Version July 2025
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What are hemorrhoids? —
These are swollen veins in the rectum. They can cause itching, bleeding, and pain. They are very common.
In some cases, you can see or feel hemorrhoids around the outside of the rectum. These are "external" hemorrhoids. In other cases, you cannot see them because they are hidden inside the rectum (figure 1). These are "internal" hemorrhoids. Some people have both.
What are the symptoms of hemorrhoids? —
Hemorrhoids do not always cause symptoms. But when they do, symptoms can include:
●Itching of the skin around the anus
●Bleeding – Bleeding is usually painless. You might see bright red blood after using the toilet.
●Pain – If a blood clot forms inside a hemorrhoid, this can cause pain. It can also cause a lump you might be able to feel.
●Swelling – Hemorrhoids can swell or dangle outside the rectum during a bowel movement.
If you have bleeding during a bowel movement, or if your bowel movements look like tar, see a doctor or nurse. Bleeding could be caused by something other than hemorrhoids, so you should have it checked out.
How do I care for myself at home? —
If you have hemorrhoids, your doctor or nurse can suggest treatments. But there are some steps you can try on your own first.
The most important thing you can do is try to prevent constipation and keep your bowel movements soft. You should have a bowel movement at least a few times a week.
Here are some steps you can take:
●Eat lots of fruits, vegetables, and other foods with fiber (figure 2). Fiber helps increase bowel movements.
You need 20 to 35 grams of fiber a day to keep your bowel movements regular (table 1). If you do not get enough fiber from your diet, you can take fiber supplements. These come as powders, wafers, or pills. They include psyllium seed (sample brand names: Metamucil, Konsyl), methylcellulose (sample brand name: Citrucel), polycarbophil (sample brand name: FiberCon), and wheat dextrin (sample brand name: Benefiber). If you take a fiber supplement, read the label so you know how much to take. If you're not sure, ask your doctor nurse.
●Drink plenty of water and other fluids. This is especially important if you take a fiber supplement.
●Limit fatty foods and alcohol. These can make constipation worse.
●Take medicines called "stool softeners" such as docusate sodium (sample brand names: Colace, Dulcolax). These increase the number of bowel movements you have. They are safe and can prevent problems later.
●Take your time when having a bowel movement. But do not spend too much time on the toilet (for example, reading). Also, try not to push hard or strain when having a bowel movement.
●Get regular physical activity. Even gentle forms of exercise, like walking, are good for your health.
To relieve symptoms of hemorrhoids, you can:
●Take sitz baths – This means soaking your buttocks in 2 or 3 inches of warm water. You can do this up to 2 to 3 times a day for 10 to 15 minutes. Do not add soap, bubble bath, or anything to the water.
●Try non-prescription medicines – You can find these in a pharmacy (table 2). They include creams or ointments you rub on your anus to relieve pain, itching, and swelling. Some hemorrhoid medicines come in a capsule (called a "suppository") you put inside your rectum. Others come in a cream that comes in a bottle with a nozzle you put inside your rectum.
Do not use medicines that have hydrocortisone (a steroid medicine) for more than a week, unless your doctor or nurse says to.
Are there other treatments for hemorrhoids? —
Yes. If you still have symptoms after trying the steps listed above, you might need treatments to destroy or remove the hemorrhoids.
One popular treatment for hemorrhoids inside the rectum is called "rubber band ligation." The doctor ties tiny rubber bands around the hemorrhoids. A few days later, the hemorrhoids shrink and stop bleeding. Doctors can also use lasers, heat, or chemicals to destroy hemorrhoids. These procedures can only treat internal hemorrhoids.
If none of these options works, your doctor might suggest surgery to remove or tie off the blood vessels of the hemorrhoids. External hemorrhoids can only be removed with surgery.
When should I call my doctor or nurse? —
Call for advice if:
●You have new or increased bleeding from your rectum.
●You have tissue sticking out from your rectum that you can't push back in.
●You cannot have a bowel movement or urinate because of pain.
●Your symptoms are getting worse even with home care.
●You have a fever of 100.4°F (38°C) or higher.
Patient education: Hemorrhoid removal (The Basics)
Patient education: Constipation in adults (The Basics)
Patient education: High-fiber diet (The Basics)
Patient education: How to take a sitz bath (The Basics)
Patient education: How to use rectal medicines (The Basics)
Patient education: Hemorrhoids (Beyond the Basics)
Patient education: Constipation in adults (Beyond the Basics)
Patient education: High-fiber diet (Beyond the Basics)
