Shrinking internal hemorrhoids at home: 3 safe, surgery-free methods

Hemorrhoids affect about 1 in 20 adults, and nearly half of people over 50 have experienced this condition, according to US data. Alarmingly, internal hemorrhoids are often not painful in the early stages, so many people only discover them when they experience bloody stools or when the hemorrhoids have prolapsed.

If you're wondering how to shrink internal hemorrhoids, patients should start by reducing constipation, avoiding straining, and not sitting on the toilet for too long. In this article, Tiptory will guide you through methods to shrink internal hemorrhoids, supporting safe treatment of internal hemorrhoids at home and recognizing when to seek medical attention. According to experts, anal bleeding should not be assumed to be due to hemorrhoids; if symptoms persist for more than a week, if hemorrhoids prolapse significantly, or if bleeding occurs, patients should be evaluated by a doctor to rule out other causes.

Method 1: Home remedies for internal hemorrhoids to quickly reduce pain and swelling

Tip 1: How to use internal hemorrhoid suppositories correctly

Understanding the correct effect of hemorrhoid suppositories

Anal suppositories can directly contact the internal hemorrhoid area, helping to reduce irritation, itching, swelling, or discomfort in the short term. However, this is not a permanent method to shrink internal hemorrhoids and does not address underlying causes such as constipation, straining, or prolonged sitting on the toilet.

Choosing medication by ingredients

• Medications containing cocoa butter or zinc oxide primarily create a protective, lubricating, and soothing layer on the mucous membrane. There is no conclusive evidence that these ingredients can make hemorrhoids disappear.

• Medications containing phenylephrine have a temporary vasoconstrictive effect, thereby helping to reduce swelling. People with heart disease, hypertension, diabetes, thyroid disease, or difficulty urinating should consult a doctor before use.

• Do not self-select medication based solely on brand name, as the ingredients and concentrations of each product may vary.

Safe application of suppositories

1. If needed, have a bowel movement before inserting the suppository, then wash your hands and gently clean the anal area.

2. Remove the wrapper, lie on your side, slightly bend the top leg, and then insert the pointed end of the suppository past the anal sphincter as directed on the packaging.

3. Lie still for about 10–15 minutes to prevent the suppository from slipping out, then wash your hands thoroughly.

4. Use the correct dose and duration indicated on the label; do not arbitrarily insert multiple suppositories with the hope of faster at-home treatment for internal hemorrhoids.

Do not overuse suppositories

If you are looking for answers to how to shrink internal hemorrhoids, patients should combine medication with a high-fiber diet, adequate fluid intake, regular exercise, avoiding straining, and not sitting on the toilet for too long. Do not use medication for more than 7 days unless instructed by a healthcare professional.

Know when to seek medical attention

Stop self-treatment and seek medical attention if anal bleeding, severe pain, dizziness, black stools, prolapsed hemorrhoids that cannot be pushed back in, or if symptoms do not improve after one week. Rectal bleeding is not always due to hemorrhoids, so it needs to be checked to rule out other gastrointestinal conditions.

Tip 2: Cold compress to relieve discomfort from hemorrhoids

Understanding the correct effect of cold compresses

Cold compresses can temporarily soothe pain, swelling, and discomfort around the anus. However, this method primarily helps with external symptoms and does not directly shrink internal hemorrhoids located deep within the anal canal.

Safe cold compress method

1. Place an ice pack or cold compress bag in a clean, soft cloth.

2. Gently apply to the anal area for about 10–15 minutes, without pressing hard.

3. After compressing, gently pat the skin dry; repeat several times a day if needed, allowing the skin to rest between applications.

4. Stop compressing if you experience a burning sensation, prolonged numbness, or unusual skin discoloration.

Do not apply ice directly to the skin

Direct contact with ice or prolonged compression can cause skin damage and further irritate the anal area. This is only a supportive measure when treating internal hemorrhoids at home, not a substitute for eating enough fiber, drinking enough water, and avoiding straining during bowel movements.

