When hemorrhoids are suspected, it is best to be seen by an in-person provider, to make sure that a more serious condition, such as colon cancer or ulcerative colitis, can be ruled out. Once hemorrhoids are diagnosed, the extent of the problem dictates what treatment is appropriate.
For mild cases of itching and annoyance without bleeding, a high fiber diet is recommended. Lots of fruits, vegetables, and high-fiber whole grains keep the stool soft so that it does not irritate. Walking, swimming, or bicycle riding help to prevent constipation and straining at stool. Taking warm baths (sitz baths) can be soothing, and over-the-counter pain medications such as ibuprofen or acetaminophen (Tylenol) can bring temporary relief.
Topical medications with cortisone, an anti-inflammatory can also be used temporarily, although habitual use can thin the skin. Witch hazel, a plant extract, contains tannins, which can shrink swollen tissue. A commonly prescribed medication is phenylephrine (Preparation H) which shrinks blood vessels and hemorrhoidal tissue.
Physicians can place rubber bands around hemorrhoids to cut off circulation, causing them to die and fall off harmlessly. Injections into hemorrhoids to shrink them are called sclerotherapy. Hemorrhoids can also be coagulated with lasers, heat, or infrared light.
In extreme cases of bleeding hemorrhoids, they can be removed surgically.