Am Fam Physician. 2011;84(2):215
See related article on hemorrhoids.
What are hemorrhoids?
Hemorrhoids (HEM-uh-roids) are dilated veins around the rectum. Most people have discomfort or bleeding from hemorrhoids sometime during their life. Hemorrhoids usually go away on their own in about one to two weeks.
What can I do about them?
Avoiding constipation is the most important thing you can do to treat and prevent hemorrhoids. Straining on the toilet for a long time can make hemorrhoids worse. These things can help keep you from getting constipated:
Eat foods high in fiber, such as brown bread, rice, pasta, fruits, and vegetables
Add extra fiber to your diet by putting bran on your cereal or by taking fiber supplements
Drink at least eight glasses of water per day
If you do get hemorrhoids, using medicated wipes after bowel movements can help with pain and itching. Sitting in a warm bath may also help.
There are some creams for hemorrhoids that you can buy without a prescription. They can shrink the hemorrhoids and help with pain and itching. But make sure you read the labels carefully; some of these creams contain steroids. You should not use steroid-containing creams for more than a few weeks because they can damage your skin permanently if they are used too long.
When do I need to see my doctor?
Call your doctor if creams and warm baths do not help, or if you have any bleeding from the rectum. It is important to make sure that hemorrhoids are causing the bleeding, and not a more serious condition. You should also call your doctor if the pain suddenly gets worse.
What if my hemorrhoids are very bad?
If your hemorrhoids are causing a lot of pain or bleeding even after treatment with creams and baths, you may need surgery. There are several options. Your doctor may be able to treat them in his or her office by giving you a shot or by using a special light that shrinks the hemorrhoids. Make sure to tell your doctor if you are taking a blood thinner or aspirin.
Some types of hemorrhoids can be treated with a procedure called rubber band ligation. A rubber band is tied around the base of the hemorrhoid to cut off the blood supply. The hemorrhoid then shrivels up. Most people do not need anesthesia with this procedure.
People with more complicated hemorrhoids may need to see a surgeon for stapling or removal of the hemorrhoids. Both of these operations require anesthesia.