Monitor for signs that require medical attention

If you're wondering how to shrink internal hemorrhoids, you should seek medical attention if the hemorrhoids prolapse, you experience severe pain, heavy bleeding, blood clots, or if symptoms do not improve after about a week. Cold compresses are only like "cooling down a fire," while the underlying causes of recurrent hemorrhoids still need to be addressed properly.

Tip 3: Proper anal soaking for hemorrhoids

Warm water soaking helps relieve discomfort

Soaking the anus in warm water, also known as a Sitz bath, can help relax the sphincter muscles and soothe pain, itching, or pressure after bowel movements. However, this method only helps reduce symptoms; there is no evidence to show that it can directly shrink internal hemorrhoids or prevent their growth.

Safe anal soaking method

1. Clean the bathtub or specialized Sitz bath basin before use.

2. Fill the basin with lukewarm water, enough to cover the anal area. Do not use water that is too hot as it can cause burns and further irritate sensitive skin.

3. Soak for about 10–20 minutes, especially after a bowel movement or when feeling discomfort.

4. Stand up slowly, then use a soft towel to pat dry. Do not rub the anal area vigorously.

5. This can be done 2–3 times a day during periods of noticeable symptoms.

No need to add Epsom salt necessarily

Clean warm water is usually sufficient to help relieve pain and discomfort. There is no reliable evidence that adding a cup of Epsom salt makes hemorrhoids shrink faster; high salt concentrations can even cause stinging or irritation to damaged skin. If you wish to use it, you should consult a doctor and follow the recommended amount.

Combine with addressing the root causes of hemorrhoids

Warm soaks are only like giving the injured area a temporary "breather." To more effectively treat internal hemorrhoids at home, patients need to eat enough fiber, drink enough water, avoid straining, and not sit on the toilet for too long. These are the important steps when learning how to shrink internal hemorrhoids and limit recurrence.

Seek medical attention when there are unusual signs

Seek medical attention if there is heavy or persistent bleeding, severe pain, fever, pus discharge, prolapsed hemorrhoids that do not retract spontaneously, or if symptoms do not improve after about a week of home care.

Tip 4: Using laxatives for hemorrhoids

Only use medication when truly necessary

Hard stools and straining increase pressure on the anal area, making hemorrhoids more likely to bleed or prolapse. If increasing fiber intake, drinking enough water, and exercising do not improve constipation, patients can ask a doctor or pharmacist about appropriate laxatives to help shrink internal hemorrhoids by reducing pressure during bowel movements.

Prioritize stool softeners

• Soluble fiber like psyllium helps retain water, softening stools and making them easier to pass. It is important to increase intake gradually and drink enough water to avoid bloating or obstruction.

• Osmotic laxatives like polyethylene glycol can be considered when fiber alone is not effective enough. These medications draw water into the intestines to help stools pass more easily.

• Docusate is a stool softener, but evidence of its effectiveness is relatively limited. It should not be assumed to be the best option for all cases of at-home internal hemorrhoid treatment.

No need to absolutely avoid stimulant laxatives

Stimulant laxatives like bisacodyl or senna are not definitively proven to cause chronic constipation when used correctly. However, they can cause abdominal cramps or diarrhea, so they are usually only suitable for short-term use or when instructed by a healthcare professional.

Using medication safely, step by step

1. Start with a high-fiber diet, adequate fluid intake, and establish regular bowel habits.

2. If still constipated, consult a doctor or pharmacist to choose the correct type and dosage of medication.

3. Use the lowest effective dose for the shortest duration. Do not combine multiple types of laxatives.

4. Stop medication and seek medical attention if severe abdominal pain, vomiting, bloating, inability to pass gas, prolonged diarrhea, or increased anal bleeding occurs.

