Hemorrhoids Won’t Go Away? What to Do?

Written by

Jessica Guht

Jessica is a medical writer with an unquenched thirst to discover something new. She believes that medical content should be accessible to everyone and strives to write content that every single person can understand. When Jessica isn’t writing, she can usually be found reading a book with a dog cuddled in her lap. Jessica has a Masters of Engineering degree in Biomedical Engineering.

Medically reviewed by

Amy Dougherty, FNP-BC, AGAC

Amy is a Board Certified Family Health Nurse Practitioner (FNP) with over 15 years of experience working in Hospital Medicine, Urgent Care and Primary Care practices. Amy graduated Thomas Jefferson University with high distinction earning a Bachelor of Science in Nursing in 2008, a Master of Science in Nursing in 2010 and a Post Master's Certificate in Adult Gerontology Acute Care (AGAC) in 2014. She was recognized by the Elite American Nurses Association in 2013 for her dedication, achievements and leadership in the field Nursing. She served as a clinical preceptor for a number of Nurse Practitioner students and enjoys teaching the bright minds of future NPs.

Hemorrhoids can be uncomfortable but mild ones disappear in a matter of days. Unfortunately, larger ones can linger longer for some patients, causing continued discomfort, bleeding, and itchiness. 

In this post, we explore what to do if your hemorrhoids won’t go away. We take a look at how long they typically last and what you should do if yours remain longer than a week. 

Table of Contents

• What Are Hemorrhoids?
• How Long Do Hemorrhoids Usually Last?
• Why Won’t Your Hemorrhoids Go Away?
• What to Do for Hemorrhoids That Won’t Go Away?
• When to See a Doctor?
• How Can DrHouse Help You?
• Key Takeaways

What Are Hemorrhoids?

Hemorrhoids are veins that bulge out of the walls of the rectum and anus. They form in a similar way to varicose veins on the legs when blood vessel walls become lax and stretched. 

Hemorrhoids occur in two places: the walls of the rectum (part of the colon) or the anus. 

Rectal hemorrhoids are internal because they protrude from the digestive tract’s mucosal lining. Symptoms include painless bleeding while passing stools and, in rare cases, prolapse out of the anus. 

Anal hemorrhoids are external and protrude from the dry skin around the anus, not the mucosal layer. They are itchier and more painful than internal hemorrhoids, but easier to treat with topical creams. 

How Long Do Hemorrhoids Usually Last?

How long hemorrhoids last depends on their size and location. Small hemorrhoids can clear up in a matter of days while larger ones can persist for a lifetime (unless removed by a doctor). 

If you have small hemorrhoids and want to get rid of them faster, you can try making diet and lifestyle changes. Sitting less, exercising more, reducing stress, and eating a high-fiber diet are all beneficial. You may also wish to apply creams. These don’t get rid of hemorrhoids, but they can reduce the temptation to scratch and may protect tissue from further damage when you poop. 

Pregnant women may develop hemorrhoids as their pregnancy progresses. That’s because pressure from the baby in the abdomen can make anal veins larger. However, piles disappear after birth.

Why Won’t Your Hemorrhoids Go Away?

Worried about a hemorrhoid not going away? There could be several reasons for that such as:

Your Hemorrhoids Are Large

Large and external hemorrhoids are less likely to go away than smaller ones, even with radical lifestyle changes. Once tissues become distended, they are unable to return to their original position. 

You Are Eating a High-Fat, Low-Fiber Western Diet

Western diets have up to seven times less fiber than traditional rural diets. They also contain significantly more fat, sugar, and meat. 

Researchers believe low fiber intake increases straining at stool, making hemorrhoids more likely. Historically, people who ate a high-fiber diet were less likely to experience the condition. However since fiber was taken out of the diet, hemorrhoids became more common. 

Today, 50 percent of people have hemorrhoids before the age of fifty, and more than 75 percent will experience them at some point in their lives. 

You Keep Itching the Affected Area

Most hemorrhoids itch, producing an almost uncontrollable urge to scratch them. This occurs for several reasons, including inflammation from the tissue itself, and abrasion from passing feces. Close-fitting clothing can also play a role. 

Unfortunately, scratching can make hemorrhoids worse. The mucus from the rectum exits the anus and then dries on the sensitive anal skin. Over time, this can cause discomfort and irritation, leading to worsening pain and symptoms. 

Scratching can also lead to the formation of tears and cracks around the anus, called anal fissures. These can quickly feel sore, increasing the risk of bleeding, particularly if they surround active hemorrhoids. 

What to Do for Hemorrhoids That Won’t Go Away?

Fortunately, there are several things you can do about hemorrhoids that won’t go away. 

See Your Doctor!

Today, doctors offer a range of minimally invasive and surgical treatments to reduce and remove hemorrhoids. 

Sclerotherapy is popular because it doesn’t involve surgery. Here, physicians inject hemorrhoids with a substance that causes them to close up. Eventually, without blood flow, they die and flake off naturally. 

Rubber band ligation is another popular technique. Here, doctors tie a small rubber band around the hemorrhoid, blocking blood flow to the protruding section. Eventually, distended tissue dies and, just as with sclerotherapy, flakes off. However, this technique comes with a significant risk of bleeding. 

Doctors may also recommend laser or infrared coagulation. This technique involves shining light on hemorrhoids to encourage the blood inside to stiffen. Unlike sclerotherapy, patients get several treatments before they see results. 

Lastly, doctors may recommend surgery. Stapled hemorrhoidectomy is one option. This procedure is suitable for patients with large, painful, or protruding internal hemorrhoids and involves using staples to excise the affected tissue. However, it is not suitable for external piles. 

