External hemorrhoids affect 75% of the population during their lifetime. They can be caused by pregnancy, a low-fiber diet, constipation and other conditions.
There are several solutions to relieve external hemorrhoids: creams , supplements & oral medications , surgical interventions and lifestyle changes.
Note: The information presented in this article is provided for informational purposes only and does not constitute professional medical advice, diagnosis, or treatment. Always consult a physician or qualified healthcare provider with any questions you may have regarding a medical condition or treatment.
Topical creams & solutions
Topical treatments (creams, ointments, suppositories) are the first line of defense for rapid relief. Most are generally available without a prescription (except those containing corticosteroids).
There are several approaches to the local treatment of hemorrhoids, and many creams use a combination of these approaches:
- Anesthetic effect: People with hemorrhoids often seek quick relief from their pain/itching. Many creams therefore contain anesthetics such as lidocaine .
- Veinotonics : These promote blood circulation, thus helping to reduce pressure around hemorrhoidal veins. They can be found in natural formulas, for example, using butcher's broom or horse chestnut.
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Local corticosteroids : they help reduce edema and inflammation linked to hemorrhoids
- Lubricating agents: Often administered in the form of suppositories, they facilitate defecation and thus reduce pressure on the anal wall, which can help relieve hemorrhoids.
Les crèmes topiques peuvent amener un soulagement bienvenu lors d'une crise hémorroïdaire. En revanche, il n’est pas démontré qu’elles préviennent les récidives à long terme, et leur usage prolongé n’est pas conseillé.
In particular, cortisone creams should not be used for more than a few days without medical advice, as prolonged use can cause irritation or thinning of the skin. Similarly, local anesthetics carry a (rare) risk of local allergy.
If you are looking for a 100% natural soothing cream, you can of course discover Butt Butter cream.
Supplements and oral medications
Dietary supplements and oral medications can be very effective in treating external hemorrhoids. Although they may take several days to work, they treat the underlying problem by addressing the underlying causes.
There are several types of dietary supplements and medications available to treat external hemorrhoids:
- Transit supplements: Dietary supplements that promote transit (for example, psyllium or certain probiotics ) can be extremely effective in treating hemorrhoidal disease. A meta-analysis of 378 patients showed that dietary fiber supplementation reduced bleeding by 50% and the risk of recurrence by 47%.
- Vein tonics: By promoting good blood circulation, vein tonics can reduce anal pressure and help heal hemorrhoidal flare-ups. Vein tonics can exist in artificial or natural forms (horse chestnut, butcher's broom). Numerous publications indicate the effectiveness of horse chestnut in relieving hemorrhoidal flare-ups.
- Les flavonoïdes : ils peuvent également avoir des priopriétés veinotoniques, ainsi que des propriétés anti-inflammatoires qui peuvent favoriser la guérison. Une méta-analyse de 14 essais contrôlés (portant sur 1 514 patients) a montré que les flavonoïdes réduisent significativement le risque de symptômes persistants ou d’absence d’amélioration par rapport à un placebo (réduction relative de 58 %), ainsi que la fréquence des saignements, de la douleur et du prurit pendant la crise. On retrouve des flavonoïdes dans de nombreux aliments tels que le thé noir, le chocolat et le persil.
Traditionally, it has been believed that certain foods that improve liver circulation (unblocking the portal vein) could help soothe hemorrhoidal disease. However, the latest published research seems to suggest that the presence of hemorrhoids is not directly related to liver circulation.
If you are looking for a dietary supplement that combines benefits for circulation and transit, try Butt Butter.
Surgical interventions
In the most severe and persistent cases (5% to 10% of cases), medical intervention may become necessary. These methods are generally considered very effective, but they can be cumbersome and require convalescence.
Surgery is also more common in the case of internal hemorrhoids.
There are several surgical methods to treat hemorrhoids:
- Ligature élastique : le principe est de placer un petit anneau élastique à la base du paquet hémorroïdaire interne afin de couper l’afflux sanguin. Le segment ligaturé nécrose et tombe en quelques jours, puis une cicatrice se forme en 2 à 3 semaines, ce qui fixe la muqueuse et réduit le volume des hémorroïdes. Les études rapportent un taux de succès de 70 à 90 % d’absence de symptômes à 3 ans après ligature.Consultez un médecin
- Excision d’une thrombose externe : Lorsque l’hémorroïde externe forme un caillot sanguin douloureux (thrombose), une solution chirurgicale rapide est l’excision du caillot. Réalisée sous anesthésie locale en ambulatoire, l’intervention consiste à inciser la peau et à enlever le caillot ainsi que le sac veineux distendu qui l’entoure. Ce geste procure un soulagement immédiat de la douleur et permet une guérison plus rapide, surtout s’il est réalisé dans les 72 premières heures suivant l’apparition de la thrombose.