Do not view medication as a direct way to shrink hemorrhoids

Regarding the question of how to shrink internal hemorrhoids, laxatives only play a role in softening stools and reducing straining, they do not immediately shrink hemorrhoids. If constipation is prolonged, requires frequent medication use, or if hemorrhoid symptoms do not improve after about a week, the patient needs to be examined to determine the cause and appropriate treatment plan.

Tip 5: Do not self-administer magnesium for hemorrhoids

Understanding the correct effect of magnesium citrate

Magnesium citrate works by retaining water in the intestines, which can soften stools and make bowel movements easier. This effect helps reduce straining but does not directly shrink internal hemorrhoids or treat the underlying cause of hemorrhoids.

Do not self-increase dose from 100 to 300 mg

• The number on the label may refer to elemental magnesium or the total weight of the magnesium citrate compound. These two calculation methods are completely different.

• The appropriate dose also depends on the product form, age, kidney function, other medications being used, and the severity of constipation.

Therefore, you should not arbitrarily apply a gradual increase from 100 to 300 mg per day. Use the correct product and dose as instructed by your doctor or pharmacist.

Monitor your body's reaction

Magnesium from supplements and medications can cause diarrhea, abdominal cramps, or nausea. Prolonged diarrhea does not help treat internal hemorrhoids at home and can even irritate the anal area, making symptoms worse.

Avoid use without consultation

People with kidney disease or impaired kidney function should not self-supplement with magnesium because the body may not be able to excrete excess amounts. Pregnant women, the elderly, and those taking other medications also need to consult a healthcare professional to avoid interactions or overdose.

Prioritize safe methods for softening stools

If you're wondering how to shrink internal hemorrhoids, start with less risky measures:

1. Gradually increase fiber from vegetables, fruits, beans, and whole grains.

2. Drink enough water according to your needs and health condition.

3. Exercise regularly, do not suppress the urge to defecate, and avoid straining.

4. If still constipated, discuss supplementary fiber or appropriate laxatives with your doctor or pharmacist.

Seek medical attention if there are unusual signs

Stop using magnesium and seek medical help if you experience severe diarrhea, vomiting, muscle weakness, difficulty breathing, abnormal heart rhythm, or dizziness. People with anal bleeding, severe pain, or prolonged constipation also need to be examined instead of continuing to self-increase the dose.

Tip 6: Choosing pain relievers for hemorrhoids

Correctly identify the cause of pain

Internal hemorrhoids that have not prolapsed usually do not cause pain. If pain occurs, the cause may be prolapsed hemorrhoids, thrombosed external hemorrhoids, anal fissures, or other conditions. Pain relievers only alleviate symptoms and do not directly shrink internal hemorrhoids.

Prioritize paracetamol for mild pain

• Paracetamol can be considered for short-term pain relief, especially when the patient is experiencing anal bleeding.

Read the dosage on the label carefully and do not use multiple medications containing paracetamol simultaneously.

People with liver disease, who frequently consume alcohol, or who are taking other medications should consult a doctor or pharmacist before use.

Be cautious with NSAID anti-inflammatory drugs

Ibuprofen and naproxen can reduce pain and inflammation but also increase the risk of bleeding or stomach irritation. Do not self-administer if hemorrhoids are bleeding, if there is a history of stomach ulcers, kidney disease, heart disease, if taking anticoagulants, or if pregnant.

Avoid pain relievers containing codeine

Codeine can cause constipation, making stools hard and requiring the patient to strain more. This goes against the goal of treating internal hemorrhoids at home and can worsen symptoms.

Use medication correctly

1. Only use medication when absolutely necessary and as directed on the packaging.

Use the lowest effective dose for the shortest possible duration.

Do not combine multiple types of pain relievers.

Combine with warm water soaks, stool softeners, adequate fluid intake, and avoiding straining during bowel movements.

Do not use medication to mask pain

When learning how to shrink internal hemorrhoids, patients need to remember that pain relievers do not make hemorrhoids disappear. Seek medical attention if pain is severe or rapidly worsening, if bleeding is heavy, if there is fever, dizziness, black stools, or if symptoms do not improve after about a week.

