an ice pack or using witch hazel wipes may provide temporary relief.

Medications

Hemorrhoids often improve within a week, but medications can help manage discomfort during recovery. Treatment choice depends on the severity and whether the hemorrhoids are internal or external.

over-the-counter options

  • topical treatments: Creams or ointments may relieve symptoms temporarily. Astringents (witch hazel, zinc oxide), phenylephrine ointment, corticosteroid creams, or topical anesthetics (dibucaine, lidocaine) can help with swelling, irritation, or pain.

  • suppositories: Inserted into the rectum to provide relief from internal hemorrhoid symptoms.

  • oral medications: Stool softeners help ease constipation and reduce straining, while pain relievers such as acetaminophen or ibuprofen can reduce discomfort.

If you still need to use these treatments after a week, consult your healthcare provider for stronger options. Stop use if you develop skin irritation or rash.

prescription options
Topical nifedipine may help control pain, while topical nitroglycerin can relieve pain from a thrombosed external hemorrhoid.

Procedures and Surgeries

When hemorrhoids are severe, persistent, or unresponsive to home care and medication, medical procedures may be necessary.

minimally invasive procedures

  • rubber band ligation: A small rubber band is placed around the base of an internal hemorrhoid to cut off blood supply, causing it to shrink and fall off.

  • sclerotherapy injection: A solution is injected to form scar tissue, cutting off the hemorrhoid’s blood supply.

  • infrared photocoagulation: Infrared light generates heat to create scar tissue and shrink the hemorrhoid.

  • electrocoagulation: Electric current is applied to form scar tissue and block blood flow.

other pain management
Botulinum toxin injections into the anal sphincter can help relieve pain from a clot in an external hemorrhoid.

surgical options

  • hemorrhoidectomy: Complete removal of the hemorrhoid and excess tissue, suitable for both internal and external cases.

  • hemorrhoid stapling or suturing: Removes surrounding tissue of an internal hemorrhoid and repositions it inside the anus.

Living With and Managing Hemorrhoids

Hemorrhoids are common and often resolve on their own with simple lifestyle changes or over-the-counter treatments. Surgery or procedures are usually reserved for severe bleeding or prolapse that does not respond to other care.

While waiting for hemorrhoids to heal, you can reduce itching by wearing cotton underwear, using fragrance- and dye-free toilet paper, or opting for baby wipes. Avoid scratching the area.

Although preventive measures can reduce future episodes, some factors—such as pregnancy or frequent heavy lifting—may make hemorrhoids unavoidable. Recurrence risk also depends on the type, severity, and treatment of the original hemorrhoid. Surgical treatment generally offers the lowest recurrence rate.

A Quick Review

Hemorrhoids are enlarged veins in the anus and rectum that may cause itching, pain, and bleeding. Many cases resolve naturally, but treatments—ranging from lifestyle changes and OTC medications to prescriptions and surgery—can improve comfort and prevent recurrence.