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<div><div>Home and office treatment of symptomatic hemorrhoids</div> <span><div><div> <div><div><select><option>Select Language</option> <option>Chinese</option><option>English</option></select></div> <div><span></span></div> </div></div></div></span><div><div><dl><dt><span> </span>Authors:</dt><dd><a>Ronald Bleday, MD</a></dd><dd><a>Elizabeth Breen, MD</a></dd><dt><span> </span>Section Editor:</dt><dd><a>Martin Weiser, MD</a></dd><dt><span> </span>Deputy Editor:</dt><dd><a>Wenliang Chen, MD, PhD</a></dd></dl><div><div><bdi><span>Literature review current through:</span>&nbsp;Jun 2025.</bdi></div><div><bdi><span>This topic last updated:</span>&nbsp;Oct 25, 2023.</bdi></div></div></div></div><div><p><span>INTRODUCTION</span></p><p>Hemorrhoids are collections of submucosal, fibrovascular, arteriovenous sinusoids that are part of the normal anorectum [<a>1</a>]. In epidemiologic studies conducted in Korea, England, and Austria, between 14 and 39 percent of the population had hemorrhoids; however, many were without symptoms [<a>2-4</a>]. Hemorrhoids without any symptoms do not require treatment. </p><p>By contrast, an estimated 10 million people in the United States complained of hemorrhoids, corresponding to a prevalence of 4.4 percent [<a>5</a>]. The most common complaint associated with hemorrhoidal disease is painless rectal bleeding during defecation with or without tissue prolapse. Other typical symptoms include anal pruritus or pain and a lump at the anal verge due to thrombosis or strangulation [<a>2</a>]. (See  <a>"Hemorrhoids: Clinical manifestations and diagnosis", section on 'Clinical manifestations'</a>.)</p><p>Those presenting for symptomatic hemorrhoids probably represent a group with relatively severe disease. Because a large variety of over-the-counter products are available and marketed for the treatment of hemorrhoids, patients often self-diagnose and self-treat before seeking medical attention. Incidentally, the quality of information about hemorrhoids on the internet is highly variable, and a significant proportion of websites assessed are poorly informed (40 percent in one study [<a>6</a>]).</p><p>Several options are available for the treatment of symptomatic hemorrhoids, and most patients with low-grade internal hemorrhoids will have relief with home-based conservative treatment or office-based procedures that are reviewed in this topic. Surgery is indicated for low-grade hemorrhoids that are refractory to home- or office-based treatments, high-grade hemorrhoids, and complicated hemorrhoids. Surgical treatment of hemorrhoids is reviewed separately. (See  <a>"Surgical treatment of hemorrhoidal disease"</a>.)</p><p><span>CLASSIFICATION OF HEMORRHOIDS</span></p><p>Hemorrhoids are classified relative to their relationship to the dentate line  (<a>figure 1</a>): </p><a></a><a></a><a></a><a></a><a></a><a></a><a></a><a></a><a></a><a></a><a></a><a></a><a></a><a></a><a></a><a></a><a></a><a></a><a></a><a></a><a></a><a></a><a></a><a></a><a></a><a></a><a></a><a></a><a></a><a></a><a></a><a></a></div><div><div>To continue reading this article, you must sign in with your personal, hospital, or group practice subscription.</div>  <div><div><a> <span> Subscribe</span> </a></div> <div><a> <span> Sign in</span> </a></div></div></div><div>Disclaimer: This generalized information is a limited summary of diagnosis, treatment, and/or medication information. It is not meant to be comprehensive and should be used as a tool to help the user understand and/or assess potential diagnostic and treatment options. It does NOT include all information about conditions, treatments, medications, side effects, or risks that may apply to a specific patient. It is not intended to be medical advice or a substitute for the medical advice, diagnosis, or treatment of a health care provider based on the health care provider's examination and assessment of a patient's specific and unique circumstances. Patients must speak with a health care provider for complete information about their health, medical questions, and treatment options, including any risks or benefits regarding use of medications. This information does not endorse any treatments or medications as safe, effective, or approved for treating a specific patient. UpToDate, Inc. and its affiliates disclaim any warranty or liability relating to this information or the use thereof.
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