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Many things in life are a total pain in the butt, but none of them quite as literally as hemorrhoids. If you’ve heard of them but aren’t exactly sure what they are (lucky you!), they are basically enlarged blood vessels that form in your rectal area, sort of like varicose veins. In addition to itching, hemorrhoids cause symptoms like swollen lumps in and around your anus and bright red blood—sometimes a lot of it—when you take a poop.
Sounds fun, right? They can be even worse in reality. “I got them during pregnancy and to this day I’m like, That was more painful than actually having my child,” Falen Gotler, 40, who first had them in her 20s—most likely from sitting too long on the toilet—tells SELF.
Fortunately, if you have hemorrhoids—about 40% of adults experience them at one point or another, FYI—there are many things you can do to treat them and keep them from coming back. Here’s what experts recommend doing if you have this super annoying butt problem.
1. First, check with your doctor.
If you think you have hemorrhoids, it’s best to see a health care professional to confirm your suspicions. (Sorry, Dr. Google won’t cut it!) This is particularly true if your main symptom is rectal bleeding, says Pooja Singhal, MD, an American Gastroenterological Association spokesperson. “We don't take any kind of bleeding lightly,” she tells SELF. “If there is blood in your stool that is visible to your naked eye, I definitely request and strongly recommend that you go see your doctor and at least get a rectal exam done.”
That’s because bleeding can also be a sign of other issues like an ulcer, a side effect of medication, a precancerous polyp, or even anal or colorectal cancer. (If you’ve eaten too many beets, which can harmlessly dye your poop red, it might not be blood at all.) Although colorectal cancer is still relatively rare in young people, rates are rising in younger adults (and even children), so it’s better to get it checked out.
2. Eat a lot of fiber.
If you are indeed experiencing the not-so-fun problem of hemorrhoids, you want to do anything in your power to prevent the need to strain when you are taking a poop. A lot of pushing—say, because you are constipated—can make the problem way worse. That means fiber is your new best friend. Soluble fiber bulks up and softens stool, while the insoluble type speeds up the transit time, which reduces the chances you’ll get backed up. “A high-fiber diet is huge,” Dr. Singhal says.
Both kinds can be found in plant-based foods. The average adult is supposed to be consuming about 22 to 38 grams of fiber daily (the recommendation varies based on your age and daily calorie intake), which you can generally get from eating more whole grains (like oatmeal); fruits and veggies; and beans, lentils, and nuts and seeds. (About 90% of people in the US don’t eat enough fiber and only consume about 15 grams a day.)
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Getting your fiber from food is great (all those nutrients!), but you can also try OTC supplements like Metamucil and Benefiber, which contain fiber from psyllium husks or wheat dextrin. One meta-analysis found that fiber supplements could cut persistent hemorrhoid symptoms like itching and bleeding by 50%.
3. Drink more water.
If you are ramping up your fiber intake, make sure to hydrate too, since soluble fiber pulls in more water to soften stool. Dr. Singhal says “90 to 92 ounces of water daily is huge in preventing constipation.”
Shivana Pemberton, 31, of Auckland, New Zealand, who has hemorrhoids, speaks from experience. “Drink lots of water [and] eat lots of fiber,” she tells SELF. “That’s to ensure that your poo remains nice and soft and easy to ensure that you don’t have to strain when you go to the toilet.”
4. Don’t overdo it when wiping.
If you have that itchy-bottom feeling or lumps and bumps around your bum (these engorged blood vessels can sometimes even prolapse, a.k.a. fall out of your anus), it’s natural to want to scrub extra hard to clean the area. Try to resist that urge, Dr. Singhal says, because irritation can make hemorrhoids worse.
“Especially when the hemorrhoids are flared, using some premedicated [hemorrhoid-specific] wipes and doing a very gentle once wipe clean is very, very helpful,” she says. Another option is to cleanse yourself with water using a bidet attachment or toilet seat. If you don’t feel like dealing with the installation, a portable bidet is even easier and less expensive (about $9 on Amazon).