Hemorrhoidectomies are another surgical option. These are suitable for the complete removal of external hemorrhoids and are often a permanent solution. Physicians may recommend this option if other treatments, such as rubber band ligation or sclerotherapy haven’t worked in the past. 

Eat More Fiber

Eating more fiber may improve hemorrhoid symptoms significantly. A systematic review found that high-fiber treatment prevented symptoms from getting worse and reduced the risk of not improving. 

Fiber increases the size of stools and makes them softer, allowing them to pass out of the anus. Therefore, those eating diets high in whole grains, legumes, fruits, and vegetables find it considerably easier to pass waste. They are also much less likely to experience constipation, a risk factor in hemorrhoid development.  

There are several simple methods you can use to increase the quantity of fiber in your diet. For instance, you can: 

• Replace animal protein with beans or lentils on three or four nights of the week
• Swap out your regular breakfast cereal for oats, dates, and fruit
• Add flax seeds to your salads and smoothies
• Reduce the amount of refined oil in your diet and eat plant sources of fat instead, such as avocado, nuts, and seeds

However, you will need to be careful. Increasing the roughage content of your diet too quickly can lead to gas and bloating. 

Use Creams

Lastly, you can get help with hemorrhoid scratching by using anal and rectal hemorrhoid creams. These creams contain several active ingredients designed to improve symptoms. 

Most formulations contain topical anesthetics. These compounds numb nerve receptors around your piles, reducing the urge to scratch significantly. 

Products also contain anti-swelling agents. These reduce the size of the hemorrhoids, making them more comfortable, similar to Epsom salt baths.

Creams also contain additional agents, such as plant or animal fats. These form a barrier between hemorrhoids and passing stools, making them less likely to bleed or cause pain when patients are on the toilet. 

If you decide to use hemorrhoid creams, always follow the instructions on the packet. If your cream contains steroids, do not use it for more than a week unless instructed to do so by your doctor. Steroids can thin the tissue around the rectum and anus, potentially making piles worse over time. 

When to See a Doctor?

If you have hemorrhoids that won’t go away, you should see a doctor as soon as you can. While piles are not a serious condition, they can be uncomfortable and reduce your quality of life. 

You should also go to your doctor as a matter of urgency if hemorrhoids cause bleeding during or after bowel movements. Physicians will want to rule out more serious conditions, such as colon cancer. 

You should also go to your doctor if symptoms last longer than a week. While some hemorrhoids will go away by themselves, many will not. You may require minimally invasive or surgical procedures to eliminate them.

If your symptoms get worse over time, a doctor’s appointment is advised. Medics can provide you with topical remedies and lifestyle advice to help ease symptoms. 

Make sure that you get medical attention as soon as you can if you notice a bulge or prolapsed hemorrhoid. Physicians may be able to push the pile back into the anus or use a procedure to remove it. 

Some patients develop thromboses in their hemorrhoids. Blood clots make piles significantly more painful and often require immediate treatment. 

When you go to the doctor’s office about your hemorrhoids, they will review your medical history, talk to you about your symptoms, and then perform a physical exam. They will tell you the type of hemorrhoids you have (internal, external, prolapsed, thrombosed, etc.), and recommend a course of treatment. They may also perform a colonoscopy to look for signs of other diseases, such as cancer. 

How Can DrHouse Help You?

If you’re dealing with hemorrhoids, DrHouse is here to help. With DrHouse you can make on-demand online doctor visits without ever having to leave your home! DrHouse is a convenient, affordable way to get the medical care you need when you need it. Plus, our online doctors can provide a diagnosis and prescription for hemorrhoids if needed. 

Key Takeaways

• Small hemorrhoids usually go away by themselves but larger ones often remain indefinitely
• If your hemorrhoids won’t go away, you should speak to your doctor about treatment
• The main causes of persistent hemorrhoids are low-fiber diets, regular scratching, and piles that have already grown to a large size
• Direct treatment for piles includes rubber band ligation, sclerotherapy, stapling, and surgical removal
• Patients may be able to improve piles symptoms with creams and eating a high-fiber diet
• If your hemorrhoids are large or don’t clear up by themselves, you should see a doctor

Sources:

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• MacKay D. Hemorrhoids and varicose veins: a review of treatment options. Altern Med Rev. 2001 Apr;6(2):126-40. PMID: 11302778.
• A. F. Avsar & H. L. Keskin (2010) Haemorrhoids during pregnancy, Journal of Obstetrics and Gynaecology, 30:3, 231-237, DOI: 10.3109/01443610903439242.
• Alonso-Coello, Pablo1; Mills, Ed2; Heels-Ansdell, Diane2; López-Yarto, Maite3; Zhou, Qi2; Johanson, John F.4; Guyatt, Gordon2. Fiber for the Treatment of Hemorrhoids Complications: A Systematic Review and Meta-Analysis. American Journal of Gastroenterology: January 2006 – Volume 101 – Issue 1 – p 181-188.
• Abraham A, Roga G. Topical steroid-damaged skin. Indian J Dermatol. 2014;59(5):456-459. doi: https://www.doi.org/10.4103/0019-5154.139872.
• John F. Johanson, Amnon Sonnenberg, The prevalence of hemorrhoids and chronic constipation: An epidemiologic study, Gastroenterology, Volume 98, Issue 2, 1990, Pages 380-386, ISSN 0016-5085, https://doi.org/10.1016/0016-5085(90)90828-O.