Comprehensive Guide to Hemorrhoids Treatment

Hemorrhoids are an incredibly common yet often misunderstood condition that many people face at some point in their lives. Whether they’re caused by straining during bowel movements, prolonged sitting, improper lifting techniques while exercising, or anal intercourse, the discomfort and inconvenience they bring can significantly impact your day-to-day life. The good news? Most hemorrhoids can be managed with simple, non-invasive treatments and a few lifestyle adjustments.

At Bespoke Surgical, we believe in empowering our patients with knowledge and support. That’s why we’ve put together this comprehensive guide to hemorrhoid treatment. From identifying the symptoms to exploring both non-surgical and surgical options, we’re here to help you find the relief you need while prioritizing your comfort and well-being.

What Is a Hemorrhoid?

Hemorrhoids are inflamed veins in and around the anus, resulting from increased pressure that causes them to bulge and expand, leading to significant pain, swelling, and or bleeding. The most common cause is constipation and straining during bowel movements, sitting for prolonged periods of time, and/or anal intercourse. Two different types of hemorrhoids can occur: external or internal. More than 90% heal without surgery, and you will be given an appropriate bowel regimen and topical creams to provide relief as they heal. However, hemorrhoids that become chronic may require surgical treatment or a hemorrhoidectomy. At Bespoke Surgical’s NYC practice, surgery is our last resort. Read further to see the non-surgical hemorrhoid treatments we recommend.

Types of Hemorrhoids: Internal vs. External

Hemorrhoids come in two main types—internal and external—and understanding the differences is key to identifying the best treatment options.

Internal hemorrhoids develop inside the rectum and are generally not visible. Because this type doesn’t have as many pain-sensing nerves, it’s often painless, but may cause rectal bleeding or a sensation of fullness and pressure. You might notice bright red blood on toilet paper or in the stool, which can be alarming, but is a common symptom. You may also feel significant tightness of the underlying muscles (the anal sphincter), as well as lumps internally. Internal hemorrhoids are typically diagnosed through a digital rectal exam or anoscopy, a procedure where a small, lighted tube allows a medical professional to view the area.

External hemorrhoids occur under the skin around the anus, making them visible and often more painful. These can cause itching, swelling, and significant discomfort, particularly if they become thrombosed (clotted). Unlike their internal counterparts, external hemorrhoids are easier to identify and diagnose because of their location.

What Are the Symptoms of Hemorrhoids?

While both external and internal hemorrhoids may cause bleeding, localized swelling, and thrombosis, the key difference between the two is that external hemorrhoids generally cause pain, while internal ones do not. Sometimes external thrombosed hemorrhoids develop anal skin tags in the region due to the overlying skin being stretched.

Should You See a Doctor?

Yes, you should see a doctor if you think you have hemorrhoids because many people misdiagnose their current ailment as hemorrhoids (via the marvels of a quick Google search) when it is actually something completely different. That difference lends itself to not only alternative medical treatments but also improved outcomes and decreased duration of one’s symptoms.

But we do understand the hesitation to see a medical professional each time an ailment occurs, especially inside one’s asshole. If you choose this self-treatment route, you can use over-the-counter medications, like stool softeners, creams, and Epsom salt baths. We would suggest only allowing 3 days to pass before re-evaluating to make sure your symptoms are improving.

When Should You See Your Doctor About Your Hemorrhoids?

Bleeding, pain, and/or lumps inside and on the outside of your ass is not normal, that’s for sure. Yes, it can happen as a one-off or over the course of a few days that resolves itself with minimal effort. But if it persists beyond that window or becomes more of a recurring issue, medical evaluation is warranted.

A thorough history and physical examination will allow an accurate diagnosis and an appropriate treatment plan. Most anal issues are more quality of life concerns, and it’s important not to keep kidding oneself if it has made a detrimental impact on both defecation and anal intercourse, especially if you believe you’re having a hemorrhoid from anal sex. This should be an easy and straightforward process without any obstacles. Get evaluated. But by who? Read on to the next question and answer.

What Kind of Doctor Should I See About My Hemorrhoids?

