Pain in the Butt: How to Get Rid of and Prevent External Hemorrhoids

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What’s the origin of the expression ‘pain in the butt’ if not the ever annoying and common condition known as hemorrhoids?

There aren’t many medical conditions that humanity, globally, uses as a euphemism for things that aggravate and irritate.

If you’ve ever experienced the nagging itch or burning pain of hemorrhoids, then you can fully understand why the expression ‘pain in the butt’ isn’t likely going to be replaced anytime soon.

While sometimes painful and distressing, hemorrhoids are a common condition that is easily treatable with conventional and natural methods.

Taking a look a diet, elimination habits, and other factors will help to understand the root and therefore the solution to hemorrhoids.

According to the Mayo Clinic, close to three out of four adults will experience hemorrhoids in their lifetime.

The good news is that because of how common this condition is, it has been well studied and there are many treatment options available as well as ways to prevent hemorrhoids.

What are external hemorrhoids? 

Hemorrhoids are blood vessels that are a normal part of the human anatomy. It is not until the blood vessels become inflamed that we refer to them as a condition known simply by the name of the tissue, hemorrhoids.

There are three kinds of hemorrhoids; internal, external, and thrombosed. External hemorrhoids are swollen veins outside the region of the anus.

When swollen veins present in this manner internally most people are unaware. External hemorrhoids are more noticeable because of their appearance and the pain associated with them.

Straining when having a bowel movement can cause internal hemorrhoids to protrude from the anus giving the appearance of being external hemorrhoids.

If you can gently push hemorrhoid back into the anus then you can be certain it developed internally.

External hemorrhoids are visible when inflamed and appear as a small pink or purplish lump around the anus. They can be quite painful and itchy or present with little to no pain at all.

External hemorrhoids can also bleed if irritated by toilet paper, clothing, or excessive sitting.

Thrombosed hemorrhoids differ slightly from external hemorrhoids. They occur both internally and externally and are formed when blood clots fill hemorrhoids. Not all external hemorrhoids lead to blood clots.

According to the University of Michigan Medince, if the thrombosed hemorrhoid is very large, your doctor may remove some of the clots under local anesthesia.

What are the causes of hemorrhoids? 

There are several known causes of external hemorrhoids but recent studies give new insight. According to Harvard Health Publishing, the smooth muscle of the anal canal is often tighter with those who have hemorrhoids, resulting in a higher resting anal canal tone.

It is uncertain as of yet if there is a direct correlation between resting anal canal tone and hemorrhoids.

Causes of higher resting anal canal tone may be genetic or related to trauma to the area, pregnancy, posture, and thyroid issues. This can be resolved with the same techniques used to relieve hemorrhoids mentioned later.

Most of the commonly known causes of hemorrhoids are related to excessive pressure being placed upon the blood vessels in and around the anus.

Chronic constipation or straining during bowel movements has been known to cause such pressure. A low fiber diet, poor water intake, lack of exercise, or prescription medications can all lead to constipation.

Many women experience their first run-in with hemorrhoids during or after pregnancy. The weight of a growing fetus can cause stress to blood vessels resulting in hemorrhoids, as well as the hormonal changes of pregnancy that can lead to constipation.

The pushing involved in childbirth is also a culprit in this condition and even having a Cesarian delivery won’t necessarily prevent hemorrhoids.

Genetics plays a small role in the development of hemorrhoids. Even if you inherit weak veins in this area, other contributing factors are needed to develop hemorrhoids.

If hemorrhoids run in your family, making hemorrhoid prevention should become part of your lifestyle.

Other known causes of hemorrhoids are obesity, standing or sitting for long periods of time, anal intercourse, diarrhea, colon cancer, frequent coughing, and sneezing, past rectal surgery and holding bowel movements rather than eliminating when the urge arises. All of the previously mentioned cause excessive pressure on the anus and surrounding veins.

How long do external hemorrhoids last? 

Typically, external hemorrhoids last between two to three weeks. They often resolve on their own without intervention. Internal hemorrhoids can resolve on their own even faster.

