From the Guidelines
Hemorrhoids typically resolve within one to two weeks with proper home care, though some may take up to a month to heal completely. For mild hemorrhoids, over-the-counter treatments like hydrocortisone creams (0.5-1%), witch hazel pads, or oral pain relievers such as acetaminophen or ibuprofen can provide relief 1. Warm sitz baths for 15 minutes, 2-3 times daily, help reduce swelling and discomfort. Increasing fiber intake to 25-30 grams daily, drinking plenty of water, and avoiding straining during bowel movements can speed healing.
Key Considerations
- The healing time for hemorrhoids can vary depending on their size, type (internal or external), and whether they're thrombosed (containing a blood clot) 1.
- Thrombosed hemorrhoids may take longer to heal but often improve significantly within 7-10 days as the clot dissolves.
- For persistent or severe hemorrhoids, medical treatments may be necessary, including prescription-strength creams, minimally invasive procedures like rubber band ligation, or surgery in extreme cases 1.
Treatment Options
- Nonoperative techniques for ablating hemorrhoids include injection sclerotherapy, diathermy coagulation, bipolar coagulation, infrared coagulation, and rubber band ligation 1.
- Rubber band ligation is most commonly used for first-, second-, or third-degree hemorrhoids and has a high success rate, but may cause pain in some patients 1.
- Surgical treatment may be beneficial in selected patients with thrombosed hemorrhoids, but the decision between non-operative management and early surgical excision should be based on physician’s expertise and patient’s preference 1.
From the Research
Duration for Resolution of Hemorrhoids
The duration for the resolution of hemorrhoids can vary depending on the treatment approach and the severity of the condition.
- For acutely thrombosed external hemorrhoids, excision and evacuation of the clot, ideally within 72 hours of symptom onset, is the optimal management 2.
- For prolapsed and strangulated hemorrhoids, management with stool softeners, analgesics, rest, warm soaks, and ice packs until recovery is recommended, with residual hemorrhoids banded or excised later 2.
- Rubber band ligation is effective in 75% of patients in the short term, but does not treat prolapsed hemorrhoids or those with a significant external component 3.
- The median follow-up time for rubber band ligation was 1,204 days, with success rates of 70.5% and failure rates of 29.5% 4.
- Time to recurrence was less with subsequent treatment courses, with treatment of recurrent symptoms with rubber band ligation resulting in success rates of 73.6%, 61.4%, and 65% for first, second, and third recurrences, respectively 4.
- Excision of thrombosed external hemorrhoids can greatly reduce pain if performed within the first two to three days of symptoms 5.
- Acutely strangulated hemorrhoids may be treated either conservatively or operatively, with the majority of patients who are treated conservatively still requiring definitive treatment at a later date 3.