Hemorrhoids Specialist

What are hemorrhoids? 

Hemorrhoids, also referred to as piles, are enlarged blood vessels in your rectum or around your anus. This digestive condition is relatively common, affecting about 1 in 20 adults in the United States. Oftentimes, hemorrhoids are misdiagnosed or mistreated, causing further complications and confusion.

Hemorrhoids are similar to varicose veins, in that they are the result of increased pressure on the vessels that respond by bulging and dilating. There are two types of hemorrhoids:

• Internal: dilated blood vessels inside the rectum, which you can’t see or feel 
• External: dilated blood vessels that sit just below the skin near and around the anus
  
  

Typically, internal hemorrhoids don’t cause pain or discomfort. With external hemorrhoids, you may not have signs, or you may have pain or other symptoms.
 

What are the symptoms of hemorrhoids?

If you have symptoms of hemorrhoids, you may experience:

• Pain or discomfort when sitting
• Itching or irritation near your anus
• Swelling around your anus
• Tenderness or burning at anus
  
  

You may also note tinges of red blood in your stools. In some cases, your hemorrhoid becomes thrombosed when it develops a blood clot. This development often causes severe pain and inflammation. 

What causes hemorrhoids? 

Hemorrhoids develop as a result of increased pressure on the vessels of the rectum and anus. Conditions that may increase your risk for developing hemorrhoids include:

• Pregnancy 
• Obesity 
• Advancing age
• Anal sexual intercourse
• Chronic diarrhea or constipation
  
  

Eating a low-fiber diet and regularly lifting heavy weights may increase your risk of hemorrhoids. 

How to Find Relief at Home and When to See a Proctologist

Hemorrhoids are a common condition – an estimated 1 in 20 Americans experience
symptomatic hemorrhoids, and over half of people above age 50 will develop them.

These swollen veins in the rectum or anus can cause pain, itching, bleeding, and
significant discomfort. The good news is that effective hemorrhoid treatment is
available, from simple home remedies to advanced medical procedures. In this post,
weʼll discuss how to treat hemorrhoids at home, the best over-the-counter (OTC)
hemorrhoid treatments (including an advanced OTC cream Dr. Aronoff
recommends), and when to seek professional care.

Dr. Jeffrey Aronoff – a board-certified colorectal surgeon (proctologist) in New York
City – has decades of experience treating hemorrhoids and helping patients find
relief. Read on for his expert tips and guidance.

Home Remedies for Hemorrhoid Relief
For many people, hemorrhoid symptoms can be managed with conservative athome treatments. In fact, hemorrhoid symptoms often improve within about a week
with diligent home care .
Here are some actionable tips for managing hemorrhoids at home:

•   Eat a High-Fiber Diet: Increasing your fiber intake softens stools and
  prevents straining. Include plenty of fruits, vegetables, whole grains, and
  consider a fiber supplement. Aim for 20–35 grams of fiber daily.
   This helps reduce constipation and pressure on hemorrhoidal veins.
   
• Stay Hydrated: Drink plenty of water throughout the day.
  Adequate fluids, along with fiber, help keep bowel movements soft and regular,
  preventing the need to strain.
• Warm Sitz Baths: Soaking the anal area in warm water for 10–20 minutes,
  several times a day, can soothe irritation and reduce swelling
• A sitz bath (a shallow, warm bath for your backside) after bowel movements is
  especially helpful for relieving pain and itching.
• Over-the-Counter Ointments: Apply OTC hemorrhoid creams or use 
  medicated wipes for symptom relief.
• Products containing ingredients like lidocaine (a local anesthetic), witch
  hazel (astringent), or hydrocortisone (anti-itch) can ease pain and itching.
  (Weʼll discuss Dr. Aronoffʼs top recommended cream in the next section.)
• Good Toilet Habits: Avoid straining or sitting too long on the toilet. Go as
  soon as you feel the urge – donʼt delay bowel movements. Afterward, gently
  pat the area clean with unscented wet wipes or damp tissue; donʼt wipe
  aggressively.
• Exercise and Avoid Heavy Lifting: Regular physical activity helps prevent
  constipation. However, try not to lift very heavy objects or hold your breath
  during exertion, as that can increase abdominal pressure and worsen
  hemorrhoids.
• Pain Relief Measures: If you have soreness, you can take an over-thecounter pain reliever like ibuprofen (an NSAID) to reduce pain and
  inflammation. Applying a cold compress to the anal area can also numb pain
  and reduce swelling in the short term.