External hemorrhoids tend to take longer to resolve due to irritation from clothing and wiping after bowel movements. If hemorrhoids develop as a result of pregnancy, often they will only go away after childbirth.

What are the signs and symptoms of hemorrhoids? 

Because of the nature of hemorrhoids, the signs and symptoms may be overlooked until the condition worsens. It’s important to pay attention to the signs to diagnose hemorrhoids early and avoid any potential complications.

Symptoms may include swelling around the anus, blood on toilet paper after a bowel movement, itching, discomfort or pain, and lumps around the anus that may be tender.

When a thrombosed hemorrhoid becomes infected it can form an abscess which can lead to additional symptoms.

The abscess may be warm to the touch, painful, and red. If the infection spreads, a fever and feeling of illness may be present. If you experience rectal bleeding or a fever please consult your physician.

How are external hemorrhoids diagnosed? 

Even though external hemorrhoids often resolve on their own without medical intervention, having a physician’s diagnoses may be necessary.

Some of the symptoms of hemorrhoids may be related to more serious conditions such as cancer or bowel rupture. Rectal bleeding is not always an indication of hemorrhoids and should not be dismissed as trivial.

After gathering information on the symptoms, a physician will do a visual examination to determine if external hemorrhoids are present.

The physician will attempt to rule out other causes for the symptoms given, such as tumors, inflammatory bowel disease, and other illnesses unrelated to hemorrhoids.

Once a positive diagnosis of hemorrhoids is made, your physician can prescribe medication of schedule a procedure to remove them. A colonoscopy may be recommended.

What are some home remedies for treating external hemorrhoids? 

In the absence of concerning symptoms such as rectal bleeding that may require a physicians diagnoses, home remedies can be a viable first response.

Home remedies can ease symptoms of inflammation and pain, giving relief during the time period needed for hemorrhoids to resolve on their own.

Some of these ingredients may already be on hand or purchased at a local pharmacy. 

– Witch hazel

Witch hazel contains tannins and oils that are reported to help reduce inflammation. It’s known for its astringent effects of tightening the skin. Witch hazel can sometimes bring immediate relief when applied to the affected area with a gauze or cotton ball.

Allow the product to rest against hemorrhoids for several minutes before replacing. It’s recommended that this process is repeated each time a bowel movement is completed.

– Aloe Vera

Aloe vera is also known for its anti-inflammatory properties. When using this plant it’s important to use the pure gel form that contains no additional ingredients. Pure aloe vera contains glycoproteins and polysaccharides.

Glycoproteins reduce inflammation and polysaccharides stimulate skin repair and ease the pain. Aloe vera gel can be applied directed to the affected area in the same manner as witch hazel. Refrigerating the gel before the application will provide soothing relief.

Pure aloe vera can also be consumed to ease constipation. It is advised that you can drink up to three glasses of aloe vera juice daily.

– Sitz Bath

Sitting in warm water for fifteen minutes can soothe the area. This needs to be repeated multiple times throughout the day. For greater convenience, a sitz bath bowl that fits over most toilets can be purchased from a pharmacy.

– Epsom salts and glycerin

The magnesium sulfate in Epsom salts is easily absorbed by the skin and prevent blood vessels from hardening making it an effective treatment for hemorrhoids.

Epsom salts and glycerin can be made into a compound that is applied directly to the hemorrhoids or placed into the sitz bath to reduce pain and inflammation.

Simply mix two tablespoons of Epsom salts with two tablespoons of glycerin, apply the mixture to a gauze for application to the affected area, or drop into the sitz bath and soak for fifteen minutes. You can even add this to your bath water and soak your entire lower body.

When applying directly to the affected area, leave on for fifteen to twenty minutes and repeat every four to six hours until relief is experienced.

– Ice

Icing the area can reduce swelling and pain. Ice treatment will numb the area and reduce swelling almost instantly.

Wrap the ice in a cloth and apply to the affected area several times a day for twenty minutes. Using ice as a treatment after taking a warm sitz bath will greatly improve hemorrhoids.