Tip 7: See a doctor when hemorrhoids do not improve

Set a monitoring period of about one week

If you have adjusted your diet, softened your stool, and taken proper care, but symptoms have not improved after about one week, you should see a doctor. Continuing to self-treat internal hemorrhoids at home can delay diagnosis and miss the appropriate time for treatment.

Do not wait a full week if there is bleeding

It is necessary to contact a doctor early if rectal bleeding, prolapsed hemorrhoids, progressively worsening pain, or recurrent symptoms occur. Anal bleeding is not always due to hemorrhoids but can also be related to anal fissures, inflammatory bowel disease, polyps, or colorectal cancer.

The doctor will examine you before treatment

• Gather information about symptoms, constipation status, and current medications.

Examine the anal and rectal area; may perform an anoscopy or order other tests if necessary.

Determine the severity of hemorrhoids and choose the appropriate method to shrink internal hemorrhoids, rather than applying a single procedure for all cases.

Procedures that may be considered

• Rubber band ligation: Cuts off the blood supply to the hemorrhoid tissue, causing it to shrink and fall off. This is a common procedure for bleeding or prolapsed internal hemorrhoids.

Sclerotherapy: A doctor injects a solution into the hemorrhoid, creating scar tissue and reducing the blood supply to the hemorrhoid.

Infrared coagulation: Infrared energy creates scar tissue, helping the hemorrhoid shrink.

Electrocautery: Electrical current creates scar tissue and reduces blood flow to the hemorrhoid.

The above procedures must be performed by a doctor; never attempt to self-ligate or interfere with hemorrhoids at home.

Go to the emergency room if there are serious signs

Do not continue to look for ways to address the question of how to shrink internal hemorrhoids if the patient has incessant bleeding, significant blood loss or large blood clots, severe anal pain, dizziness, abdominal pain, fever, or diarrhea. These are signs that require immediate medical evaluation.

Method 2: What to eat to shrink internal hemorrhoids? Standard diet

Tip 1: Drink enough water to reduce constipation

Water helps fiber work effectively

Drinking enough water helps fiber retain water in the stool, making it softer and easier to pass through the anus. By reducing constipation and straining, this habit can prevent hemorrhoids from worsening but does not directly shrink internal hemorrhoids.

Do not rigidly apply the 8-glass rule

Water needs vary according to age, weight, activity level, weather, diet, and health status. The benchmark of 6–8 glasses of fluid per day is only a reference, not a suitable formula for everyone.

Drink water correctly throughout the day

1. Drink regularly in small amounts, don't wait until you're thirsty to drink.

Increase water intake when exercising heavily, in hot weather, with fever, or when sweating a lot.

Monitor urine color: pale yellow usually indicates adequate hydration.

Choosing the right beverages

• Plain water should be the primary choice when treating internal hemorrhoids at home.

• Clear broth, low-fat milk, unsweetened tea, and some water from food also contribute to daily fluid intake.

• Limit alcohol and sugary drinks as they are not beneficial for gut health.

No need to completely abstain from caffeine

Moderate amounts of tea and coffee still count towards daily fluid intake and do not inherently cause dehydration. However, individuals sensitive to caffeine should limit their intake if they experience jitters, frequent urination, diarrhea, or difficulty sleeping.

Adjust based on health condition

Individuals with heart disease, kidney disease, liver disease, or who are advised to restrict fluids should not independently increase their water intake. When wondering how to shrink internal hemorrhoids, it's important to remember that adequate water intake is just one link; patients must still eat enough fiber, exercise, and avoid straining during bowel movements.

Tip 2: Increase fiber to reduce pressure on hemorrhoids

Fiber helps make bowel movements easier

Fiber retains water and increases stool bulk, making stools softer, easier to pass, and reducing the need to strain. This is a crucial foundation when treating internal hemorrhoids at home, but it is not a direct measure to shrink internal hemorrhoids.