The best recommendation is to see a gay-friendly or sex-friendly proctologist who has the sensitivities to provide the appropriate care to your specific community and healthcare needs. If they don’t ask you for an appropriate sexual history that is compatible with how you engage sexually, walk out and find a new doctor.

Even though the ass may be seen as simply another hole, it’s actually quite unique. We see time and time again complications leading from one’s initial improper medical and surgical diagnosis and management. The key is early, accurate diagnosis and treatment with appropriate follow-up. This is why you should see a doctor: if done correctly, a simple ailment, like a hemorrhoid, can be a thing of the past, leaving no trace of functional and/or cosmetic concern.

If you live in or near the New York City area, we at Bespoke Surgical would be happy to help you with any questions or treatment options for your hemorrhoids. Bespoke Surgical is an elite anal surgery practice purpose-built for anyone looking to improve their anal health.

What Is the Treatment for Hemorrhoids?

Non-Surgical Hemorrhoid Treatments

There are ways to attempt to treat hemorrhoids from home. The appropriate initial non-surgical regimen to treat hemorrhoids consists of:

• Over-the-counter stool softeners, such as Colace, three times daily
• Over-the-counter fiber supplements, such as Metamucil
• Over-the-counter internal and external hemorrhoidal creams
• Sitz baths with over-the-counter Epsom salts
• Proctozone 2.5% or a similar steroid, a prescription topical anal ointment, should be applied as directed by your physician.
• Boosting your fiber intake with choices such as grains and whole-grain products, fruits, vegetables, legumes, nuts, and seeds
• Increasing your overall water intake to 8-12 ten-ounce glasses per day
• Keeping the anal area clean and dry. Wash gently with warm, soapy water, and pat dry.
• Limiting the use of toilet paper, as wiping causes local inflammation. Please refrain from using baby wipes or medicated pads for prolonged periods, and do not spend more time sitting on the toilet than necessary.
• If you believe you have a hemorrhoid from anal sex or other anal play, consider beginning exercises to help gain control of your sphincter. This may help prevent anal sex hemorrhoids in the future.

Surgical Hemorrhoid Treatments

When non-surgical options fail to provide relief or if hemorrhoids become chronic and severely symptomatic, surgical intervention may be necessary. At Bespoke Surgical, we view surgery as a last resort, but for some patients, it’s the most effective way to restore comfort and quality of life. The most common surgical hemorrhoid treatments include:

• Cauterization: This procedure uses heat or electrical energy to seal off the blood vessels supplying the hemorrhoid, causing it to shrink and eventually fall off. While minimally invasive, cauterization can lead to temporary sensitivity in the area, so it’s important to allow time for complete healing before engaging in anal sex.
• Banding: Rubber band ligation involves placing a small elastic band around the base of the internal hemorrhoid. This cuts off its blood supply, causing it to wither and detach naturally. Banding typically has a short recovery time, but the treated tissue can leave behind scarred areas. These scars may reduce elasticity slightly, which could influence comfort during anal sex. Open communication with a healthcare provider is key to managing these outcomes.

• Hemorrhoidectomy: A hemorrhoidectomy involves the surgical removal of hemorrhoids and is often recommended for large external or chronic hemorrhoids that don’t respond to other treatments. While highly effective, this procedure can lead to a longer recovery period and temporary discomfort. Scar tissue formation is common, which may impact flexibility and sensation during anal sex. Proper post-surgical care and gradual reintroduction to activities can help mitigate these effects.
• Procedure for prolapse and hemorrhoids (PPH): Also known as a stapled hemorrhoidectomy, this method treats prolapsed internal hemorrhoids by repositioning them and reducing their blood flow. PPH typically results in less pain than traditional hemorrhoidectomy and a faster recovery. However, similar to other surgeries, scar tissue may develop, potentially altering the area’s sensitivity. This is not recommended for people who engage in anal play, as it can have detrimental long-term effects.

Recovering from Hemorrhoid Surgery

Recovering from hemorrhoid surgery is a process that requires care, patience, and attention to your body’s signals. While recovery timelines can vary depending on the individual and the procedure performed, most clients return to their normal routines within a few weeks.

