Question:

What is the best treatment to relieve the pain of hemorrhoids? I am not interested in surgery.

Answer:

First, see your doctor to make sure the problem is hemorrhoids. Pain is an unusual symptom from hemorrhoids. (You might have an anal fissure or abscess.)

If you have hemorrhoids, the best way to reduce swelling and discomfort is to keep stools soft and the anal area clean.

Here are some suggestions:

Take fiber to keep stools soft. Bulk forming fiber powder (psyllium fiber) is available without a prescription. "Metamucil," "Citrucel," "Konsyl," and "Perdiem Plain" are some brand names. Your pharmacist may be able to suggest others. You can find flavored and sweetened types. The usual dose is 2 teaspoons or 2 packets in liquid once or twice a day.

Unprocessed bran is an alternative way to take fiber. It may be cheaper than psyllium fiber, but might be less convenient to take. You can buy it from health food stores and some grocery stores. (Look for "Quaker Unprocessed Bran".) Take 1/4 to 1/3 cup per day. Mix it with cereal, bread, salad, applesauce, or whatever you wish. "All Bran" and "Bran Chex" cereal have a good amount of fiber, but "40% Bran Flakes" has very little.

Bran and psyllium fiber are not laxatives. They are from natural, nondigestible seed husks. They stay in the intestine and absorb water to make the stools soft. They do not stimulate the bowels to move. They make bowel movements bulky and soft, and easier for your intestine to handle. Some people notice a little cramping, bloating, or gas when they begin taking fiber. If so, start with a small amount (a teaspoon a day of psyllium powder, or a couple of tablespoons a day of bran), and gradually increase the dose. Keep increasing the dose until your stools are quite soft, like paste. Drink plenty of liquids with it.

Salads, fruits, and vegetables contain many beneficial vitamins, but provide only small amounts of fiber.

Docusate ("Colace") is a weak stool softener in pill form, and much less important than bran or psyllium fiber.

Take frequent sitz baths, especially after bowel movements. Sit in a tub or pan of plain warm water 2 to 4 times a day for 15 minutes each time. (Pharmacies sell plastic sitz baths, which fit onto a toilet). The water cleans the area and the warmth reduces inflammation and discomfort. "Tucks Pads," "Moist Mates," or even baby wipes can be used for cleansing. (They are not as thorough as a sitz bath, but they are more convenient.) Wiping with a moistened tissue or cotton pad after bowel movements can also help. Avoid colored or perfumed toilet paper and soaps, which may contain chemicals that irritate. After a regular bath or shower, rinse soap from the anal area completely.

If a hemorrhoid pushes out or drops down outside the anus, push it back inside.

Do not sit on the toilet for long periods. This tends to make hemorrhoids push out and swell up.

Ointments, creams, and suppositories are not usually needed.

Last Annual Review Date: 2010-07-20T00:00:00-06:00 Copyright: Copyright Harvard Health Publications