Set appropriate fiber targets

Adults typically need about 22–34g of fiber per day, depending on age and gender. Another way to calculate is about 14g of fiber per 1,000 kcal; equivalent to 28g for a 2,000 kcal daily diet.

Increase fiber gradually

1. Add an extra serving of fiber-rich foods every few days to allow the digestive system to adapt.

2. Drink enough water to help fiber soften stools effectively.

3. Maintain consistency instead of only eating a lot of vegetables when constipation occurs.

4. If you experience bloating, abdominal pain, or diarrhea, reduce the supplement amount and then increase it more slowly.

Prioritize common foods

• Whole grains: brown rice, oats, barley, whole-wheat bread, and corn.

• Fruits: pears, unpeeled apples, oranges, dragon fruit, plums, and papaya.

• Vegetables: sweet potato leaves, jute mallow, kale, broccoli, carrots, and sweet potatoes.

• Legumes: black beans, kidney beans, chickpeas, soybeans, lentils, and peas.

• Nuts and seeds: chia seeds, flaxseeds, almonds, and peanuts.

Limit low-fiber foods

Eating too many fast foods, snacks, processed meats, pastries, or refined foods can lead to a diet lacking in fiber. Replace small portions with vegetables, fruits, and whole grains for easier long-term maintenance.

Consider fiber supplements

If your diet is not meeting your needs, psyllium can help soften stools. Start with a low dose, follow directions carefully, and drink plenty of water; individuals with difficulty swallowing or suspected bowel obstruction should consult a doctor before use.

Don't rely solely on fiber

Regarding the question of how to shrink internal hemorrhoids, patients need to combine fiber with adequate water intake, exercise, not holding in bowel movements, and not sitting on the toilet for too long. See a doctor if you experience rectal bleeding, severe pain, or if symptoms do not improve after about a week.

Tip 3: Use psyllium to help relieve constipation

Understanding the effects of psyllium

Psyllium is a bulk-forming soluble fiber. When it encounters water, it swells into a gel, making stools softer, increasing their volume, and making them easier to pass. Psyllium can reduce straining during bowel movements but does not directly shrink internal hemorrhoids.

Supplement only when diet is insufficient

• Prioritize fiber from vegetables, fruits, legumes, and whole grains.

• If you are not meeting the daily recommended intake of about 22–34g of fiber, consider psyllium or other fiber supplements.

• Start with a low dose as directed on the label, then gradually increase to minimize bloating and abdominal distension.

Safe use of psyllium

1. Measure the exact amount indicated on the package, as concentrations vary between products.

2. Mix the powder with a full glass of water, stir well, and drink immediately before the mixture thickens.

3. Drink more water afterward and maintain adequate fluid intake throughout the day.

4. Do not swallow dry psyllium powder and do not increase the dose yourself in hopes of faster bowel movements.

5. Take other medications separately from psyllium as directed by your doctor or pharmacist, as fiber can affect the absorption of some medications.

Monitor digestive reactions

Psyllium may cause bloating, abdominal distension, or changes in bowel movement frequency in the first few days. If abdominal pain, worsening constipation, or inability to pass stool occurs, discontinue use and consult a healthcare professional.

Do not use in certain cases

Individuals with difficulty swallowing, narrowed digestive tract, suspected bowel obstruction, unexplained abdominal pain, or a history of psyllium allergy should not use it independently. Seek immediate medical attention if you experience choking, chest pain, difficulty breathing, or difficulty swallowing after taking it.

Combine with good bowel habits

When treating internal hemorrhoids at home, psyllium is just a supportive link. Patients still need to drink enough water, exercise, go to the bathroom when needed, and avoid prolonged straining. For questions like how to shrink internal hemorrhoids, see a doctor if you experience rectal bleeding or if symptoms do not improve after about a week.