Exercise After Hemorrhoid Surgery

Most clients feel ready to return to the gym about a week after surgery. However, it’s important to ease back into physical activity. Avoid heavy gluteal work or exercises that put pressure on the pelvic area for at least two to three weeks. Walking and light cardio are great ways to stay active without disrupting the healing process.

Intercourse After Hemorrhoid Surgery

Many clients are curious about when they can safely resume sexual activity. For those engaging in vaginal intercourse or topping, most can do so about one week after surgery. We recommend starting with masturbation to ensure the pelvic floor muscles, which contract during orgasm, are not causing significant pain. For clients who bottom, it’s best to wait at least six weeks to allow for complete healing and reduce the risk of anal fissures or infections. Gradual reintroduction with proper lubrication and communication is key to preventing discomfort.

Water Submersion After Hemorrhoid Surgery

Pools, jacuzzis, and even the ocean can be safe and beneficial for healing after hemorrhoid surgery. These activities can often be resumed within 2-3 days post-procedure, provided you follow proper hygiene practices. Showering immediately after submerging and adhering to your usual cleansing rituals will help prevent infections while allowing you to enjoy the soothing benefits of water.

Prevention: Lifestyle Tips and Patient Education

Preventing future hemorrhoids requires a combination of mindful practices during sexual activity and lifestyle adjustments to support overall anal and digestive health.

Protection During Anal Sex

To minimize the risk of developing hemorrhoids from anal sex, lubrication is essential. Generously apply a high-quality lubricant to reduce friction and protect vulnerable tissue. We recommend Future Method’s Silicone Anal Lube, which is specially formulated to support a healthy anal environment, maintaining your natural pH balance and microbiome. Prioritizing proper preparation and communication during intimacy also plays a crucial role in preventing irritation or injury.

Diet and Lifestyle Modifications

Hemorrhoid prevention starts with a healthy digestive system. Incorporating more dietary fiber into your meals helps regulate bowel movements, reducing the need for straining during defecation—a major cause of hemorrhoids. Foods like fruits, vegetables, whole grains, and legumes are excellent sources of fiber.

Stay hydrated by drinking plenty of water throughout the day to soften stool and promote smoother digestion. You should also exercise regularly to improve circulation and maintain a healthy weight, which ultimately reduces pressure on the rectal veins.How Bespoke Surgical Helps Patients Prevent Future Hemorrhoids

The key to managing hemorrhoids effectively isn’t just about treating the symptoms—it’s about identifying and addressing the underlying causes. At Bespoke Surgical, we go beyond standard treatments to evaluate why hemorrhoids developed in the first place. Without tackling the root cause, the problem can persist, especially for those engaging in anal intercourse.

Many clients experience tightness and elevated pressure in the anal region, which can exacerbate hemorrhoid issues. Muscle spasms and high pressures often need targeted intervention, such as anal manometry testing to measure these forces. From there, treatments like anal botox and pelvic floor physical therapy can help relax the area and improve overall function.

For long-term prevention, we frequently recommend anal dilation protocols to enhance pelvic floor mechanics and strengthen the anal muscles in a healthy, controlled way. Optimizing stooling habits, lifting techniques, and sexual practices also plays a critical role in reducing pressure on the anal region. With Bespoke Surgical’s comprehensive approach, we can not only treat hemorrhoids but also set the stage for improved anal health and long-term prevention—because prevention is the ultimate goal.

Conclusion

Hemorrhoids may be a common condition, but their impact on comfort and confidence is anything but minor. The good news is that with the right treatments, recovery strategies, and preventative measures, managing and even avoiding hemorrhoids is entirely possible. Whether you’re addressing the issue through non-surgical methods, considering surgical options, or taking steps to prevent future occurrences, knowledge and preparation are your best allies.

At Bespoke Surgical, we understand the unique concerns that come with anal health. Our goal is to provide compassionate care, expert guidance, and tailored solutions that fit your lifestyle. Remember, your health is an investment in your future. If you have questions or need personalized care, we’re here to support you every step of the way. Let’s take the journey toward better anal health together.

Additional Resources

At Bespoke Surgical, we offer expert hemorrhoid surgery solutions tailored to your comfort and recovery. Whether managing chronic discomfort or addressing advanced cases, our team prioritizes compassionate care and personalized treatment to help you heal and regain confidence in your body.