-Over-the-counter painkillers and Hemorrhoid medication

Over-the-counter painkillers may be taken for extended pain relief. Follow the directions provided on the packaging or consult your physician.

There are also over-the-counter medications that are specific for hemorrhoids such as creams that reduce swelling and itching.

-Adjust clothing

Making sure that underwear is cotton and not tightly fitting ensures that hemorrhoids are not further irritated by moisture and friction.

– Exercise

Moderate exercise can stimulate bowel movement when constipated and encourage increase blood circulation.

Kegel exercises will also help prevent and relieve hemorrhoids. This exercise strengthens the pelvic floor and anal muscles, increasing blood flow.

Strong pelvic floor muscles make it easier to have bowel movements. The increased blood flow promotes healing if you have hemorrhoids and suppleness if you have higher resting anal canal tone.

To perform Kegel exercises squeeze your pelvic floor muscles as if you are stopping yourself from urinating.

Initially, to learn how to do a proper squeeze you can practice on the toilet while you are urinating. Once you have located the correct muscle, you will want to squeeze for ten to twenty seconds, several times a day.

This treatment, as with any exercise, doesn’t provide immediate relief but over time you will notice a great improvement.

It is advised that you should continue these exercises for the rest of your life to maintain a healthy pelvic floor.

– Fiber supplements

Fiber supplements can decrease inflammation and rectal bleeding as well as remove stool trapped around inflamed blood vessels. Make sure to increase your water consumption while using these supplements.

Take fiber supplements with caution, as they can cause bloating and gas.

If conventional fiber supplements are not desirable or available, consider psyllium. Psyllium is a soluble fiber from a plant called Plantago Ovata. It softens the stool for easier bowel movements.

Mix one teaspoon of psyllium seeds with eight ounces of water and consume with your first meal of the day.

– Essential oils

This natural method involves mixing essential oils in a carrier oil. The mixture is then applied directed to hemorrhoids. Many essential oils are antispasmodic, anti-inflammatory, antiseptic, and have a sedative effect.

Consulting a physician for what oils are safe to use on hemorrhoids is recommended.

– Coconut oil

Coconut oil can be taken internally to assist with constipation or applied externally to soothe swollen hemorrhoids.

Mix a tablespoon in a smoothie to enjoy it as a delicious gentle laxative or put a little directly onto hemorrhoids to relieve itching and inflammation.

– Apple cider vinegar

Apple cider vinegar may significantly reduce the symptoms of hemorrhoids. It contains lactic and malic acid with may aid in reducing inflammation and shrinking hemorrhoids.

You can add a little apple cider vinegar to a sitz bath or soak a cotton ball in it and apply directly to the hemorrhoids, repeating as needed.

– Black Tea

Black tea contains tannic acid which is an astringent known to reduce swelling and pain. Dip a black tea bag into a cup of lukewarm water and apply to the affected area for ten minutes.

Repeat the process a few times during the day. Freezing the tea bags will give you the added benefit of the ice treatment.

What are the best and worst foods for hemorrhoid prevention and treatment? 

Improper diet can be the root cause of hemorrhoids or aggravate hemorrhoids caused by other means.

The main reason is that diet impacts your ability to have easily passable stools. Making dietary changes can resolve hemorrhoids and bring significant relief by addressing constipation.

Not consuming enough water can dehydrate the body, leading to constipation. Our bodies are made up of seventy-two percent water and drinking enough water can cause things to slow down.

Make sure to drink at least half your body weight in ounces of water daily. Sodas and caffeinated beverages don’t count towards this needed fluid intake as they are known to dehydrate the body.

Adding fiber to your diet from foods such as whole grains, vegetables, beans, and fruits can prevent and resolve constipation. According to WebMD, you will need to consume between 25-30 grams of fiber per day.

Examples of great foods that will encourage bowel movement are: 

  • Apples
  • Pears
  • Broccoli
  • Sweet potatoes
  • Carrots
  • Oats
  • Brown rice
  • Various beans

Aim to avoid to avoid foods that lack fiber and dehydrate you such as highly processed foods. Examples of foods to avoid are:

  • Fast food
  • Junk food
  • Sodas
  • Candy
  • Diary

According to clinical studies of hemorrhoids, fiber supplementation reduced the risk of bleeding and persisting symptoms by approximately fifty percent.

