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Choosing the best hemorrhoid treatment depends mostly on the severity and cause of the hemorrhoids. Mild hemorrhoids can often be treated with home remedies and lifestyle changes. Severe internal hemorrhoids and those that do not respond to more conservative treatment methods may require medical intervention, including medication or surgery. Some people who are prone to hemorrhoids, such as pregnant women, may not be able to use all forms of hemorrhoid treatment and must rely on natural methods.
Most people should try home treatment methods to heal hemorrhoids and relieve symptoms before turning to medical care. Patients who experience severe pain, rectal bleeding that does not clear up within two to three days, black stools, abnormally thin feces, fever, or severe anal swelling should see their doctors to evaluate their conditions. A small amount of bleeding during bowel movements is normal with mild hemorrhoids and is not usually cause for concern. Other common symptoms include itching, swelling, and pain in the anal area.
Keeping the anal area clean is the best hemorrhoid treatment method. Cleansing the area with warm water is usually sufficient and helps avoid irritation from soaps. Rubbing the area dry with a towel can further irritate the anus and may cause bleeding, so the area should be dried with a hair dryer. Soaking the anal area in warm water for 10 to 15 minutes several times a day can also relieve pain. Sitz baths that fit over the toilet seat are excellent for soaking the area.
Dry toilet paper can irritate hemorrhoids, so moist wipes should be used to clean the area after a bowel movement. Over-the-counter pain relievers can help keep pain manageable, and certain medications, such as ibuprofen, can also decrease swelling. The best hemorrhoid treatment creams are those containing witch hazel or hydrocortisone. These products also help relieve itching.
Patients whose hemorrhoids do not improve with home treatment may need medical care. Most hemorrhoids can be treated with minimally invasive procedures, such as rubber band ligation, in which the doctor places a small rubber band around the hemorrhoid to cut off the blood supply so that it falls off. Other minimally invasive hemorrhoid treatment methods include injecting the hemorrhoid with a chemical to shrink it or using infrared heat to shrivel the hemorrhoid. These procedures have few side effects and are safe for most patients.
Large hemorrhoids or hemorrhoids that come back despite more conservative treatments may require more invasive surgery. Surgeons may remove the hemorrhoid completely through a surgical procedure called a hemorrhoidectomy. Many patients experience pain and difficulty urinating after the procedure, but it is the best hemorrhoid treatment to completely eliminate hemorrhoids. A surgeon may also staple the hemorrhoid to cut off the blood supply. This procedure has a higher risk of recurrence, but it has a quicker recovery time than a hemorrhoidectomy.