Hemorrhoids: Causes, Symptoms, and Effective Home Remedies Backed by Evidence

Hemorrhoids—also known as piles—are swollen or dilated veins in the rectum or anus that can lead to itching, burning, pain, and rectal bleeding. While hemorrhoids rarely cause severe complications, they can be extremely uncomfortable and may interfere with daily activities, particularly when sitting or during bowel movements. Fortunately, many cases improve with proper home care, lifestyle adjustments, and early symptom management.

This article provides a comprehensive overview of hemorrhoid causes, symptoms, and the most effective evidence-based home treatments. It also explains when medical evaluation is necessary since rectal bleeding may sometimes indicate serious conditions such as colorectal cancer.

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What Are Hemorrhoids?

Hemorrhoids occur when the veins in the lower rectum or around the anus become swollen due to increased pressure. According to the American Society of Colon and Rectal Surgeons (ASCRS), hemorrhoids are one of the most common anorectal disorders and affect millions of adults worldwide.

There are two main types:

Internal Hemorrhoids

These develop inside the rectum and are usually painless. The most common symptom is bright-red bleeding during bowel movements (Mayo Clinic).

External Hemorrhoids

These form under the skin surrounding the anus. External hemorrhoids may cause burning, itching, swelling, and sharp pain, especially if a blood clot forms (a thrombosed hemorrhoid).

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Common Causes of Hemorrhoids

Numerous factors can increase pressure in the rectal veins and contribute to hemorrhoids. Research published in Clinics in Colon and Rectal Surgery identifies the following major causes:

• Chronic constipation

• Straining during bowel movements

• A low-fiber diet

• Prolonged sitting on the toilet

• Pregnancy, due to increased abdominal pressure

• Obesity

• Aging, which weakens supporting tissues

• Heavy lifting or intense pressure on the pelvic floor

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Symptoms of Hemorrhoids

According to Dr. Scott C. Thornton of Yale School of Medicine, hemorrhoid symptoms vary depending on severity but often include:

• Bright-red blood on toilet paper or in the bowl

• A tender lump near the anus (external hemorrhoid or prolapsed internal hemorrhoid)

• Itching or irritation in the anal region

• Pain during bowel movements

• A sensation of incomplete evacuation

Hemorrhoids are also classified into four grades based on prolapse severity, from Grade I (no prolapse) to Grade IV (permanently prolapsed and potentially requiring surgery).

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Evidence-Based Home Remedies for Hemorrhoids

Below are the most effective, research-supported methods to relieve hemorrhoid symptoms at home.

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1. Increase Fiber Intake

A high-fiber diet is considered one of the best ways to relieve and prevent hemorrhoids. Fiber softens stool, reduces straining, and improves bowel regularity.

The American College of Gastroenterology (ACG) recommends adults consume 25–35 g of fiber daily from foods such as:

• Beans and legumes

• Whole grains

• Fruits and vegetables

• Psyllium husk supplements

Multiple clinical trials have shown fiber can reduce bleeding, pain, and prolapse by nearly 50% (American Journal of Gastroenterology).

Hydration is equally important—drinking enough water keeps stool soft and prevents constipation.

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2. Witch Hazel

Witch hazel (Hamamelis virginiana) is rich in tannins with natural anti-inflammatory and astringent properties. Cleveland Clinic notes that applying witch hazel to external hemorrhoids may help:

• Reduce swelling

• Relieve itching

• Soothe skin irritation

Apply pure witch hazel using a cotton pad several times daily.

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3. Aloe Vera

Aloe vera is widely used for soothing inflamed skin. Studies published in Journal of Evidence-Based Complementary & Alternative Medicine show aloe vera gel may ease pain, itching, and inflammation associated with hemorrhoids. It may also improve healing of anal fissures.

Apply pure, additive-free aloe vera gel directly to the affected area.

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4. Cold Compress

The Mayo Clinic recommends using cold packs to reduce swelling and numb painful hemorrhoids. Apply a cold compress for 10–15 minutes several times a day to shrink enlarged veins.

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5. Sitz Baths

A sitz bath—soaking the anal area in warm water—is one of the simplest and most effective remedies.

A 2018 study in Women and Birth found that sitz baths used 2–3 times daily significantly improved hemorrhoid symptoms and provided pain relief comparable to medicated creams.

Sit in warm water (with or without Epsom salt) for 10–15 minutes, three times per day.

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6. Diluted Apple Cider Vinegar

Although not scientifically proven to cure hemorrhoids, apple cider vinegar has mild antiseptic and anti-inflammatory properties (Medscape). When diluted properly, it may help reduce irritation.

Mix equal parts water and ACV, apply gently with a cotton pad. Avoid using undiluted vinegar, as it may worsen irritation.

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7. Essential Oils (Used with Caution)

Some essential oils have demonstrated anti-inflammatory or soothing properties:

• Chamomile oil: may ease swelling and discomfort

• Peppermint oil: provides cooling relief due to menthol

• Rose oil or myrtle oil: traditionally used for anorectal inflammation

Always dilute essential oils in a carrier oil (e.g., coconut oil) and avoid internal application.

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8. Helpful Supplements

Certain herbal supplements may improve circulation and vein strength:

Horse Chestnut Extract

Shown to enhance venous tone and reduce hemorrhoid symptoms (Alternative Medicine Review).

Butcher’s Broom

Research indicates it may improve venous circulation and reduce swelling.

Pycnogenol (Pine Bark Extract)

Studies in Phytotherapy Research show it may reduce bleeding and pain within 48 hours.

Flavonoids (Diosmin, Hesperidin)

Widely used in Europe; shown to reduce bleeding, itching, and pain in multiple randomized trials.

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How to Prevent Hemorrhoids

Hemorrhoids are often preventable. Key strategies recommended by Harvard Health Publishing and NIH include:

• Eat a high-fiber diet

• Drink 6–8 glasses of water daily

• Avoid straining during bowel movements

• Do not sit on the toilet for long periods

• Exercise regularly to improve bowel function

• Avoid heavy lifting when possible

• Use a proper toilet posture (slight squatting position)

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When to See a Doctor

Seek medical attention immediately if:

• You notice rectal bleeding

• Symptoms persist beyond 1 week of home care

• A painful lump becomes severely swollen or thrombosed

• You experience dizziness or weakness

Rectal bleeding can sometimes signal colon polyps, inflammatory bowel disease, or colorectal cancer. The NHS and American Cancer Society emphasize that persistent bleeding should never be ignored.

Medical treatments—including rubber band ligation, sclerotherapy, infrared coagulation, or surgery—may be recommended for severe or recurring hemorrhoids.

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Conclusion

Hemorrhoids are common, uncomfortable, but highly treatable. Most cases improve significantly with simple lifestyle changes such as increasing fiber, staying hydrated, using sitz baths, and applying soothing topical remedies like witch hazel or aloe vera. However, rectal bleeding or persistent symptoms should always be evaluated by a healthcare professional to rule out more serious conditions.