The initial treatment of hemorrhoids usually involves lifestyle changes focused on reducing constipation, including consuming more fiber, increasing fluid intake, using stool softeners, avoiding straining on the toilet, and improving anal hygiene by cleansing with warm water and using unscented wipes in place of toilet paper.[1]
Over-the-counter topical creams/ointments and suppositories containing a variety of ingredients (e.g., zinc, corticosteroids, anesthetics, phenylephrine) can improve symptoms temporarily, but there is little evidence to support their long-term efficacy and safety.[1][2] Prescription topical medications containing nitroglycerin or nifedipine can also be helpful for managing pain.[2]
For more severe hemorrhoids, or when initial treatments have failed, a clinician may perform nonsurgical (e.g., rubber band ligation) or surgical interventions (e.g., hemorrhoidectomy) to remove the hemorrhoid. However, these more invasive treatments are associated with a high risk of hemorrhoid recurrence and post-procedure pain.[3][2]