By following these self-care steps, many people experience improvement. However,
if your symptoms persist or worsen despite home treatment, it may be time to
consider other options.

Over-the-Counter Hemorrhoid Treatment Options
In addition to lifestyle remedies, over-the-counter (OTC) hemorrhoid treatments
can provide significant relief. Non-prescription creams, ointments, suppositories,
and wipes are readily available and can help shrink hemorrhoids and soothe
symptoms. Common active ingredients include:

•  Lidocaine – a local anesthetic that numbs pain and itching
• Phenylephrine – a vasoconstrictor that reduces swelling of hemorrhoidal
  tissue
• Hydrocortisone – a mild steroid that relieves itch and inflammation
•  Witch hazel – a natural astringent that can reduce bleeding and swelling,
  often found in medicated pads
• Protectants like petrolatum or glycerin – which form a barrier to protect irritated skin and promote healing

When choosing an OTC product, look for one that addresses the range of
hemorrhoid symptoms (pain, itch, swelling, and irritation) with a combination of
effective ingredients. Dr. Aronoff often guides patients toward high-quality,
comprehensive ointments rather than basic creams that only numb pain.
Dr. Aronoffʼs Top Choice for OTC relief.
#1 Revivol-XR Advanced Hemorrhoid & Fissure Cream – This maximum-strength
ointment is one of the most complete OTC hemorrhoid treatments available at
hemorrhoid.com.

It combines 5% lidocaine for rapid pain and itch relief, 0.25% phenylephrine HCl to
shrink swollen tissue, and 14.4% glycerin to protect delicate skin. Itʼs also enriched
with soothing botanicals like Aloe Vera, Witch Hazel, Horse Chestnut, Calendula,
and Centella Asiatica, which help calm inflammation and promote healing. By
addressing multiple symptoms at once, Revivol-XR provides fast, multi-faceted
relief for hemorrhoid sufferers. (Dr. Aronoff is a paid sponsor of Revivol-XR
products, and he recommends this cream for patients seeking OTC relief.)

When using an OTC cream or suppository, be sure to follow the package
instructions. Typically, you would apply the ointment after bowel movements and
up to 3–4 times a day for a week, or as directed by a physician. If an over-thecounter hemorrhoid treatment is going to help, you should notice improvement in
symptoms within several days. If a week goes by with no relief, or if you
experience significant bleeding or worsening pain, seek medical advice instead
of continuing self-treatment.

When to Seek Professional Hemorrhoid Treatment
While mild hemorrhoids often improve with home care and OTC products, more
severe cases require medical evaluation and treatment. You should see a Colon &
Rectal Doctor (proctologist) if you have:

• Persistent or Worsening Symptoms: If pain, bleeding or itching continue for
  more than a week despite home treatment .
  Hemorrhoid symptoms that interfere with your daily life or sleep are a sign you need
  professional help.
•  
• 
  Frequent Recurrences: If hemorrhoid flare-ups keep coming back or
  chronically bother you, a specialist can provide a long-term solution.
• Significant Bleeding: Any rectal bleeding should be evaluated. Hemorrhoids
  are a common cause of bleeding, but a doctor will want to rule out other
  causes and may need to treat a bleeding hemorrhoid with a procedure.
• Extreme Pain or a Lump: A very painful, hard lump near the anus could be a
  thrombosed external hemorrhoid (a clot formed in the hemorrhoid). These
  sometimes need minor surgery to remove the clot and relieve pain.
• Prolapse: If internal hemorrhoids protrude out of the anus and donʼt retract
  on their own (or canʼt be gently pushed back), this prolapse may require
  medical or surgical intervention.

