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General Medical Questions
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Question : I have an external hemorrhoid. It's only uncomfortable some of the time. What do you suggest?
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The Trusted Source
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Howard LeWine, M.D.

Howard LeWine, M.D., is chief editor of Internet Publishing, Harvard Health Publications. He is a clinical instructor of medicine at Harvard Medical School and Brigham and Women's Hospital. Dr. LeWine has been a primary care internist and teacher of internal medicine since 1978.

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March 25, 2014
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The best way to reduce swelling and discomfort is to keep stools soft and the anal area clean.

You can help soften stools by taking fiber and drinking plenty of fluids throughout the day.

A good source of fiber is unprocessed bran. Take 1/4 to 1/3 cup per day. Mix it with yogurt, cereal, applesauce or anything you like. 

Or you can buy fiber powder, such as psyllium fiber, without a prescription. There are many brands. Generic versions work just as well as brand name products. The usual dose is 2 teaspoons or 2 packets in liquid once or twice a day.

Bran and psyllium fiber are not laxatives. They are from natural, nondigestible seed husks. They stay in the intestine and absorb water to make the stools soft.

Some people notice a little cramping, bloating, or gas when they begin taking fiber. If so, start with a small amount and gradually increase the dose. Keep increasing the dose until your stools are quite soft, like paste. Drink plenty of liquids with it.

Take sitz baths, especially after bowel movements. Sit in a tub or pan of plain warm water 2 to 4 times a day for 15 minutes each time. Drug stores sell plastic sitz baths, which fit onto a toilet. The water cleans the area and the warmth reduces inflammation and discomfort.

Baby wipes can be used for cleansing. They are not as thorough as a sitz bath. But they are more convenient.

Do not sit on the toilet for long periods. This tends to make hemorrhoids push out and swell up.

There are many over-the-counter hemorrhoidal creams and ointments available. They can provide temporary relief. But usually they aren’t needed. Some of them contain hydrocortisone or other steroid. If you choose one of these, don’t use it for more than one week.

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