- Hémorroïdectomie chirurgicale : C’est l’intervention la plus radicale, réservée aux formes sévères (hémorroïdes prolapsées irréductibles, saignements chroniques entraînant une anémie, ou échecs des autres traitements). L’hémorroïdectomie consiste à enlever les paquets hémorroïdaires en totalité. Elle se pratique au bloc opératoire, sous anesthésie locale ou générale, le plus souvent en ambulatoire (sortie le jour même). Cette chirurgie offre le taux de guérison le plus élevé à long terme, au prix d’une convalescence plus douloureuse (douleurs à la défécation durant 1 à 2 semaines).
Preventing recurrences: practical everyday advice
After overcoming a hemorrhoidal crisis, the goal is to prevent another flare-up. Here are some tips that may help prevent a relapse:
- Alimentation riche en fibres : Adoptez un régime riche en fibres alimentaires (fruits, légumes, céréales complètes) pour ramollir les selles et faciliter leur passage. Un apport d’au moins 25–30 g de fibres par jour est recommandé chez l’adulte. Vous pouvez notre article détaillé sur les sources en fibres.
- Hydratation adéquate : Buvez suffisamment d’eau tout au long de la journée (au moins 1,5 L, voire 2 L par jour). Une bonne hydratation, couplée aux fibres, aide à assouplir les selles et prévenir la constipation. Limitez aussi l’alcool et les boissons caféinées excessives qui peuvent favoriser la déshydratation ou l’irritation digestive.
- Careful local hygiene: After each use of the toilet, gently clean the anal area with warm water or a damp, non-irritating toilet paper. We also recommend patting yourself dry rather than rubbing.
- Aller à la selle régulièrement, sans forcer : Ne retardez pas l’envie d’aller aux toilettes, ce qui peut durcir les selles. Aux toilettes, adoptez de bonnes habitudes : évitez de rester assis trop longtemps ou de pousser trop fort. Une astuce souvent proposée est de surélever légèrement les pieds (par exemple avec un petit tabouret - c'est la méthode squatty-potty) pour adopter une position accroupie, qui peut aider à l’évacuation sans effort excessif.
- Physical activity: Some studies suggest that exercising the Kegel muscles (of the pelvic floor) can help reduce anal fissures and hemorrhoids. However, avoid repetitive lifting of very heavy loads which increases abdominal pressure, as well as prolonged sedentary lifestyle (do not remain seated for hours without a break).
The most important thing: consult a doctor
Regardless of your approach, if you suffer from hemorrhoids, consult a doctor or pharmacist. They will be best placed to provide you with a prescription and a personalized treatment plan tailored to your symptoms.
Consulting a medical professional when suffering from hemorrhoids may seem embarrassing, but this fear is unfounded: doctors and pharmacists are used to dealing with these cases on a daily basis, as they are extremely common.
Sources:
Higuero, T. (2014). Recommendations for clinical practice in the treatment of hemorrhoidal disease Short text. Colon & Rectum, 8(2), 105-109.
Alonso-Coello, P., Mills, E. D., Heels-Ansdell, D., López-Yarto, M., Zhou, Q. I., Johanson, J. F., & Guyatt, G. (2006). Fiber for the treatment of hemorrhoids complications: a systematic review and meta-analysis. Official journal of the American College of Gastroenterology| ACG, 101(1), 181-188.
Hippocastanum, HHTA (2018). Aesculus hippocastanum (Aescin, horse chestnut) in the management of hemorrhoidal disease. Turk J Colorectal Dis, 28, 54-57.
Alonso-Coello, P., Zhou, Q., Martinez-Zapata, M.J., Mills, E., Heels-Ansdell, D., Johanson, J.F., & Guyatt, G. (2006). Meta-analysis of flavonoids for the treatment of haemorrhoids. Journal of British Surgery, 93(8), 909-920.
Mayo Foundation for Medical Education and Research. (2023, August 25). Hemorrhoids . Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/hemorrhoids/diagnosis-treatment/drc-20360280