5. Move your body.
Because it can increase your circulation and prevent constipation, exercise is generally recommended if you are prone to hemorrhoids. However, you might need to be careful to keep the area dry and avoid workouts that cause friction or put pressure on your bottom half, particularly if you are having a flare-up. For example, if you normally lift, you might focus on doing more reps using less weight and limit the amount of time you spend rowing, horseback riding, or cycling.
“For my runners, I tell them right after you run, go change your clothes, your underwear, make sure it’s not moist and sweaty,” Dr. Singhal says. “That’s not going to be helping the hemorrhoids.” Walking, swimming, and yoga are generally safe and effective options if you have hemorrhoids.
6. Elevate your feet when you’re pooping.
In addition to not sitting on the toilet for too long, it can also help to elevate your feet when you go no. 2, Dr. Singhal says. Squatting is the natural position of the human body to get the job done, she says, so elevating your feet can help since you won’t have to push as much. “We were always meant to squat, to open the angle in the colon, so we can completely evacuate without straining,” she says. “With the modern luxuries and lifestyle that doesn’t happen anymore.”
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You can use a Squatty Potty or literally any step stool to elevate your legs a few inches when you’re sitting on the toilet, she says. A lot of her patients tell her they tend to raise up on their toes or bend forward when they are straining on the toilet, Dr. Singhal says, which people do naturally because it helps open up that angle in the colon. “When I talk about the importance of squatting and our natural defecation process, they’re like, ‘Oh, that makes sense,’” she says. “It is very good for anorectal health.”
7. Try OTC treatments.
There are ointments, creams, and other OTC products you can buy at any drugstore, like Preparation H, which are designed to help ease hemorrhoid symptoms. “It doesn’t make them go away; it’s just meant to ease inflammation,” Pemberton says.
Dr. Singhal says they can be helpful, but again, not to use them in a way that further irritates the area. “I tell people to take a dime-size amount, put it on the toilet tissue paper and then just wipe your anal area; the medication will just absorb,” she says. Do not “manipulate that area or put a finger inside the rectum because that may irritate or cause further pain.”
8. Take a sitz bath.
What the heck is a sitz bath you say? It’s essentially one where you sit in a few inches of warm water (generally soaking everything below the hips) to get some relief. You can do that twice a day for 10 minutes, in just plain water. While there’s no hard-and fast-rule, some people prefer putting Epsom salt or baking soda in the bath. You can do that once a day for several days.
This super low-tech approach is well-established for helping not only hemorrhoids but things like vaginal or vulvar irritation. “Sitz baths can really help mitigate that irritation and inflammation and kind of calm down the pain,” Dr. Singhal says.
9. Get them removed by a professional.
While all of these tips can often help shrink or prevent hemorrhoids, there may come a time when you need to have them removed to make them go away. There are quite a few options in this case, and an operation isn’t always necessary. “The perception is, oh, the only way to get rid of hemorrhoids is surgery,” Dr. Singhal says. “That's no longer true.”
You can have:
- Sclerotherapy. In this type of treatment, your doc injects hemorrhoids with medication to shrink them.
- Rubber band ligation. This is often just called “banding,” and your doctor places a tiny rubber band around the ’roids to cut off the blood supply, which causes them to fall off.
- Surgical removal. In this case, also known as a hemorrhoidectomy, your surgeon uses a scalpel, scissors, or laser to remove the offending blood vessels.
- Stapling. With this procedure, a doctor removes some of the tissue and then staples the rest to the lining of the anus.
To find out the risks and benefits of each of these, you need to talk about your symptoms with a health care professional, but a lot of people don’t, Dr. Singhal says, because they’re too embarrassed. Hemorrhoids are so common that providers treat this type of problem daily and can help you resolve your symptoms with zero judgment—or even a second thought, for that matter. The take-home message is that “if you have trouble with hemorrhoids, seek care, ask questions earlier, so you then avoid complications,” she says.
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