Hemorrhoid Discharge Instructions
Patients with hemorrhoids should follow a regimen of increased dietary fiber and water intake, along with proper bathroom habits, as first-line management to prevent symptom recurrence and avoid surgical intervention. 1
Dietary and Lifestyle Modifications
Fiber intake:
- Increase dietary fiber through foods or supplements (5-6 teaspoons of psyllium husk with 600mL water daily) 2
- Aim for 25-30g of fiber daily from fruits, vegetables, whole grains
- Fiber helps create soft, bulky stools that pass more easily
Hydration:
- Drink at least 8 glasses (2 liters) of water daily
- Adequate hydration works with fiber to soften stool
Bathroom habits (TONE method):
- T: Three minutes maximum time on toilet (avoid prolonged sitting)
- O: Once-a-day bowel movement frequency (establish regular routine)
- N: No straining during defecation (straining increases pressure on hemorrhoids)
- E: Enough fiber daily 2
Pain Management
- Take warm sitz baths (sitting in warm water) for 10-15 minutes, 2-3 times daily
- Apply cold compresses to reduce swelling
- Use over-the-counter pain relievers as needed:
- Acetaminophen or NSAIDs for pain relief
- Avoid opioid pain medications as they can cause constipation
Topical Treatments
- Apply topical hemorrhoid creams or ointments as directed
- For thrombosed or strangulated hemorrhoids, topical muscle relaxants may provide relief 1
- Limit use of topical corticosteroids to short periods (less than 7 days) as prolonged use can be harmful 1
- Consider flavonoid supplements to relieve symptoms 1
Warning Signs (When to Seek Medical Attention)
Return to healthcare provider if you experience:
- Severe pain not relieved by prescribed measures
- Heavy rectal bleeding or blood clots
- Fever
- Inability to urinate
- Increasing swelling or pain despite treatment
- Symptoms that don't improve within 1-2 weeks
Follow-up Care
- Schedule a follow-up appointment as recommended by your provider
- If bleeding persists or recurs, further evaluation with anoscopy or colonoscopy may be necessary 1
- For patients with risk factors for colorectal cancer (family history, age >45), colonoscopy should be considered to rule out other causes of bleeding 1
Prevention of Recurrence
- Maintain the dietary and lifestyle modifications long-term
- Avoid prolonged sitting, especially on the toilet
- Exercise regularly to promote healthy bowel function
- Respond promptly to the urge to defecate (don't delay bowel movements)
Special Considerations
For thrombosed external hemorrhoids:
- Cold compresses and pain medication are most helpful in the first 48-72 hours
- Surgical excision is most effective if performed within the first 2-3 days of symptoms 3
- Pain typically resolves after 7-10 days even without surgical intervention 1
Implementing these discharge instructions can help most patients avoid surgical intervention, even those with advanced hemorrhoids 2. Proper fiber supplementation combined with the TONE method has been shown to stop progression of hemorrhoids and prevent bleeding episodes in the majority of patients.