How Long Do Hemorrhoids Last?

Hemorrhoids are a condition in which the veins or blood vessels in and around the anus and lower rectum swell and become irritated. This is due to pressure on the area. They can cause unpleasant symptoms, but they rarely result in long-term health concerns.

Read on to learn how long hemorrhoids last and how to treat them.

How Long Do Hemorrhoids Last?

Hemorrhoids often clear up within a few days to weeks, either independently or with home treatment measures. If the hemorrhoids are more severe, they may take longer to go away or require more extensive treatment, such as surgery.

Hemorrhoid Symptoms

The symptoms that present depend on the location and severity of hemorrhoid(s).

Common Hemorrhoid Symptoms

External hemorrhoids occur under the skin around the anus. Symptoms include:

• Anal itching
• Hard, tender lump(s) near the anus
• Ache or pain in the anal area, particularly when sitting

These symptoms tend to ease within a few days, but straining, rubbing, or excess cleaning of the area can worsen symptoms.

Internal hemorrhoids occur inside the anus. Symptoms include:

• Bright red blood on stool, toilet paper, or in the toilet bowl after a bowel movement
• Prolapse (when a hemorrhoid comes down through the anal opening)

Typically, internal hemorrhoids do not cause pain, but ones that are prolapsed may be painful or uncomfortable.

Other symptoms of hemorrhoids may include:

• Soilage (poop "accidents") or mucous discharge
• Difficulties with hygiene
• A sense of incomplete evacuation

Severe and Recurrent Hemorrhoids

Internal hemorrhoids are graded using the Goligher classification method, which is based on appearance and degree of prolapse.

• First-degree (Grade I): Anal cushions (tissues inside the anus) bleed but do not prolapse
• Second-degree (Grade II): Anal cushions prolapse through the anus during straining but go back in on their own
• Third-degree (Grade III): Anal cushions prolapse through the anus on straining or exertion and must be manually placed back into the anal canal
• Fourth-degree (Grade IV): The prolapse stays out at all times and can't be manually placed back inside

A thrombosed hemorrhoid is when a blood clot forms inside the hemorrhoid, blocking blood flow. This is usually, but not always, external. This causes a sudden painful swelling and often a lump that may be bluish in color.

Topical treatment tends not to be effective for thrombosed hemorrhoids, but the pain and swelling tend to peak at 48 hours and subside after four days.

Hemorrhoids During Pregnancy

The tissue inside the anus that swells slightly during a bowel movement and helps with continence is prone to congestion during pregnancy, which can lead to symptomatic hemorrhoids. These symptoms tend to be most noticeable in the third trimester, when the enlarged uterus causes venous obstruction.

Constipation and dehydration are also common in pregnancy, which can contribute to hemorrhoid symptoms.

Usually, pregnancy hemorrhoids gradually resolve after birth and don't typically require intensive interventions. In most cases, treatment focuses on acute symptom relief, using measures such as:

• Dietary and lifestyle modification
• Kegel exercises
• Lying on the left side
• Preventing constipation

Hemorrhoid Treatment

Hemorrhoids can usually be treated conservatively with symptom relief until they resolve on their own. If home treatments and non-operative approaches have not been effective, or there are complications, surgery may be necessary.

Over-the-Counter Treatments

Topical treatments can be used for temporary relief on a short-term basis, but have not been shown to be beneficial or safe for prevention or long-term hemorrhoid treatment.

Topical treatments may include one or more of these ingredients:

• Astringents, such as witch hazel (used in Tucks pads)
• Protectants, such as zinc oxide
• Decongestants, such as phenylephrine (used in Preparation H)
• Corticosteroids
• Topical anesthetics
  

Rubber Band Ligation

Rubber band ligation (RBL) is the most common hemorrhoid treatment procedure in the United States.

In RBL treatment, a small elastic band is placed around the base of a hemorrhoid, causing the hemorrhoid to shrink. The surrounding tissue scars as it heals, which holds the hemorrhoid in place.

Advantages of RBL include:

• Performed in office without anesthesia or bowel preparation
• Fast recovery
• More cost-effective than surgery
  
• Successful in approximately 80% of cases (may recur with time, but recurrent symptoms can often be resolved with repeated banding)

Complications are rare, but can include:

• Pain or rectal discomfort
• Minor bleeding
• Urinary retention
• Thrombosed external hemorrhoids

Pelvic sepsis (the body's extreme response to an infection) is a serious complication that can occur, but it is extremely rare.

Anticoagulants (blood thinners) should not be taken for one week before and two weeks after RBL.

Sclerotherapy

During sclerotherapy, a solution is injected into an internal hemorrhoid, causing scar tissue to form. This scar tissue cuts off the blood supply, which can shrink the hemorrhoid.

