Top OTC Medications for Hemorrhoid Relief

Hemorrhoids, also known as piles, are swollen veins located in the lower rectum and anus. They can cause discomfort, itching, and bleeding, especially during bowel movements. Hemorrhoids are a common condition in the U.S., affecting around 1 in 20 Americans, with the prevalence increasing to nearly 50% in adults over the age of 50.

Types of Hemorrhoids

• Internal hemorrhoids: Inside the rectum, above the anal canal
  Internal hemorrhoids are typically painless due to their location, but they can cause bleeding, especially during or after a bowel movement. In some cases, they can prolapse, meaning they extend outside the anus, which may cause additional discomfort.
• External hemorrhoids: Under the skin around the anus
  External hemorrhoids are often painful, especially when irritated. They can cause itching, swelling, and discomfort. If a blood clot forms inside an external hemorrhoid, it can lead to severe pain, a condition known as a thrombosed hemorrhoid.

What causes hemorrhoids?

Hemorrhoids are caused by increased pressure on the veins in the lower rectum and anus, making them swell. This pressure can build up from straining during bowel movements, which often happens with constipation or diarrhea. Sitting for long periods, especially on the toilet, can also put extra strain on these veins. Pregnancy can lead to hemorrhoids because the growing baby puts more pressure on the mother's pelvic area. Additionally, being overweight, having a low- fiber diet, and lifting heavy objects can all contribute to the development of hemorrhoids.

What are hemorrhoid symptoms?

Hemorrhoids are very common and can cause a variety of uncomfortable symptoms. Some common signs you might experience include the following:

• Itching or irritation
• Pain or discomfort: Hemorrhoids, especially external ones, can cause pain or discomfort. This can be mild or more intense, especially when sitting or having a bowel movement.
• Swelling or lumps: External hemorrhoids can form small lumps around the anus that may feel tender or swollen.
• Bleeding during bowel movements: This is often from internal hemorrhoids.
• Internal hemorrhoids can sometimes extend outside of the anus. This is known as a prolapsed hemorrhoid, which can cause more irritation or discomfort.
• Mucus discharge: This can occur particularly with internal hemorrhoids that have prolapsed.

These symptoms can vary from mild to severe, and it’s important to know that while hemorrhoids can be uncomfortable, they are usually treatable with proper care.

When to consider OTC treatments for hemorrhoids

OTC treatments for hemorrhoids are designed to relieve symptoms such as pain, itching, and swelling. Many of these products contain active ingredients that target inflammation, provide soothing relief, or protect the affected area from further irritation. Studies suggest that OTC treatments can be effective for mild to moderate cases of hemorrhoids because they address the key symptoms that contribute to discomfort.

Hemorrhoid creams and ointments are among the most popular OTC treatments. They work by soothing the irritated area, reducing inflammation, and protecting the skin from further irritation.

Key ingredients include the following:

• Hydrocortisone: A mild corticosteroid that helps reduce inflammation, itching, and swelling. It's widely recommended for treating hemorrhoids because it targets the core symptom of inflammation.
• Phenylephrine: A vasoconstrictor that helps shrink swollen blood vessels, reducing discomfort and swelling in the affected area. It's often found in creams like Preparation H.

Ingredients in Pads and Wipes

OTC pads and wipes are often used for their convenience and ease of use. They provide instant relief and can be used on the go to maintain comfort. Key ingredients include the following:

• Witch hazel: Known for its anti-inflammatory and astringent properties, witch hazel is commonly found in hemorrhoid wipes and pads. It soothes the area and helps reduce swelling.
• Aloe vera: Helps soothe and hydrate irritated skin. It's gentle and works well for external hemorrhoids.

At Home Treatment

In addition to OTC products, there are several at-home treatments that can alleviate hemorrhoid symptoms. These methods help ease pain and discomfort, reduce swelling, and prevent future occurrences.

• Sitz baths: A warm sitz bath can provide relief by promoting blood flow and reducing inflammation. Soaking the area in warm water for 10-15 minutes several times a day can ease symptoms.
• Cold compresses: Applying a cold compress or ice pack to the affected area can help reduce swelling and numb the pain. This is especially helpful after a bowel movement.
• Fiber-rich diet: Increasing fiber intake can prevent constipation and reduce the strain on hemorrhoidal tissues. Adding more fruits, vegetables, and whole grains can soften stools and make them easier to pass.

