Hemorrhoids that do not cause symptoms typically do not require treatment. Even when symptoms do occur, they often go away on their own in just a few days. If a temporary source of pressure (e.g., pregnancy) caused the hemorrhoids, they will usually disappear after the source is gone (e.g., following childbirth).

Hemorrhoids can usually be treated with measures that patients can perform at home. Fiber and plenty of fluids help to eliminate constipation and reduce straining during bowel movements. Eating more fiber-rich foods (e.g., fruits and vegetables) or taking fiber supplements such as bulking agents can help reduce occurrence. It is also important to increase the amount of fluids consumed. Spicy foods are generally not recommended when hemorrhoids cause symptoms.

People with hemorrhoids should locate a toilet as soon as possible if they experience the urge to have a bowel movement. A bowel movement should not be forced either. It is best to allow sufficient time rather than straining.

Exercise may help relieve pressure around the anus and rectum and ease the symptoms of hemorrhoids. It is also important to avoid irritating the hemorrhoids and the anal area. Tips to avoid irritation include:

• Use moist toilet paper or towelettes instead of dry toilet paper.
  
• Blot the area clean instead of rubbing.
  
• Keep the anal area clean by washing daily with warm water.
  
• Do not scratch or use irritating soaps around the anus.
  
• Keep the anal area dry (a hair dryer can be used).

When hemorrhoids protrude beyond the anus, they often return inside the anus on their own. However, they may need to be gently pushed back in with a finger. Soaking the anus in warm water cleans the area and usually eases symptoms. This can be accomplished by squatting in a partially filled tub or using a sitz bath. A sitz bath involves a special container for warm water that can be placed on the toilet. Patients may benefit from soaking the area several times a day. When swelling occurs in or around a hemorrhoid, cold compresses may help.

Medicated creams and suppositories are also available over-the-counter and often help relieve symptoms. Numbing agents or witch hazel compresses may be recommended for some patients. Pain relievers, such as acetaminophen, aspirin or ibuprofen, may also be recommended to alleviate any discomfort.

Surgery is very rarely needed for hemorrhoids, but may be performed to relieve excessive bleeding or pain. Surgery may also be recommended for large hemorrhoids or hemorrhoids that fail to respond to non-surgical treatment methods. It is typically performed in the office of a physician (usually a surgeon). Procedures that are available to treat hemorrhoids include:

• Sclerotherapy. May be used to treat internal or persistently bleeding hemorrhoids. A chemical is injected into the hemorrhoids that blocks bleeding by causing the formation of scar tissue and makes the hemorrhoids shrink.
  
  
• Rubber band ligation. May be used to remove internal hemorrhoids that are large or do not respond to sclerotherapy. Tiny rubber bands are placed around the base of the hemorrhoids to cut off the circulation. This causes the hemorrhoids to wither and atrophy.
  
  
• Stapled hemorrhoidopexy. Also known as circular stapling, this relatively new procedure involves inhibiting the flow of blood to tissue through use of staples. However, recent research indicates that circular stapling may pose a greater risk of recurrence and prolapse than traditional surgery.
  
  
• Photocoagulation. A burst of infrared light or a laser is used to burn and shrink hemorrhoids.
  
  
• Electrocoagulation. Uses an electric current to destroy hemorrhoids.
  
  
• Clot removal. May be used when pain due to a blood clot in an external hemorrhoid is severe. The vein is cut with a small incision and the clot is removed. The pain may go away very rapidly after this procedure.
  
  
• Cryotherapy. Freezes the hemorrhoids. This procedure is no longer used very frequently because it is more complicated than other procedures and is often accompanied by a foul odor.
  
  
• Hemorrhoidectomy. The surgical removal of a hemorrhoid performed under anesthesia. Unlike the other surgeries, this typically requires a one or two day hospital stay.