Hemorrhoid help: Do hemorrhoids go away on their own?

Do hemorrhoids go away on their own?

Yes, most do, but it depends on how severe they are.

Small hemorrhoids often clear up in a few days without any treatment. If you're dealing with mild swelling and itching, rest, fiber and over-the-counter creams usually do the job.

Larger hemorrhoids that cause serious pain, swelling, or itching are tougher. They often can't heal on their own and may need medical help.

There are two types: 

• Internal hemorrhoids (inside the rectum). Internal hemorrhoids are less likely to go away on their own compared to external ones, especially if they prolapse (push outside).
• External hemorrhoids (under the skin around the anus). External ones are usually more painful.

Hemorrhoids timeline: how long they last without treatment.

There's no set timeline for hemorrhoids, but here's what research shows:

• Small, mild hemorrhoids. Go away in a few days with home care, usually within a week. Increase fiber, drink water, use sitz baths (warm water soaks) and apply over-the-counter creams.
• Larger hemorrhoids. Can take 3 to 4 weeks to heal, even with treatment. If they have a blood clot (thrombosed hemorrhoids), healing may take 2 to 3 weeks for the pain to improve.
• Persistent hemorrhoids. If symptoms don't improve after a week of home treatment, see a doctor. They may need medical intervention like rubber band ligation, sclerotherapy, or other minimally invasive procedures.
• Recurring hemorrhoids. This is common. Research shows that about 25% of people who use home treatment get hemorrhoids again, compared to those who had surgical removal.
• After pregnancy. Hemorrhoids often develop during pregnancy due to extra pressure. They usually improve after childbirth, though some persist.

What speeds healing:

• High-fiber diet (fruits like pears and berries, vegetables, whole grains, legumes and seeds)
• Drinking plenty of water
• Regular movement and exercise
• Avoiding prolonged sitting
• Not straining during bowel movements

What slows healing:

• Chronic constipation
• Obesity
• Sitting for long periods
• Straining during bowel movements
• Ignoring the underlying cause

Recurring hemorrhoids can sometimes be confused with or occur alongside anal fissures. Read more about the connection between anal fissures and hemorrhoids.

Hemorrhoid symptoms that won't improve: bleeding, pain and severe itching.

Most home remedies work for mild hemorrhoids. But some symptoms mean you need medical care.

See a doctor for hemorrhoids if you have:

• Bleeding during bowel movements that doesn't stop (especially dark red or excessive blood)
• Pain that doesn't improve after a week of home treatment
• Severe itching or swelling that interferes with daily life
• Hemorrhoid symptoms after age 40 (to rule out other conditions)

Go to the ER immediately if:

• Severe pain from a blood clot (thrombosed hemorrhoid). This needs emergency treatment within 72 hours for the best results
• Heavy bleeding or signs of anemia (dizziness, fatigue, shortness of breath)
• Stool that's black or tarry (could indicate bleeding higher in your digestive tract)

What about rectal bleeding? When should you worry?

• Bright red blood during a bowel movement. That's usually just the hemorrhoid irritating tissue. It'll stop when the hemorrhoid heals.
• Dark red, black, or tarry stools. This one's worth paying attention to. Darker blood in your stool could mean bleeding higher up in your digestive tract, which needs medical attention.

Don't assume all rectal bleeding is hemorrhoids. If you're not sure about the color or amount, or if bleeding keeps happening, get it checked out.

What actually helps with hemorrhoids (and what doesn't).

Home hemorrhoid treatments that work:

• Sitz baths (15 minutes, warm water, multiple times daily)
• High-fiber foods (oatmeal, chia seeds, beans, vegetables) and stool softeners like Colace and Miralax
• OTC creams with witch hazel or hydrocortisone, like Preparation H
• Avoiding straining and prolonged sitting

Medical treatments for persistent hemorrhoids:

• Rubber band ligation. The most common procedure. A tiny rubber band is placed around the base of the hemorrhoid, cutting off its blood supply. The hemorrhoid typically falls off within a week or two.
• Sclerotherapy. A chemical solution is injected directly into the hemorrhoid, causing it to shrink and scar over. 
• Infrared coagulation. Heat from an infrared light is applied to the hemorrhoid to shrink the tissue. 

When to see a doctor for hemorrhoids.

Try home treatment for 3 to 7 days if:

• Symptoms are mild to moderate
• You have no significant bleeding
• Pain is manageable with OTC creams

Visit CityMD if:

• Hemorrhoid symptoms don't improve after a week
• You have bleeding or severe pain
• You're unsure what's causing your symptoms
• Over-the-counter treatments aren't working

When home hemorrhoid treatment isn't working, visit CityMD.

If OTC creams, fiber supplements and sitz baths don't help after a week, CityMD can evaluate your hemorrhoids and discuss treatment options. 

Hemorrhoids usually aren't serious, but persistent or painful ones deserve professional evaluation. You don't have to live with discomfort.

Walk into CityMD anytime for quick assessment and treatment options, no appointment needed.

Most hemorrhoids do go away. But if yours don't, we're here to help.