Tip 4: Exercise regularly to reduce constipation

Exercise supports bowel motility

Regular physical activity can help the bowels move stool more effectively, thereby reducing constipation and straining during bowel movements. However, exercise does not directly shrink internal hemorrhoids and does not replace medical treatment when hemorrhoids are prolapsed or bleeding.

Start with light activities

1. Walk for about 10–15 minutes after meals or at a convenient time during the day.

2. If you have to sit for long periods, stand up and do light exercises every 30–60 minutes.

3. Gradually increase the duration and intensity according to your physical condition; no need to start with heavy exercise immediately.

4. Aim for at least 150 minutes of moderate-intensity exercise per week if your health permits.

Choose suitable exercises when you have hemorrhoids

• Walking, swimming, light yoga, and cycling at a comfortable intensity are easily applicable options.

• Stop or adjust exercises if you feel increased pain, bleeding, or anal discomfort.

• Walking can aid digestion but does not guarantee an immediate urge for a bowel movement.

Be cautious when lifting heavy objects

Lifting excessively heavy weights, holding your breath, or straining your abdominal muscles vigorously can increase pressure in the abdomen and anal area. If doing strength training, use moderate weights, breathe evenly, and avoid straining. Individuals with prolapsed or bleeding hemorrhoids should consult a doctor before heavy exercise.

Combine with good toilet habits

Exercise will be more effective when combined with a high-fiber diet, adequate water intake, not holding in bowel movements, and not sitting on the toilet for too long. This is the practical foundation for treating internal hemorrhoids at home and understanding how to shrink internal hemorrhoids.

See a doctor if symptoms do not improve

Consult a doctor if you experience rectal bleeding, severe pain, prolapsed hemorrhoids, or if symptoms do not subside after about a week. If exercise causes chest pain, shortness of breath, dizziness, or unusual pain, stop exercising and seek medical help.

Method 3: Reduce pressure on hemorrhoids to avoid complications

Tip 1: Have bowel movements at the right time, avoid prolonged straining

Don't ignore your body's signals

When you feel the urge to have a bowel movement, go to the toilet as soon as conditions allow. Frequent holding can cause stool to remain in the colon longer, becoming dry and hard to pass, thereby increasing pressure on hemorrhoids.

Don't force it if you can't go yet

1. Sit relaxed and breathe deeply, without holding your breath or straining your abdomen.

2. You can place your feet on a low stool to raise your knees higher than your hips, which helps facilitate a more favorable bowel movement posture.

3. If you still can't go after a few minutes, stand up and try again when your body has a clear urge.

4. Do not try to "force" stool out, as severe straining can cause hemorrhoids to bleed or prolapse further.

Shorten the time spent on the toilet

Sitting for too long puts pressure on the blood vessels in the anal area. Avoid bringing your phone, reading books, or working in the bathroom; those seemingly harmless minutes scrolling can sometimes turn into a "meeting" that your hemorrhoids definitely don't want to attend.

Establish regular bowel habits

• You can try to go to the toilet at the same time each day.

• About 15–45 minutes after breakfast is often a good time because the colon's reflex is more active after eating.

• Combine eating enough fiber, drinking enough water, and exercising to keep stools soft and easy to pass.

Understand the correct goals of home care

Having bowel movements at the right time does not directly shrink internal hemorrhoids, but it helps reduce straining and prevents hemorrhoids from worsening. This is a practical step when treating internal hemorrhoids at home and learning how to shrink internal hemorrhoids safely.

See a doctor if any unusual signs appear

Consult a doctor if you experience prolonged constipation, severe pain, rectal bleeding, black stools, unexplained weight loss, or if symptoms do not improve after about a week.

Tip 2: Establish a regular bowel movement schedule

Train your habit instead of forcing your body

Setting a relatively stable time each day can help the body form a bowel reflex. This habit helps reduce constipation and straining, but it doesn't mean you have to go at a specific time no matter what, or that it directly shrinks internal hemorrhoids.

