What is hemorrhoids?
Hemorrhoids are swollen veins in the rectum and anus. They're extremely common — about half of US adults have them by age 50. Internal hemorrhoids cause painless bleeding; external ones can be itchy, painful, and form clots (thrombosed hemorrhoids).
Most resolve with conservative treatment. Persistent or severe cases may need procedures, but the first step is usually a structured plan of fiber, sitz baths, and topical relief.
Do I have hemorrhoids? Common signs
If most of these describe what you're experiencing, telehealth may be a good next step:
What causes it
Increased pressure on rectal veins — chronic constipation, straining, prolonged sitting, pregnancy, obesity, low-fiber diet, heavy lifting.
Is it contagious?
No.
Bright red blood on toilet paper is almost always hemorrhoids — but blood mixed with stool or dark/tarry stools needs in-person evaluation.
Can it be treated online?
Routine hemorrhoid symptoms are well-suited to telehealth. Blood mixed with stool, change in bowel habits, weight loss, or family history of colon cancer needs in-person workup. Severe pain, large prolapsed hemorrhoids, or signs of infection need in-person care.
How hemorrhoids is treated
Fiber + fluids + sitz baths are foundational. Hydrocortisone cream (Anusol HC, Proctofoam HC) reduces inflammation. Witch hazel (Tucks) pads help itching. Lidocaine ointment for pain. Suppositories for internal hemorrhoids. For persistent symptoms or large hemorrhoids: rubber band ligation, sclerotherapy, or hemorrhoidectomy (in person).
Self-care while you wait
- Sitz baths 15 min, 2–3x daily
- Wet wipes instead of dry toilet paper
- Don't strain — squat position helps
- Stay hydrated
- 25–35g fiber daily
- Don't sit on toilet for long periods (no phone scrolling)
- Stool softeners (docusate) if needed
- Witch hazel pads for relief
How long does it last?
Most acute hemorrhoid flares resolve in 1–2 weeks with treatment. Chronic hemorrhoids can persist but are well-controlled with ongoing management.
Frequently asked questions
Is the blood really hemorrhoids?
Bright red blood on TP or in toilet, usually with straining or hard stool, is consistent with hemorrhoids. Blood mixed with stool, black/tarry stool, or change in bowel habits needs investigation.
Can I treat thrombosed hemorrhoids at home?
Mild ones, yes — sitz baths, pain relievers, ice. Severe pain or large clots may benefit from in-office incision/drainage within 72 hours.
Will pregnancy hemorrhoids go away?
Usually yes — after delivery and once baseline pressure resolves. Manage symptoms conservatively in the meantime.
Are hemorrhoid wipes worth it?
Witch hazel wipes (Tucks) help with itching and irritation more than plain TP.
When do I need surgery?
Persistent, recurrent, or large prolapsing hemorrhoids that fail conservative treatment. Banding is less invasive than full surgery.
