The goal of hemorrhoid treatment is to relieve symptoms, improve quality of life, and prevent disease progression. Treatment strategies are typically tailored based on the severity of symptoms and the patient's overall health, including medication, non-pharmacological therapies, and surgical options. Physicians will combine different treatments according to individual needs to achieve the best outcomes.
Addressing the root causes of hemorrhoids involves improving bowel function, reducing pressure on the anal area, and maintaining proper daily care. Mild symptoms can often be managed through lifestyle modifications and medication, while severe bleeding, thrombosis, or prolapse that cannot be reduced may require surgical intervention. Patients should seek early diagnosis and work closely with their healthcare team to develop the most appropriate treatment plan.
Modern hemorrhoid treatment follows the concept of "graded therapy," categorizing severity into three levels: Level I targets mild symptoms with medication and lifestyle adjustments; Level II addresses moderate symptoms with additional local treatments or non-invasive procedures; Level III involves severe or recurrent cases, potentially requiring surgical excision or advanced therapies.
Treatment plans often combine multiple methods, such as pairing medication with sitz baths to reduce pain, or using analgesics post-surgery to promote recovery. Physicians assess patient age, medical history, and symptom characteristics to select the safest and most effective combination.
Emerging therapies like laser treatment and radiofrequency ablation offer more precise tissue repair, but their use depends on the facilities available and the physician’s expertise. These new techniques are typically suitable for specific types of internal or external hemorrhoids.
Topical ointments and suppositories act directly on affected areas to quickly reduce inflammation and swelling. Ointments containing local anesthetics (such as lidocaine) provide temporary pain relief, while steroids or non-steroidal anti-inflammatory drugs (like hydrocortisone) help decrease tissue swelling. Nitroglycerin suppositories can dilate blood vessels to improve blood flow and promote tissue healing.
Common drug combinations include anti-inflammatory and vasoconstrictive components, such as calcium alginate gels, which strengthen vessel walls and reduce exudation. Long-term use of steroids should be monitored carefully to avoid skin atrophy, and usage should follow physician instructions.
Oral drugs are often used to manage associated complications, such as fiber supplements (like methylcellulose) to soften stool and facilitate bowel movements. Non-steroidal anti-inflammatory drugs (NSAIDs) can alleviate acute pain but should be used cautiously due to gastrointestinal side effects.
Venous hemorrhoids may benefit from microcirculation enhancers like diosmin, which increase venous tone and reduce exudation. These medications are usually adjuncts to other treatments and require combined care for significant improvement.
Daily 15-20 minute warm sitz baths can significantly relieve pain and swelling, recommended 2-3 times daily. Water temperature should be maintained between 38-40°C, with optional additions like salt or herbal teas (such as witch hazel) to enhance anti-inflammatory effects. This method promotes blood circulation and keeps the affected area clean to prevent infection.
Warm sitz baths are especially useful during acute flare-ups and post-surgical recovery. Care should be taken to avoid water that is too hot to prevent burns, and bath equipment should be used exclusively and disinfected regularly to prevent bacterial infections.
Rubber band ligation is a common outpatient procedure suitable for second- and third-degree internal hemorrhoids. The physician places a rubber band at the base of the hemorrhoid to cut off blood supply, causing the tissue to necrose and fall off naturally, typically requiring 2-3 sessions for effective results. This method causes minimal trauma and quick recovery but may be associated with mild pain or bleeding.
Sclerotherapy involves injecting a sclerosing agent into the hemorrhoid base to induce fibrosis and shrinkage, suitable for bleeding internal hemorrhoids. Common sclerosants include phenol or sodium tetradecyl sulfate. Post-treatment, vigorous activity should be avoided to prevent tissue detachment. The effects can last 6-12 months, with possible repeat treatments.
Stapled hemorrhoidopexy (PPH) involves using a specialized device to excise prolapsed hemorrhoidal tissue and suture it, preserving anal sphincter function. It is suitable for severe prolapsed hemorrhoids. The procedure usually shortens hospital stay but requires assessment of the anal anatomy for suitability.
Laser coagulation and radiofrequency ablation use thermal energy to destroy abnormal blood vessels, suitable for small internal hemorrhoids. These techniques are precise with minimal bleeding but may require multiple sessions, with results varying based on individual tissue response.