Choose a time when your body is most responsive

About 15–45 minutes after breakfast is often a good time because eating stimulates colon contractions. It's not necessary to force yourself to go at exactly 8:30 AM and 7:00 PM every day; your routine should be adjusted according to your body's natural signals.

Follow simple steps

1. Choose a time slot with minimal interruptions, preferably after breakfast.

2. Go to the toilet as soon as you feel the urge to defecate, don't try to hold it in to wait for the "right time."

3. Sit relaxed, breathe deeply; you can place your feet on a low stool to raise your knees higher than your hips.

4. If you still can't go after a few minutes, stand up and try again when you feel the urge.

5. Maintain a regular routine but don't pressure yourself to have a bowel movement every day.

Do not sit for too long or strain

Bringing a phone into the bathroom can easily prolong the time spent sitting without the user realizing it. Sitting for too long and straining intensely increases pressure on the anal area, which can cause hemorrhoids to prolapse or bleed more.

Combine with supportive habits

• Eat enough fiber and gradually increase the amount.

• Drink enough water to soften stools.

• Exercise regularly, avoid sitting continuously for many hours.

• Do not abuse laxatives or enemas.

Understand bowel movement frequency correctly

Not everyone needs to have a bowel movement once or twice a day. The important thing is that stools are soft, bowel movements are painless, there's no excessive straining, and there are no unusual changes. This is a practical goal when treating internal hemorrhoids at home and learning how to shrink internal hemorrhoids.

See a doctor if warning signs appear

Consult a doctor if you experience prolonged constipation, abdominal pain, unexplained weight loss, black stools, rectal bleeding, or if hemorrhoid symptoms do not improve after about a week.

Tip 3: Do not strain hard during bowel movements

Let the defecation reflex do the main work

Straining hard increases pressure in the abdomen and on the blood vessels in the anal area, making hemorrhoids prone to swelling, bleeding, or prolapsing. Therefore, reducing straining is an important step when treating internal hemorrhoids at home, although it does not directly shrink internal hemorrhoids.

Adjust sitting posture

1. Sit firmly on the toilet, leaning slightly forward.

2. Place both feet on a low stool to raise your knees higher than your hips.

3. Relax your abdomen and anal muscles, breathing evenly.

4. When you feel the urge to push stool, exhale gently instead of holding your breath and straining hard.

Stop if you have to exert yourself

If you still cannot have a bowel movement after a few minutes, stand up instead of continuing to strain. There is no need to wait for an exact hour; try again when the urge to defecate becomes clear.

Support your body while waiting

• Drink water regularly throughout the day, especially when increasing fiber intake.

• Walk or do light exercises to support bowel motility.

• Do not self-administer enemas or abuse laxatives to force immediate bowel movements.

• Maintain daily fiber, water, and exercise instead of only applying them when constipated.

Do not rely entirely on gravity

An appropriate posture can facilitate the passage of stool, but the stool still needs to be soft enough. If stools are consistently hard, you need to review your fiber intake, water consumption, activity level, and any medications that may cause constipation.

Know when to see a doctor

Regarding the question of how to shrink internal hemorrhoids, patients should not continue self-treatment if constipation is prolonged, they have to strain frequently, experience rectal bleeding, severe pain, prolapsed hemorrhoids, or if symptoms do not improve after about a week.

Tip 4: Choose a suitable sitting cushion for hemorrhoids

Prioritize flat, moderately soft cushions

When you have to sit for long periods, a flat foam cushion with moderate elasticity can help distribute weight and reduce discomfort compared to a hard surface. However, a sitting cushion only aids comfort; it does not directly shrink internal hemorrhoids.

Be cautious with donut-shaped pillows

Donut-shaped pillows create a space in the middle but can put pressure on the surrounding anal tissue. Evidence of their benefit for hemorrhoids is limited, so they should not be automatically considered the best choice.

