Hemorrhoids affect nearly three out of every four adults at some point in their lives. Though, hemorrhoids do not always cause symptoms. Hemorrhoids can be caused by a variety of factors, although the cause is typically unknown.

The most common symptoms of hemorrhoids might include painless bright red blood while having a bowel movement, itching, or pain. Hemorrhoids that cause symptoms can be treated successfully with a variety of methods. Many people get comfort by using home remedies and making lifestyle modifications. With a variety of treatment methods, what are some of the best hemorrhoid pain treatments?

Hemorrhoids, often known as piles, are bulging veins that resemble varicose veins in the anus and lower rectum. Everyone actually has these clusters of veins beneath the rectal and anal lining, but when they become swollen and protrude, it results in what we typically think of when we say hemorrhoids. Internal hemorrhoids develop inside the rectum, while external hemorrhoids develop beneath the skin around the anus. Occasionally, an external hemorrhoid may form a clot (thrombus) and result in what is called a thrombosed hemorrhoid, leading to pain, swelling, and a hard lump near the anus.

For most minor hemorrhoids, dietary changes (like increasing water intake and increasing dietary fiber) or stool softeners may be all that is needed. Increased exercise and sitz baths are other methods that can help with hemorrhoids. There are also a variety of over-the-counter hemorrhoid therapies available. These may provide immediate relief for itching and pain, but most have not been evaluated for long-term effectiveness or safety. If there is rectal bleeding, or the condition has progressed to prolapse (hemorrhoids bulging out from the anus), over-the-counter treatments should not be used and medical attention is needed. If you are pregnant, you should not use any over-the-counter treatments that are inserted rectally (such as suppositories or ointment with long applicator tubes that are inserted). To be safe, it is always best to talk with your doctor to make sure there isn’t a more serious condition that needs attention.

Over-The-Counter Hemorrhoid Relief Options

Preparation H Soothing Relief Anti Itch Cream or Tucks Hydrocortisone Ointment

These products contain a topical steroid called hydrocortisone. It can be used up to four times a day, after bowel movements, or as directed by your doctor. Products containing hydrocortisone should only be used temporarily and not for long periods of time without talking to a doctor. 

Doctor Butler’s Hemorrhoid & Fissure Ointment

This cream has several recommended ingredients, including lidocaine, which helps numb the area relieving itching, burning, and pain, phenylephrine to help reduce swelling of hemorrhoids, and aloe for cooling and soothing. It also contains bio-enhanced herbs, essential oils, and amino acids, which can aid healing. This medicine was created by a board-certified proctologist and can help provide you with quick pain relief. Doctor Butler has many products available that may be helpful.

Hemorrhoid Wipes

For example, Preparation H Flushable Medicated Wipes, are made with witch hazel and aloe to chill, soothe, and comfort areas where hemorrhoids form. These wipes can be used every day to cleanse and reduce irritation. They also may be used before Preparation H Ointment, Cream, Gel, or Suppositories for added relief. The wipes are flushable, biodegradable, & septic safe

Motherlove Rhoid Balm (Herbal)

Rhoid Balm from Motherlove is often used during pregnancy and post-partum for relief of hemorrhoid symptoms. Did you know that hemorrhoids affect up to 50% of all pregnant women? This calming balm with witch hazel relieves the itch and swelling of hemorrhoids brought on by pregnancy and childbirth.

Sitz Bath Soaks

A sitz bath is a shallow and warm bath made to just cover your hips and buttocks. There are some over-the-counter formulations that can be mixed into the water. For example, Thena Natural Wellness Organic Sitz Bath Soak has a good reputation for being both relaxing and pain-relieving. This soak is made with natural oils, soften skins, offers some pain relief, and is safe in pregnancy. Sitz baths are not necessarily proven to help, but they are a recommended option for hemorrhoids that some find relief with.

Prescription medications may also be used as a first-line option for hemorrhoid pain treatment. Although it is more typically used for anal fissures, topical nitroglycerin as a 0.4 percent ointment reduces rectal pain caused by thrombosed hemorrhoids. Topical nifedipine has also been shown to be useful for pain relief, but it must be manufactured by a pharmacy because there is no commercially available preparation. Surgical intervention is sometimes necessary for more severe cases of hemorrhoids and may be discussed with your doctor.

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Resources:

“Hemorrhoids” The Mayo Clinic, 11 June 2021, https://www.mayoclinic.org/diseases-conditions/hemorrhoids/symptoms-causes/syc-20360268

“Hemorrhoids: Diagnosis and Treatment Options” American Academy of Family Physicians, 11 June 2021, https://www.aafp.org/afp/2018/0201/p172.html

“Hemorrhoids and what to do about them” Harvard Health Publishing, 11 June 2021, https://www.health.harvard.edu/diseases-and-conditions/hemorrhoids_and_what_to_do_about_them

“Counseling Patients With Hemorrhoids” US Pharmacist, 20 December 2011
https://www.uspharmacist.com/article/counseling-patients-with-hemorrhoids