A high-fiber diet is essential for long-term management, recommending 25-30 grams of fiber daily from sources like whole grains, vegetables, and pectin-rich foods. Adequate hydration (2-2.5 liters daily) helps keep stool soft, reducing straining during defecation.
Spicy foods and alcohol should be avoided as they can irritate the anal mucosa and exacerbate inflammation. Some patients may need to limit dairy intake, especially if lactose intolerant, as it can worsen gastrointestinal discomfort.
Avoid sitting on the toilet for more than 5 minutes and use a footstool to elevate the legs, adjusting the posture for easier bowel movements. Reading or using a mobile device during defecation should be avoided to reduce straining.
Regular pelvic floor exercises can strengthen anal sphincter control. It is recommended to perform contraction-relaxation exercises for 15 minutes daily to improve coordination and reduce prolapse.
Research is underway to develop drugs targeting angiogenesis, such as biologics that inhibit VEGF, potentially reducing abnormal vascular dilation in hemorrhoids. Tissue engineering techniques are also exploring the cultivation of artificial anal tissue, though still in experimental stages.
Artificial intelligence-assisted diagnostic systems are being developed to evaluate hemorrhoid severity through image analysis, with future prospects including wearable devices for real-time monitoring of anal pressure changes to prevent flare-ups.
Minimally invasive catheter systems are being tested, which use catheters to inject coagulating agents or laser energy precisely at the lesion, aiming to reduce trauma and accelerate recovery.
Gene therapy and stem cell repair are in basic research phases, with future potential to intervene in vascular proliferation and connective tissue fibrosis mechanisms.
If persistent bleeding, irreducible hemorrhoids, severe pain, or suspected thrombosis occurs, immediate medical attention is necessary. Chronic episodes leading to anemia, vomiting, or fever require ruling out other gastrointestinal diseases.
If symptoms do not improve or recur after treatment, reevaluation of the treatment plan is advised. Elderly patients or those with diabetes, cardiovascular diseases should undergo careful surgical risk assessment, preferably with a multidisciplinary consultation involving gastroenterologists or colorectal surgeons.
Internal hemorrhoids are located inside the anal canal and are often noticed due to bleeding (bright red), prolapse, or itching, usually painless in early stages; external hemorrhoids are on the surface of the anal skin and often cause noticeable pain, swelling, or tenderness, especially thrombosed external hemorrhoids that form hard lumps and are intensely painful. Diagnosis involves anoscopy or visual inspection to confirm the location differences.
What types of medications are available for non-surgical hemorrhoid treatment, and how do they work?Common medications include anti-inflammatory suppositories (containing ingredients like phenylephrine) that constrict blood vessels to reduce bleeding, oral plant extracts (like horse chestnut extract) that strengthen venous walls, and steroid creams that alleviate inflammation and swelling. These should be used under medical supervision to avoid side effects such as skin atrophy.
How can diet and exercise improve hemorrhoid problems in daily life?Increasing dietary fiber (whole grains, fruits, vegetables) and water intake helps soften stool and reduce friction during defecation. Regular aerobic exercise (such as brisk walking for 30 minutes) promotes blood circulation, while avoiding prolonged sitting or standing. Limiting straining during bowel movements and keeping them under 5 minutes can prevent worsening of hemorrhoids.
What symptoms indicate the need to stop using hemorrhoid medications or suppositories and seek medical attention?If adverse reactions such as skin redness, allergic rash, increased bleeding, or abdominal pain occur, medication should be discontinued immediately and medical consultation sought. If symptoms persist beyond 3 days or worsen, reevaluation of the treatment plan is necessary.
What precautions should be taken during recovery after rubber band ligation?During the first 7-10 days post-procedure, avoid heavy lifting and prolonged sitting. Maintain a low-fiber diet to reduce bowel frequency. Mild bleeding or discomfort in the first few days is normal; however, if there is heavy bleeding, high fever, or severe pain, immediate medical attention is required. Daily warm sitz baths for 15 minutes are recommended to promote healing.
%201.svg)
Copyright © 2025 MedFrontiers. All Rights Reserved.
