6 Self-help tips for hemorrhoid flare-ups

Daniel Pendick, Executive Editor, Harvard Men's Health Watch

Getting older has its benefits—and its drawbacks. Included in the latter are hemorrhoids. These swollen blood vessels on the outer rectum and anus can turn bowel movements into intensely painful experiences. Classic symptoms include rectal pain, itching, bleeding, and possibly prolapse (protrusion of hemorrhoids into the anal canal). Although hemorrhoids are rarely dangerous, they can be a painful recurrent bother.

Hemorrhoids come in two varieties. The internal type sprout from within the rectum. External hemorrhoids develop on the anus itself. Either way, stools passing by them can cause pain and bleeding.

But simple self-help measures can ease the ordeal of most hemorrhoids and allow healing. In this month’sHarvard Men’s Health Watch, I asked Dr. Jacqueline Wolf, a gastroenterologist and associate professor of medicine at Harvard-affiliated Beth Israel Deaconess Medical Center, about effective steps you can take to care for hemorrhoids—and when it’s time to seek out a procedure to remove them.

Here are six self-help tips:

Step up the fiber. “The most important thing is to add fiber to your diet,” Dr. Wolf says. This is best done with food, but some people find they need to take a fiber supplement to get 20 to 30 grams of fiber per day. To start, try a psyllium husk fiber supplement, such as Metamucil or a generic equivalent. If psyllium causes gas or bloating, try a supplement containing wheat dextrin or methylcellulose.

Lubricate the process. Mixing a tablespoon of mineral oil with applesauce or yogurt and eating it at breakfast or lunch allows stool to slide by the hemorrhoid more easily. But don’t do this for a long period, cautions Dr. Wolf. (if you try this, you may want to place a liner in your undergarments to absorb any oil leakage.)

Don’t delay. When you feel the urge, go to the bathroom immediately; don’t wait for a more convenient time. Putting off bowel movements can worsen constipation, which then aggravates hemorrhoids.

Try elevation. Elevating your feet a bit with a step stool as you sit on the toilet changes the position of the rectum in a way that may allow for easier passage of stools.

Off-the-shelf remedies. Over-the-counter products are available for hemorrhoids. These include witch hazel infused pads and soothing creams, like the iconic brand Preparation H and its generic equivalents. If these don’t work, ask your doctor about prescription preparations.

Sit in a sitz. Don’t overlook the relief offered by sitz baths. Using a basin that fits under the toilet seat, soak the inflamed area in warm water for 10 to 15 minutes, two to three times a day.

Time for hemorrhoid removal?

If hemorrhoids persist no matter what steps you take to make them go away, or they begin to bleed, interfere with bowel movements, or make life difficult, ask your doctor about medical procedures to remove or reduce hemorrhoids. Two minimally invasive techniques—rubber-band ligation and laser, infrared, or bipolar coagulation—shrink internal hemorrhoids. Some people need surgery (hemorrhoidectomy) to take care of the problem.

Hemorrhoids develop when the channels that carry blood away from the anus and rectum become dilated (widened). They are classified according to their location. External hemorrhoids develop in the anus, internal hemorrhoids in the rectum. Many people have both.