There are a number of over-the-counter creams and other products that are available to patients with hemorrhoids. “These products may help you feel more comfortable,” Lerner says, “but they won’t get rid of the underlying hemorrhoids, such as internal hemorrhoids, that commonly cause bleeding.”
According to FDA gastroenterologist Rajat Malik, M.D., other ways to relieve mild symptoms may include soaking regularly for 10 to 15 minutes in a warm bath, and using wet toilet paper after a bowel movement.
“With these measures, mild symptoms should decrease in two to seven days,” Malik says “If your symptoms don’t improve with these home treatments, and certainly if they get worse, it’s time to talk to your health care provider.”
If the hemorrhoid is thrombosed (there is a blood clot), your physician may decide to remove the clot with a small incision, Lerner explains. “You can do this under local anesthesia and as an outpatient,” he says. “I’ve had a lot of uncomfortable, unhappy patients walk into my office with a thrombosis, and then leave happy after it’s been excised.”
Other procedures include ligation (cutting off the hemorrhoid’s blood supply with a rubber band), sclerotherapy (the injection of a chemical solution into the hemorrhoid tissue to shrink it), and coagulation, which uses a laser or infrared light to harden and shrink hemorrhoids. “FDA is responsible for reviewing the devices used in both ligation and coagulation,” Lerner says.
Large hemorrhoids may not be able to be treated with less invasive procedures such as ligation and sclerothapy, and may require surgery, known as a hemorrhoidectomy.
Of course with hemorrhoids, as with so many other ailments, prevention is key, Malik says. For the most part, the best way to prevent hemorrhoids is to keep your stools soft, so they pass easily. Some ways to do this are:
- eating foods high in fiber, such as fruits, vegetables and whole grains;
- drinking plenty of fluids;
- exercising and not sitting for long periods of time;
- using stool softeners; and
- using fiber supplements.
Asked if he believes most people would rather search anonymously online for information about hemorrhoids than ask their doctors, Lerner says not necessarily. “Most people came to see me not because of the hemorrhoid itself, but because of the bleeding associated with it.”
“By the time they came to see me, they were usually pretty uncomfortable,” he adds. “They were more than happy to talk about hemorrhoids if it meant getting some relief.”