Around one in 20 Americans¹ is affected by hemorrhoids. As the condition is linked to aging, that number is much higher (around one in two) in adults over 50. If you’re among the many people who struggle with hemorrhoids, you may be wondering how long they’ll last and how you can get rid of them sooner.
Most hemorrhoids can be managed at home with simple self-care measures and over-the-counter medications. However, more severe hemorrhoids may require treatment at a hospital or clinic.
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Hemorrhoids, sometimes called piles, are swollen veins in and around the lower rectum and anus. Interestingly, hemorrhoids are a type of varicose vein² (like the swollen, twisted veins that sometimes develop in a person’s legs).
Hemorrhoids may be painful and can result in bleeding during bowel movements. They’re commonly linked to pregnancy, constipation, and advancing age. There are two types of hemorrhoids: internal and external.
As their names suggest, internal hemorrhoids are located inside the rectum, while external hemorrhoids develop around the anal opening. A prolapsed hemorrhoid is a type of internal hemorrhoid that develops inside but bulges out through the opening of the anus.
Hemorrhoids may bleed when you have a bowel movement. You may notice blood on the toilet paper or in the toilet bowl, or you may see some blood on your underwear. External hemorrhoids can become thrombosed³, meaning that a hard, inflamed blood clot forms inside the hemorrhoid.
A thrombosed hemorrhoid isn’t dangerous, but it can be very painful and, in cases of severe pain, may require medical intervention.
Other common symptoms of hemorrhoids include:
Pain or discomfort
Sollen, tender lumps near the anus (or, in the case of a prolapse, a swollen, tender lump protruding through the anal opening)
Some of these symptoms can indicate more serious health conditions. If you have symptoms of hemorrhoids that don’t resolve within a week, see your doctor so they can rule out other potential causes.
Hemorrhoids affect about half of adults over age 50. Anyone can get hemorrhoids, but they’re more likely to develop in situations that trigger the pooling of blood in the veins of the rectum and anus. For example, straining during bowel movements or sitting on the toilet for long periods can trigger hemorrhoids.
In pregnant women, the increased risk of hemorrhoids is linked⁴ to hormonal changes and increased pressure from the baby. Likewise, lifting heavy objects can increase pressure in the abdomen and lead to hemorrhoids.
Other causes and risk factors associated with hemorrhoids include:
Long-term constipation or diarrhea
Straining during bowel movements
Insufficient dietary fiber intake
A family history of hemorrhoids
To form a diagnosis, your doctor will perform a physical exam, which may include a digital rectal exam. This assessment involves inserting a gloved, lubricated finger into your rectum to feel for abnormalities.
A doctor can typically diagnose hemorrhoids based on symptoms and a physical exam. If your diagnosis is unclear, your doctor may decide it’s necessary to evaluate your condition further by using a scope to look inside your anus and rectum. You won’t need to stay in the hospital or go to sleep (general anesthesia) for an anoscopy⁵. The doctor will use a topical anesthetic (numbing) and lubricating gel to ensure it doesn’t hurt. This procedure can help confirm your symptoms aren’t caused by a more serious condition.
Fortunately, because hemorrhoids are so common, a variety of treatments are widely available.
Hemorrhoids can usually be treated at home. External hemorrhoids may be treated with over-the-counter creams or ointments, which aim to soothe the area and reduce swelling. If you’re comfortable inserting them, suppositories (small, tubular medications that are inserted directly into the rectum) may also provide relief from symptoms. If you have internal hemorrhoids or aren’t comfortable using topical treatments or suppositories, you can opt for oral pain relievers, such as acetaminophen or ibuprofen.
Most people can effectively manage their hemorrhoids without seeing a doctor. Along with over-the-counter medications, home remedies can provide relief.
Try the following home remedies to improve your hemorrhoid discomfort:
Take a sitz bath. A sitz bath is a shallow, warm bath with just water. Run a few inches of water into the tub and sit for 15 to 20 minutes several times daily.
Take fiber supplements. Including fiber in your diet can help prevent hemorrhoids, but taking fiber supplements while you have hemorrhoids can also soften your stool and make it easier to use the bathroom without irritating your hemorrhoids.