Consuming anti-inflammatory foods will speed up your recovery. Foods such as pineapple, ginger, turmeric, green tea, and garlic are all excellent for reducing inflammation. try to use fresh ingredients for a more potent remedy.

Turmeric’s anti-inflammatory properties are so effective, you can even mix it with a bit of water to form a paste and apply it directly to hemorrhoids. Be aware that turmeric can stain clothing.

What are the medical treatments for hemorrhoids? 

When home remedies and over-the-counter medicines fail to resolve hemorrhoid irritation and pain, medical intervention may be needed. A physician may suggest over-the-counter solutions before scheduling surgery.

Some procedures are minimally invasive while others require an inpatient hospital stay. A physician can help you determine which treatment option will best suit your needs. Here are some of the procedures a physician might suggest:

– Rubber band litigation

Rubber band litigation involves a physician placing small rubber bands around the base of the hemorrhoids, cutting off blood flow.

This will cause hemorrhoids to shrink, eventually drying up and be falling off. This procedure causes little to no pain and can be done as an outpatient treatment.

– Sclerotherapy

This treatment involves a chemical solution being injected into hemorrhoids to shrink it. It is relatively painless but not as effective as the rubber band method. It too can be done without requiring an inpatient stay.

– Cauterization

With cauterization, the hemorrhoid is burned off using a laser, heat, or infrared light. This technique closes off and seals the end of hemorrhoids and causes little discomfort.

– Surgery

If the previously mentioned methods don’t work or if the hemorrhoids are too large, surgery may be the best option for relief.

Hemorrhoidectomy removes hemorrhoids using various surgical techniques. Complete sedation or a local anesthetic may be used.

Hemorrhoidectomy is the most effective way to treat reoccurring hemorrhoids.

Another option is stapling, which has a faster recovery time than hemorrhoidectomy. Similar to the rubber band method, staples are used to cut off blood flood to hemorrhoids causing it to shrink and fall off. However, this is not a method commonly used for external hemorrhoids.

How can you prevent external hemorrhoids from developing? 

Preventing external hemorrhoids can be as easy as making a few lifestyle adjustments. While hemorrhoids can seem to be an unavoidable consequence of life and aging, remembering the acronym F.E.W. can help you experience few to no hemorrhoids.


Consume adequate fiber daily. Ideal sources include whole grains, fresh vegetables, and fruit. Avoid overly processed foods that dehydrate and constipate bowels.


Make sure to exercise for a minimum of twenty minutes, three to five times a week. Taking a walk after having a meal is a great way to get the digestive tract moving and meet your daily exercise requirement.


Consume enough water to prevent dehydration. Dehydration leads to constipation. Taking your weight and dividing it in half will give you your ideal water intake in ounces.

Also, make sure to not strain when having bowel movements in the event you do become constipated. If you are unable to pass stool easily without straining, try some of the suggestions above before attempting to pass stool again.

If constipation is not an issue, remember to eliminate bowels when the need arises. Holding in bowel movements for extended periods of time can result in strain on blood vessels.

What’s the prognosis for a person with external hemorrhoids? 

Having hemorrhoids can be embarrassing. It is not something you think about until you are suffering from them and find yourself cautiously sitting on the edge of your seat wondering how could life be so cruel.

Sometimes seeing a visual representation of hemorrhoids can help ease the mind and help in identifying if you have them.

This YouTube video will provide a visual explanation that will help you better understand what external hemorrhoids are, how they are caused, and the ways they are treated.

Hopefully, the information presented helps you to understand hemorrhoids are actually very common and nothing to be ashamed of. We all occasionally have pains in our butts.

With the myriad of treatment options available, the prognosis for someone suffering from hemorrhoids is not at all dismal.

Combining prevention methods along with natural and effective home remedies may eliminate the need for medical intervention.

Even if self-treatment fails, there are safe conventional methods to fall back on that will make the pain in your butt a thing of the past.