When to call the doctor

• If you develop bleeding between bowel movements or have a moderate amount of bleeding from hemorrhoids, you should consult your doctor.
• If you are over age 40 years or have a family history of colon cancer, you should see your doctor for rectal bleeding.
• If you have prolapsed hemorrhoids that will not go back through the anus, or you have significant pain from your hemorrhoids, you should consult your doctor.
• Other causes of rectal bleeding exist that are much more serious than hemorrhoids. Inflammatory bowel disease and colorectal cancers can have rectal bleeding. Make your doctor aware of your bleeding. If you are older than 40 years, have a family history of colorectal cancer, prolonged bleeding, or are experiencing other symptoms, you should not delay in seeing a doctor.

When to go to the hospital

Most of the time hemorrhoids can be managed by your doctor. A few situations may require you to go to the emergency department.

• If you have significant pain, bleeding, or a prolapsed hemorrhoid and are unable to contact your doctor, then you should be evaluated in the hospital.
• If you have a large amount of bleeding from your rectum, become weak, or experience dizziness, you should go to your hospital's emergency department

Self-Care at Home

The treatment for hemorrhoids is different depending on the severity of the problem. Most of the time, the treatment is conservative and performed at home.

• Hot sitz baths
  • A sitz bath is recommended 3 times a day and after each bowel movement for at least 15 minutes.
  • For a sitz bath, sit in a few inches of warm water in a tub.
  • This is the best way to lessen the swelling and the pain.
  • Be sure to thoroughly dry the skin around your anus after each bath so that it doesn't rub and become torn.
• Dietary changes
  • Drink more liquids and eat more leafy green vegetables, which will make stools bulkier and softer to relieve constipation.
  • Some people with constipation  or hard stools may benefit from increasing the amount of bran and fiber in their diet.
• Stool softeners
  • Stool softeners might also help.
  • You should be cautious in choosing a laxative for your constipation.
  • If a laxative causes watery, runny stools, it could cause an infection in the anus and should not be used.
• Sitting restrictions
  • Some doctors also recommend people with hemorrhoids not sit for a long period of time.
  • Some people feel more comfortable sitting on an air doughnut.
• Over-the-counter medications
  • Many creams, ointments, and suppositories are sold as pain relievers and medicines for hemorrhoids.
  • These medications are of little help and sometimes might even cause the hemorrhoids to take longer to heal, so consult with your doctor first

Follow-up

• Warm sitz baths 3 times a day and after each bowel movement along with increasing the amount of liquids and leafy vegetables in your diet are beneficial.
• Any pain from hemorrhoids should be managed with over-the-counter pain relievers.
• You may receive prescriptions for stool softeners, and these should be taken as directed by your doctor.
• If you develop worsening pain, bleeding, fever, abdominal pain, or vomiting after being treated for hemorrhoids, then you should contact your doctor or go to the emergency department.

Prevention

No definite way has been found to avoid hemorrhoids. Eating a high-fiber diet and avoiding straining at bowel movements is thought to aid in preventing hemorrhoids, but there is no way to completely eliminate the risk.