There’s a spectrum of possible treatment for a hemorrhoid disease. We start with stool softeners and bulking agents to decrease any straining on the stool. Many physicians recommend warm sitz baths in which the bottom is immersed in a basin of warm water for 15 minutes up to four times daily. Personally, I think our fast-paced society frowns on people who stop work to immerse their bottom.
A mainstay of treatment is immaculate anal hygiene. It is difficult to get the nooks and crannies around those suckers clear of fecal debris, and this residual poo leads to the equivalent of painful diaper rash. I recommend using no toilet tissue, just baby wipes, the hypoallergenic type with aloe, to clean the outlet area thoroughly. You should allow the affected region to dry, wearing breathable cotton clothing, and going around unclothed down below when socially acceptable.
After you’re clean down there, you’d like to shrink the enlarged hemorrhoids. Our best bet is desiccating witch hazel products, with an intent to turn a fat juicy grape into a dehydrated raison. I prefer Tucks pads, which include the witch hazel but no moisturizing cream or ointment.
The pain can be improved by occasional dabs of 2% lidocaine jelly, available at the pharmacy with a prescription. Steroid suppositories or creams, containing hydrocortisone, should not be used for longer than one week, as they cause skin rash or thinning of the skin with prolonged use.
If the hemorrhoids are huge or just won’t resolve, more aggressive management might be advised by your doctor. The techniques include banding (a rubber band is placed around the hemorrhoid causing it to fall off), sclerotherapy (a caustic agent is injected into the hemorrhoid to fibrose the tissue), and one of five surgical techniques.