Ways to sit to reduce pressure

1. Choose a flat cushion that is not too soft and is wide enough to support the entire buttock area.

2. Keep your back in a comfortable position, distributing weight evenly on both sides.

3. Change your posture frequently, avoiding continuously leaning to one side.

4. Stand up and walk gently every 30–60 minutes if your job requires prolonged sitting.

5. Stop using any cushion that causes increased pain, numbness, or anal discomfort.

Don't just change the cushion and still sit all day

A soft cushion cannot negate the effects of continuous sitting for many hours. When treating internal hemorrhoids at home, regular movement is often more important than choosing a very thick or specially shaped cushion.

Monitor for unusual pain

Unprolapsed internal hemorrhoids usually cause little pain. If pain increases when sitting, a hard swollen mass appears, bleeding, prolapsed hemorrhoids, or severe pain, the patient should see a doctor to rule out thrombosed external hemorrhoids, anal fissures, or other causes.

Understand the correct purpose of using a cushion

Regarding the question of how to shrink internal hemorrhoids, a sitting cushion is just like a shock absorber that helps reduce discomfort. To manage hemorrhoids long-term, patients still need to soften stools, avoid straining, limit prolonged sitting on the toilet, and seek prescribed treatment when necessary.

References

1. Alonso-Coello, P., Mills, E., Heels-Ansdell, D., López-Yarto, M., Zhou, Q., Johanson, J. F., & Guyatt, G. (2005). Laxatives for the treatment of hemorrhoids. Cochrane Database of Systematic Reviews, (4), CD004649.
2. Chang, L., Chey, W. D., Imdad, A., Almario, C. V., Bharucha, A. E., Diem, S., Greer, K. B., Hanson, B., Harris, L. A., Ko, C., Murad, M. H., Patel, A., Shah, E. D., Lembo, A. J., & Sultan, S. (2023). American Gastroenterological Association–American College of Gastroenterology clinical practice guideline: Pharmacological management of chronic idiopathic constipation. Gastroenterology, 164(7), 1086–1106.
3. Hawkins, A. T., Davis, B. R., Bhama, A. R., Fang, S. H., Dawes, A. J., Feingold, D. L., & Steele, S. R. (2024). The American Society of Colon and Rectal Surgeons clinical practice guidelines for the management of hemorrhoids. Diseases of the Colon & Rectum, 67(5), 614–623.
4. Mott, T., Latimer, K., & Edwards, C. (2018). Hemorrhoids: Diagnosis and treatment options. American Family Physician, 97(3), 172–179.
5. National Institute of Diabetes and Digestive and Kidney Diseases. (2016). Eating, diet, and nutrition for hemorrhoids. National Institutes of Health, U.S. Department of Health and Human Services.
6. National Institute of Diabetes and Digestive and Kidney Diseases. (2016). Symptoms and causes of hemorrhoids. National Institutes of Health, U.S. Department of Health and Human Services.
7. National Institute of Diabetes and Digestive and Kidney Diseases. (2016). Treatment of hemorrhoids. National Institutes of Health, U.S. Department of Health and Human Services.
8. National Institute of Diabetes and Digestive and Kidney Diseases. (2018). Eating, diet, and nutrition for constipation. National Institutes of Health, U.S. Department of Health and Human Services.
9. National Institute of Diabetes and Digestive and Kidney Diseases. (2018). Treatment for constipation. National Institutes of Health, U.S. Department of Health and Human Services.
10. National Institutes of Health, Office of Dietary Supplements. (2022). Magnesium: Fact sheet for health professionals. U.S. Department of Health and Human Services.
11. Sun, Z., & Migaly, J. (2016). Review of hemorrhoid disease: Presentation and management. Clinics in Colon and Rectal Surgery, 29(1), 22–29.
12. World Health Organization. (2024). WHO guidelines on physical activity and sedentary behaviour. World Health Organization.

Content edited by: Rowan Hudson Le.

Information consulted and verified by expert: Charlotte Davis.