Sclerotherapy is 75% to 89% effective in grade one, two, and three hemorrhoids, but 30% of people who get this procedure see a recurrence at four years.

Infrared Photocoagulation

With infrared photocoagulation, a tool is used to direct infrared light at an internal hemorrhoid. The infrared light creates heat, which causes scar tissue to form. The scar tissue cuts off the blood supply, which can shrink the hemorrhoid.

Electrocoagulation

To perform electrocoagulation, a healthcare provider uses a tool to send an electric current into an internal hemorrhoid, causing scar tissue to form. The scar tissue cuts off the blood supply, often shrinking the hemorrhoid.

Surgical Removal

Two types of surgeries may be used to treat hemorrhoids if necessary. Both procedures are day surgeries done under general anesthesia.

Traditional Hemorrhoidectomy

The affected blood vessels are removed through a narrow incision made around external and internal hemorrhoid tissue.

This is the most effective treatment, with a success rate of 95%, and has the lowest rate of recurrence compared to other procedures.

This procedure has a low complication rate, but can involve a painful recovery period, requiring seven to 10 days off work.

Complications from the surgery can include:

• Acute urinary retention
• Fecal incontinence
• Postoperative bleeding
• Bacteremia (bacteria in the bloodstream) and septic complications

Stapled Hemorrhoidopexy

Used to treat bleeding or prolapsed internal hemorrhoids, this procedure anchors hemorrhoids in their normal position using a stapling device.

Risk Factors for Hemorrhoids

Situations that increase intra-abdominal pressure can contribute to hemorrhoids. This can include:

• Pregnancy
• Constipation
• Prolonged straining (including heavy lifting)
• Weakening of supporting tissue due to aging or genetics

How to Prevent Hemorrhoids

Hemorrhoids can't always be prevented, but there are some ways to reduce your chances of getting them and help your symptoms.

Diet: Best and Worst Foods for Hemorrhoids

Constipation can cause or worsen hemorrhoids.

One way to prevent and treat constipation is to increase fiber intake with fiber supplements or eat a high-fiber diet. It may take a few weeks to notice a difference, but these changes can be effective.

High-fiber foods include:

• Beans
• Whole-grain foods
• Fruits and vegetables

Foods that are low in fiber and may worsen constipation include:

• Cheese
  
• Fast food
• Meat
• Prepared or processed foods

Lifestyle Changes

Changes you can make that may help treat or prevent hemorrhoids include:

• Exercise regularly
• Improve anal hygiene (but be gentle, too much cleaning can irritate the area)
• Try to strain less while on the toilet
• Spend less time on the toilet
• If possible, avoid medication that causes constipation or diarrhea

Natural Remedies

Some practices you can try to prevent or ease hemorrhoid symptoms include:

Sitz Baths

• A warm water bath for the butt and hips
• Helps relieve itching, irritation, and sphincter muscle spasms
• Can be done with a plastic device that sits on the toilet seat (sold in pharmacies) or with a few inches of water in the bathtub

Manage Your Bathroom Schedule

• Don't hold it and go as soon as you feel the urge
• Establish a regular bathroom routine

Cool the Area

• Place an ice pack or cold compress on the affected area for a few minutes to help reduce pain and swelling
• Don't put ice directly on the skin; make sure it is wrapped in a towel or cloth

Use a Cushion

• Avoid sitting on hard surfaces
• If a soft surface, such as a couch or bed, isn't available, place a cushion down before sitting
  

Outlook With Hemorrhoids

Hemorrhoids are common and generally resolve on their own within a few days to a few weeks. More severe cases may require interventions, but treatment for hemorrhoids can be quite effective.

How Often Do Hemorrhoids Return?

Whether or not hemorrhoids return depends on a number of factors, including the type and severity of the hemorrhoids and the treatment used. Surgical removal of hemorrhoids has the lowest recurrence rate, but is usually unnecessary.

Summary

Hemorrhoids are a swelling and irritation of tissues in the anal and rectal area. They can cause uncomfortable symptoms, such as pain, itching, and bleeding. They are common and generally not serious.

Hemorrhoids usually go away on their own or with home treatment, such as over-the-counter topical medication, diet and lifestyle changes, and home remedies.

In more serious cases, procedures, such as rubber band ligation or surgery, may be necessary.

A Word From Verywell

It's natural to be frightened if you notice blood when you have a bowel movement, but don't panic. Hemorrhoids are very common and relatively easy to treat. See your healthcare provider to make sure the bleeding is from hemorrhoids and not another condition. Once you have a diagnosis, discuss your treatment options with your healthcare provider.