Over the Counter Products

PREPARATION H OINTMENT 1 OZ

This ointment provides soothing relief from pain and swelling, making it a go-to for many patients.

Ingredients:

• Phenylephrine: A vasoconstrictor, meaning it helps shrink swollen blood vessels, reducing the size of the hemorrhoid and alleviating discomfort.
• Mineral oil and petrolatum: Create a protective barrier on the skin, reducing further irritation and promoting healing.

PREPARATION H SUPPOSITORIES 24

These suppositories are designed to treat internal hemorrhoids by targeting the area inside the rectum where the condition may originate. They are especially effective for those who experience internal discomfort or bleeding.

Ingredients:

• Phenylephrine: This ingredient helps constrict blood vessels to reduce swelling and discomfort.
• Cocoa butter: Suppositories often contain cocoa butter, which provides a soothing and moisturizing effect, helping to calm irritated internal tissues and make bowel movements less painful.

PREPARATION H COOLING GEL 0.9 OZ

This product offers a cooling effect and is a unique option for those who prefer fast-acting, soothing relief from hemorrhoid discomfort.

Ingredients:

• Witch hazel: As an astringent, witch hazel tightens the skin and reduces swelling, while also offering anti-inflammatory benefits.
• Aloe vera: The addition of aloe vera helps moisturize and calm irritated skin, making it particularly effective for soothing external hemorrhoids.

PREPARATION H MAX STRENGTH CREAM 0.9 OZ

This product is a potent formulation that provides maximum relief from the symptoms of hemorrhoids. This cream is ideal for those suffering from more severe discomfort, itching, or swelling.

Ingredients:

• Phenylephrine: A vasoconstrictor that helps reduce swelling and discomfort by shrinking swollen blood vessels. This ingredient is key in relieving the pressure and discomfort caused by hemorrhoids.
• Pramoxine HCl: A topical anesthetic that provides immediate relief by numbing the affected area, and reducing pain and itching.
• Glycerin and petrolatum: These moisturizing agents create a protective barrier on the skin, preventing further irritation and promoting healing.

TUCKS PADS 40

Tucks pads are a convenient, soothing option for external hemorrhoids, providing quick relief from itching and irritation. They are particularly useful for those who prefer a product that can be easily carried and applied on the go.

Ingredients:

• Witch hazel: These pads contain witch hazel, a natural astringent that helps reduce inflammation and soothe irritated tissues. Witch hazel tightens the skin and helps to reduce swelling, providing relief from external hemorrhoids.

When to see a doctor: Signs your hemorrhoid needs professional care

While hemorrhoids are often manageable at home, there are certain times when it’s important to get professional help. If you notice any of the following signs, it might be time to see a doctor for more advanced care.

If your hemorrhoids are causing severe pain or discomfort that doesn’t improve with OTC treatments, a doctor can help by offering stronger medications or procedures to relieve the pain.

Bleeding during bowel movements is common with hemorrhoids, but if you’re experiencing heavy or continuous bleeding, or if the blood is dark red or mixed with stool, this could signal a more serious issue that needs medical attention.

Additionally, if you have hemorrhoids that have prolapsed and aren’t going back inside on their own, or if you notice a lump that seems hard and is extremely painful, you might have a thrombosed hemorrhoid, where a blood clot has formed. This condition often requires treatment from a doctor to avoid complications.

Other signs to watch for include persistent itching or irritation, infections, or fevers, which could indicate that the hemorrhoids are getting worse or that there’s another underlying condition.

If you’ve tried at-home treatments and lifestyle changes but your hemorrhoids keep coming back, or if they are affecting your quality of life, it’s time to consult with a healthcare provider.

Hemorrhoids are common, but it’s important not to ignore symptoms that are severe or don’t go away. A doctor can recommend the best treatment options, including non-invasive procedures or, in rare cases, surgery to remove the hemorrhoid.