Hemorrhoids can be very bothersome if they become painful or if they start to bleed a lot. If you are reading this, it’s likely that you’ve finally had a ‘run in’ with this problem and can now better understand what all the fuss is about when people mention hemorrhoids or complain about them. Before that, you probably wondered why all the talk and advertisements.

Hemorrhoids are swollen veins in the rectal area and can occur inside the rectum (bottom portion of the colon) or outside the anus (the opening from the rectum). Typically, then occur during times of changes in bowel habits…in particular with constipation or straining to move the bowels. That said, they may come on ‘out of the blue’ or related to other issues that irritate the backside (sitting for prolonged periods, sitting on an irritating surface).

If you’ve tried on your own and failed to achieve resolution of this issue, I have listed below the simple methods you should use as the next steps in treatment.


1. DO NOT USE SOAP. This may come as a surprise, but this is not a problem OF your ‘cleanliness’. There is no way to sterilize the area and generally speaking, your bottom is happiest when it has some germs around, as this is its normal situation. Trying to use soap will irritate the hemorrhoids, which are only veins that are covered with a thin layer of skin.
2. WASH YOUR BACKSIDE WITH EITHER PLAIN WATER OR CETAPHIL LIQUID CLEANSER (available over-the-counter at any CVS, Waglreens, etc.….) Avoiding soap will prevent harsh irritants from perpetuating the irritation in the area and it will prevent the area from getting ‘dried out’ as soaps often do.
3. DRY YOUR BOTTOM THOROUGHLY. Probably the best way to do this is to use a hair blower on medium heat. Alternatively, you can ‘pad’ the area dry with a dry towel or air dry by leaving your bottoms off and letter nature dry things up.
4. SOAK IN A BATH OF PLAIN WARM WATER. This is the simplest and most effective method to stop pain, irritation, and bleeding. Sitting in a plain tub of warm water (or a sitz bath….a device that goes in the toilet bowl) will provide immediate relief that is impressive. Do this one to several times a day…as often as you need. You cannot do this too much. Do realize that a hot tub is not good for hemorrhoids and will cause increased symptoms due to the chemicals in the water. As well, a warm pool will not do well either.
5. APPLY A TOPICAL CREAM, such as ANUSOL HC (prescription) in a small amount to the inflamed area around the rectum. This works much much better than Preparation H (a product that I think is not very effective). If you would rather use a home cream, you can try a mild cortisone cream such as CORTAID 10 Cream, which is available at any pharmacy or grocery store.
6. KEEP THE BOWEL MOVEMENTS SOFT. Use either a softener such as Colace (Docusate Sodium), Metamucil (fiber product), or Mirilax (over the counter constipation aid) to keep the bowels moving easily. This prevents straining at movement, which can perpetuate the hemorrhoids.
7. USE SUPPOSITORIES IF SYMPTOMS OR BLEEDING IS MORE BOTHERSOME. These are ANUSOL HC SUPPOSITORIES (prescription) and they are sometimes necessary for more vexing cases of irritation or bleeding.

This combination of treatments will generally handle most mild to moderate hemorrhoids when used consistently for a few to several days. If symptoms continue despite these efforts, then its time to come in for a check and possible referral to a proctologist (rectum specialist).

So…try these simple steps before worrying about coming into the office for a check on things; if it resolves the situation….you’re all set.

Elvis lived by the moniker TCB….Taking Care of Business. Now you too can TCB (only a in a little different way!)