Online Hemorrhoid Treatment and Medication
Hemorrhoids can make every trip to the bathroom uncomfortable, and the bleeding can be worrying. You don’t have to sit in a waiting room to get help. Our board-certified doctors are available 24/7 to review your symptoms, recommend the appropriate treatment, and, when medically appropriate, send a prescription to your pharmacy.
Get care from home for painful, itchy, or bleeding hemorrhoids, flare-ups during pregnancy, or a refill of treatment that works for you.
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Hi Dr. Nicole, I have anal pain, bleeding, and swelling. Could it be hemorrhoids?
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Our online doctors can help you with your medical issues and give you prescriptions.
Prescription
- Anusol-HC 25 mg suppository
- Insert one morning and night for up to two weeks
- Tell your doctor if you are pregnant or breastfeeding
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What are the treatment options for hemorrhoids?
Most hemorrhoids improve with simple treatment and do not need surgery. The right treatment depends on how severe your symptoms are and whether something else may be causing the bleeding.
- Increase fiber and fluids: Eating more fiber and drinking enough water can soften your stool and make bowel movements easier.
- Take warm baths: Sitting in warm water for about 15 minutes can help ease pain and irritation.
- Use stool softeners or fiber supplements: These can help prevent constipation and reduce straining during bowel movements.
- Try prescription creams: A doctor may recommend a steroid cream, such as hydrocortisone, to reduce swelling and itching, sometimes with a numbing medicine to relieve pain.
Many early hemorrhoid treatments can be discussed through an online visit. A licensed doctor can review your symptoms and, when appropriate, provide an online doctor prescription to your local pharmacy. Because rectal bleeding can have other causes, your doctor may ask about the color and amount of blood before recommending treatment.
What hemorrhoid medications can we prescribe online?
Here are a few of the commonly prescribed hemorrhoid medications that you might receive from your doctor.
- Corticosteroid suppositories, such as Anusol-HC (hydrocortisone acetate 25 mg)
- Corticosteroid creams, such as Anusol-HC 2.5 percent hydrocortisone cream
- Steroid and anesthetic combinations, such as Analpram-HC or Proctofoam-HC, which pair hydrocortisone acetate with pramoxine, so itching and pain are treated together
- Topical anesthetics, such as Lidocaine or Pramoxine, to numb the area
- Stool softeners and laxatives, such as docusate sodium or lactulose, so you are not straining
- Pain relievers, usually Acetaminophen.
What are hemorrhoids?
Hemorrhoids are normal blood vessels and tissue inside and around the anus. Everyone has them. They become a problem when they swell, move downward, or bleed, causing itching, pain, or lumps around the anus.
There are two main types. Internal hemorrhoids develop inside the anus and may bulge out during a bowel movement. External hemorrhoids form under the skin around the anus and can be painful, especially when a blood clot forms inside one.
Most hemorrhoids can be treated without surgery with fiber, fluids, warm baths, stool softeners, or medication to relieve swelling, itching, or pain.
What are the symptoms of hemorrhoids?
External hemorrhoids sit under skin that is full of nerve endings, so they cause:
- Pain, especially while sitting
- Itching and irritation around the anus
- A hard, tender lump near the anus, which can be a clot known as a thrombosed hemorrhoid
- Swelling
Internal hemorrhoids are often painless but may cause:
- Bright red bleeding, classically at the end of a bowel movement, on the paper, in the bowl or on the stool
- Prolapse, where the hemorrhoid slips out through the anal opening
- Mucus discharge, moisture and difficulty keeping the area clean
What causes hemorrhoids?
Hemorrhoidal cushions swell when pressure in the anal veins goes up, or when the tissue holding them in place weakens. The common factors causing hemorrhoids include:
- Straining during bowel movements or spending a long time on the toilet
- Ongoing constipation or diarrhea
- Not getting enough fiber
- Pregnancy, aging, and childbirth, which can weaken the supporting tissue
- Frequently lifting heavy objects
Conditions that increase pressure in the veins around the anus, such as liver cirrhosis, can also increase the risk.
FAQs about hemorrhoid treatment online
What is the best prescription medicine for hemorrhoids?
There is no single best one, it depends on what is bothering you. For inflammation and itching, a corticosteroid such as hydrocortisone acetate 25 mg suppositories or hydrocortisone 2.5 percent cream. When pain is the bigger problem, a steroid combined with a local anesthetic like pramoxine. Witch hazel and zinc oxide turn up in a lot of hemorrhoid products, but they are astringent and protectant ingredients you can buy over the counter, not prescriptions. If bleeding or prolapse keeps coming back, the next step is usually rubber band ligation in a clinic rather than another cream.