Keep in mind that hemorrhoid-like symptoms can sometimes be due to other
anal/rectal conditions (like fissures or fistulas), so getting an accurate diagnosis is
important

“Oftentimes, hemorrhoids are misdiagnosed or mistreated, causing further
complications and confusion,ˮ Dr. Aronoff notes. Seeing a colorectal specialist
ensures you know exactly what youʼre dealing with and receive the proper
treatment.

Advanced Hemorrhoid Treatments by a Proctologist
If you visit Dr. Aronoff (or another colorectal specialist) for hemorrhoids, the first
step will be a thorough evaluation. Dr. Aronoff will review your health history and
symptoms and perform a gentle physical exam to assess any internal or external
hemorrhoids.

This exam might include an anoscopy (a small scope to view the anal canal) to see
internal hemorrhoids clearly. Based on the severity and type of hemorrhoids, an
appropriate treatment plan will be recommended.

Professional hemorrhoid treatment options include:

• 
  Prescription Medications: If needed, stronger prescription-strength
  hemorrhoid creams or suppositories can be used (often containing higherdose hydrocortisone or compounded ingredients) to reduce severe
  inflammation.
•  Minimally Invasive Office Procedures: Doctors can often treat hemorrhoids
  with quick, non-surgical procedures done right in the office. For example,
  rubber band ligation is a common technique where a tiny rubber band is
  placed at the base of an internal hemorrhoid to cut off its blood supply – the
  hemorrhoid then shrinks and falls off in a few days. Other options include
  sclerotherapy (injecting a solution to shrivel the hemorrhoid) and infrared or
  electrocoagulation (using heat or electric current to shrink the hemorrhoid).
  These treatments are typically for internal hemorrhoids and ccause minimal
  discomfort, with no general anesthesia needed. Dr. Aronoff offers these kinds
  of procedures in-office to provide quick relief in a private setting. According
  to Dr. Aronoff, techniques like sclerotherapy or banding can effectively treat
  bleeding Grade 1–3 hemorrhoids, often relieving symptoms significantly soon
  after treatment.
• Surgical Procedures: For large external hemorrhoids or advanced internal
  hemorrhoids (such as Grade 4 hemorrhoids that remain prolapsed), surgery
  might be the best option. A hemorrhoidectomy, the surgical removal of
  hemorrhoids, can permanently resolve severe cases. There are also newer
  surgical approaches like hemorrhoid stapling or Doppler-guided
  hemorrhoidal artery ligation. Surgery is typically considered only if other
  measures fail, but when needed, it is highly effective in providing lasting
  relief. Dr. Aronoff is a skilled surgeon who can perform hemorrhoid surgeries
  with precision, often using techniques to lessen post-op discomfort and
  speed up recovery.    
•  

At Dr. Aronoffʼs NYC practice, youʼre in the hands of an expert. Dr. Jeffrey Aronoff,
MD, FACS, FACRS, has over 35 years of experience in colorectal and anorectal
carehealthgrades.com. He is a Fellow of the American Society of Colon and Rectal
Surgeons and has been recognized with numerous awards for his compassionate
patient care colorectalassociates.com. Whether you need a straightforward fix or a
more involved procedure, Dr. Aronoff can both diagnose the problem and provide
the appropriate treatment – often on the same day, right in the office. This means
you wonʼt be shuttled between different providers; Dr. Aronoff personally sees
every patient and can offer immediate solutions when needed .

Get Expert Hemorrhoid Treatment from Dr. Aronoff

You donʼt have to suffer in silence or live with chronic hemorrhoid pain. With proper
treatment, hemorrhoid relief is possible – and often faster than you might think. If
youʼve tried home remedies and still find yourself struggling with hemorrhoids, Dr.
Aronoff is here to help. As an experienced proctologist, he will pinpoint the cause
of your discomfort and tailor a treatment plan that provides lasting relief. From
advanced over-the-counter solutions like Revivol-XR cream to in-office procedures
or surgery, Dr. Aronoff offers the full spectrum of hemorrhoid treatment options to
get you feeling better.

Take the first step toward relief today: Call our New York City office at (212) 888-
5932 or schedule an appointment online. During your consultation, Dr. Aronoff will
answer all your questions and guide you through your options with the compassion
and expertise heʼs known for. Donʼt let hemorrhoids control your life – with the right
care, you can ge