Painful Chronic Hemorrhoids? Proven Relief Options

Chronic Hemorrhoids

About half of all Americans will develop hemorrhoids at some point in their lives. In many cases, they resolve on their own or improve with dietary adjustments, over-the-counter creams, medications, or supplements. However, for some people, hemorrhoids can persist, leading to ongoing bleeding, itching, and painful bowel movements—often referred to as chronic hemorrhoids.

The symptoms of chronic hemorrhoids can include:

Rectal bleeding
Itching or irritation
Pain or discomfort
Swelling or lumps
Black or tarry stools

It is important to note that rectal bleeding isn’t always hemorrhoids and could be a sign of a more serious condition.

What causes hemorrhoids?

The primary cause of chronic hemorrhoids is persistent, increased pressure in the lower rectum. This can be the result of constipation, frequent straining during bowel movements, long periods of time sitting on the toilet, heavy lifting or pregnancy. The pressure causes the veins in and around the anus to stretch and swell, which weakens them over time and leads to the development of hemorrhoids.

Treatment Options

Conservative treatment

The first line of treatment for hemorrhoids includes topical creams or suppositories, witch hazel pads, sitz baths and over-the-counter medications (if you are experiencing pain). Stool softeners may also be used to make bowel movements less uncomfortable. If symptoms persist despite these conservative treatments, further treatment may be needed.

Surgery

For more severe cases, a surgical treatment called hemorrhoidectomy is sometimes recommended. This approach is most effective for large external or prolapsed internal hemorrhoids. However, there is a long and painful recovery which can be made even more difficult by the need to have daily bowel movements.

Rubber band ligation

This less invasive approach uses a small band to cut the blood supply to the hemorrhoid. As a result, the hemorrhoid shrinks and falls off. However, this can also require a lengthy recovery, and it is not appropriate for those who are on anticoagulant medication, those at increased risk for infection and those with insufficient tissue to pull into the banding device.

Hemorrhoidal artery embolization (HAE)

Hemorrhoidal artery embolization (HAE) is a minimally invasive, image-guided procedure used to treat symptomatic hemorrhoids by reducing their blood supply. Unlike surgical hemorrhoidectomy, HAE is performed under local anesthesia, requires no incisions in the anal region, and patients experience shorter recovery times and a much less painful recovery.

Please visit our HAE section to learn more about this option.

Hemorrhoidal Artery Embolization