What do doctors prescribe for severe hemorrhoids?
Severe hemorrhoids are usually a procedure question rather than a prescription one. A doctor may prescribe hydrocortisone acetate suppositories, or a steroid and anesthetic combination such as Analpram-HC or Proctofoam-HC, to settle the inflammation in the meantime. For grade 3 and grade 4 internal hemorrhoids, or a large external component that has not responded to medical management, StatPearls describes surgical hemorrhoidectomy as what is needed, and puts recurrence after surgery below 5 percent against 10 to 50 percent over five years with conservative treatment alone. Acetaminophen is the safer pain reliever here, because aspirin and NSAIDs make bleeding more likely.
What medicine shrinks hemorrhoids fast?
Nothing shrinks a hemorrhoid in minutes. The over-the-counter options work on the symptoms: topical anesthetics numb the area, hydrocortisone creams bring down inflammation and itching, witch hazel pads are astringent, and a warm sitz bath of about 15 minutes relaxes the anal sphincter and eases the pain. Acetaminophen is a reasonable pain reliever. Be careful with aspirin and NSAIDs such as ibuprofen, because they make bleeding more likely, and bleeding is the thing you are trying to stop. StatPearls gives conservative treatment 4 to 6 weeks before reassessing, so if nothing has shifted after a week, ask a doctor rather than layering on more creams.
Does prescription hemorrhoid cream work?
Yes, for the symptoms. A corticosteroid cream such as hydrocortisone 2.5 percent reduces inflammation and itching, and a steroid combined with a local anesthetic like pramoxine also takes the edge off the pain. Phenylephrine, zinc oxide, lanolin and glycerin appear in hemorrhoid products too, but those are over-the-counter ingredients rather than prescriptions. What none of them do is fix a prolapsing hemorrhoid, so a cream is a trial of a few weeks and not a long-term plan. Steroids are not meant for continuous use on anal skin either, which is why a doctor gives you a duration.
How to get rid of external hemorrhoids without surgery?
Most external hemorrhoids settle with conservative treatment: more fiber, which StatPearls puts at 25 g a day for women and 38 g for men, at least 64 oz of water, no straining, less time on the toilet, warm sitz baths, and a topical for the itch and pain. If an internal component is prolapsing or bleeding, office procedures avoid an operation: rubber band ligation is the most commonly performed, sclerotherapy is the option if you take a blood thinner, and infrared coagulation is a third. All three are done in a clinic rather than online, so a virtual consultation is where you find out whether you need one.
What is the fastest way to heal a thrombosed hemorrhoid?
A thrombosed external hemorrhoid is a blood clot, and it arrives as a sudden hard, painful lump. StatPearls notes the pain usually lasts 5 to 12 days and that a skin tag is often left behind once the swelling settles. The clot can be excised in a clinic under local anesthesia, which relieves the pain quickly, and that is far more useful early on than after a week of waiting it out. In the meantime, sitz baths, stool softeners, more fiber and water, and a topical anesthetic make it bearable. Because it is sudden and painful, this is worth raising with a doctor the day it happens.
Do I need to see a doctor for a thrombosed hemorrhoid?
Yes, get it assessed. A doctor can tell a thrombosed hemorrhoid apart from an abscess or a fissure, decide whether excising the clot under local anesthesia is worth it, and prescribe something for the pain. Talk to a doctor at Your Doctors Online first if you are not sure what you are dealing with, and go to an emergency department instead if there is heavy bleeding, a fever, or pain and swelling that is spreading.
How do you stop hemorrhoids from getting worse?
Take the pressure off. Get enough fiber, drink enough water, and do not sit on the toilet reading your phone, because straining and long sits are the two habits that make hemorrhoids worse. Treat constipation properly, with a fiber supplement or a stool softener if you need one. Keep a healthy weight, move regularly, and do not hold in a bowel movement. Use a topical for the itch and pain while a flare settles. If you are still bleeding or prolapsing after a few weeks of that, the answer is a procedure such as banding rather than more cream, so get it reviewed.
What is better for hemorrhoid cream or suppositories?
It depends where the hemorrhoid is, not on which form is stronger. A suppository is inserted into the rectum, so it reaches an internal hemorrhoid. Anusol-HC 25 mg suppositories are labelled for inflamed hemorrhoids and taken one morning and night. A cream or ointment is applied to the skin around the anus, so it suits an external hemorrhoid and the itching that comes with it. Plenty of people end up using both, and a doctor picks based on your symptoms.
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