Avoid sitting too long. Changing positions frequently and taking breaks to move around may relieve pressure.
If over-the-counter treatments aren’t effective, your doctor may prescribe medication. However, more severe cases may require more invasive treatments, such as rubber band ligation, coagulation, and sclerotherapy. None of these treatments are considered major surgical procedures.
Your doctor will use local anesthesia (where you’re awake but can’t feel any pain associated with the procedure), and you won’t need to stay in the hospital.
Rubber band ligation: This involves treatment in which a doctor places a medical rubber band around the base of hemorrhoid to cut off its blood supply. The banded part of hemorrhoid will then shrivel and fall off, while any remaining tissue will often develop scars and shrink.
Coagulation: This involves using infrared light (infrared photocoagulation) or electric current (electrocoagulation) to provoke scarring and cut off the blood supply to hemorrhoid, which causes it to shrink.
Sclerotherapy: Like coagulation, this procedure aims to reduce blood flow and shrink hemorrhoids by stimulating the development of scar tissue. In sclerotherapy, a doctor injects a specialized solution into an internal hemorrhoid.
If your hemorrhoids are exceptionally persistent and don’t respond to other treatments, your doctor may recommend surgery. In a hemorrhoidectomy, a doctor surgically removes large external or prolapsed internal hemorrhoids. Hemorrhoid stapling — a procedure in which a doctor uses a specialized surgical stapling tool to remove internal hemorrhoid tissue and place the prolapsed hemorrhoid back into the anus — is typically reserved for patients whose prolapsed hemorrhoids are resistant to all other forms of treatment.
If you're dealing with hemorrhoids, you're probably wondering how long the symptoms will last. Unfortunately, there's no precise answer.
The duration of your symptoms will depend on the severity of your hemorrhoids, the steps you take at home to heal them, and the treatments you use. While minor hemorrhoids may resolve within a few days, severe ones may last weeks. In pregnant women, hemorrhoids usually develop during the third trimester and may persist until they’ve given birth (at which point they’ll likely spontaneously resolve).
If you’ve had hemorrhoids once, there’s a chance you’ll get them again, especially if you don’t make changes to reduce your risk. Even with treatment, hemorrhoids can come back. For example, in a review of relevant literature⁶, one researcher found that the risk of recurring hemorrhoids is between 11% and 50% in patients who undergo rubber band ligation.
If your hemorrhoids return, the treatments you used before may work again, but they won't prevent them from returning.
No medication specifically targets hemorrhoids to prevent them from recurring. Although people who struggle with hemorrhoids are undoubtedly thankful for treatments that relieve discomfort, prevention is the best course of action. You can reduce your risk and prevent hemorrhoids from coming back by:
Eating a high-fiber diet
Not straining while using the bathroom or sitting on the toilet for long periods
Avoiding heavy lifting
If your hemorrhoids are linked to long-term constipation, try to limit foods that make you constipated, such as:
If home treatments, such as over-the-counter ointments and sitz baths, aren’t working and your hemorrhoids persist for more than a week, it may be time to see a doctor. While they may decide the treatment isn’t necessary, a doctor can ensure another medical condition doesn’t cause your symptoms.
One symptom in particular, rectal bleeding, may indicate a serious health concern, such as colon cancer. You should also seek medical attention if hemorrhoids are accompanied by fever, severe pain, or rectal discharge.
Hemorrhoids are a common cause of pain, itching, and bleeding in the rectum and anus, especially among people who are pregnant or of advancing age. Though they aren’t usually dangerous, hemorrhoids can disrupt your daily life. Most often, hemorrhoids will go away on their own. However, in some cases, a doctor will need to carry out a minor, straightforward procedure to shrink hemorrhoids. Rarely, surgery may be necessary. If your hemorrhoid symptoms last more than a week, visit your doctor.
Definition & facts of hemorrhoids | NIH: National Institute of Diabetes and Digestive and Kidney Diseases
Varicose veins | NIH: National Heart, Lung, and Blood Institute
Thrombosed hemorrhoid | Osmosis from Elsevier
Hemorrhoids in pregnancy (2008)