How long do hemorrhoids last?

Most hemorrhoids get better within a few days to about a week, especially small ones (NHS; Cleveland Clinic). A thrombosed hemorrhoid, which has a small blood clot inside, hurts most for the first 2 to 3 days and usually settles over 1 to 3 weeks. Internal hemorrhoids that slip out and stay out tend to last until they are treated, even though home care can calm the symptoms.

Hemorrhoids (spelled haemorrhoids in the UK, and often called piles) are swollen blood vessels inside and around the back passage, or anus (NHS). Everyone has this tissue. It only becomes a problem when it swells, bleeds or slips out (ASCRS). How long yours last depends mostly on which type you have.

How long do hemorrhoids last? Timelines by type

There are two main types. Internal hemorrhoids sit inside the back passage. Doctors grade them from 1 to 4 by how far they prolapse, which means slip down and out of the opening. External hemorrhoids sit under the skin at the edge of the opening. If you are not sure which you have, our guide to internal vs external hemorrhoids walks through the differences.

These are typical ranges, not promises. Everyone heals at a different pace, and a hemorrhoid that keeps getting irritated by hard stools or straining will take longer.

Internal hemorrhoids, grades 1 and 2

Grade 1 hemorrhoids bleed but never come out. Grade 2 hemorrhoids slip out when you strain on the toilet and slide back in by themselves. Both are usually painless, because the lining inside the back passage does not sense pain the way skin does (ASCRS).

A bleeding flare often settles within a few days (NHS), though pain and bleeding can last a week or slightly longer (Cleveland Clinic). Smaller hemorrhoids often go away with more fibre and better toilet habits. The habit changes take longer to show their full effect: in the trials pulled together by Cochrane, fibre roughly halved the chance of ongoing symptoms, especially bleeding, and that benefit held over up to three months (Cochrane).

If bleeding keeps coming back despite a few weeks of good habits, rubber band ligation (banding) is a quick clinic treatment for these grades (ASCRS).

Internal hemorrhoids, grades 3 and 4

Grade 3 hemorrhoids come out and need to be pushed back in with a finger. Grade 4 hemorrhoids stay out and cannot be pushed back. Symptoms of internal hemorrhoids tend to come and go and get worse slowly over a long time (ASCRS).

Home care can calm a flare of soreness, itching or bleeding. But the prolapse itself rarely goes away on its own at these grades. Severe cases can take several weeks to settle even with a procedure (Cleveland Clinic). Surgeons usually offer banding for some grade 3 hemorrhoids and an operation (hemorrhoidectomy) for larger grade 3 and grade 4 ones (ASCRS guideline).

External hemorrhoids

External hemorrhoids are covered by skin, so they can itch and feel sore, especially when you sit. For many people the symptoms go away within a few days (NIDDK). A flare that keeps getting rubbed or irritated can take a week or two to calm down. Too much straining, rubbing or cleaning around the area can make symptoms worse.

Thrombosed external hemorrhoids

A thrombosed hemorrhoid is an external hemorrhoid with a blood clot inside. It shows up as a sudden, firm, bluish or purple lump with constant pain (ASCRS).

Here is how it usually goes:

• Days 1 to 3: the pain builds and is usually at its worst around 48 to 72 hours after the lump appears (ASCRS).
• Days 4 to 5: the pain is largely easing for most people.
• Weeks 1 to 3: the body slowly reabsorbs the clot and the pain improves a little each day. Most go away within a few weeks (Cleveland Clinic).

The 2024 ASCRS guideline describes a study of 504 people treated without surgery. Half noticed improvement within 5 days and half were symptom-free within 8 days, but for a few it took up to about six weeks (ASCRS guideline).

If the pain is severe, a doctor can remove the clot under local anaesthetic. This gives the fastest relief and the lowest chance of it coming back when done within the first 2 to 3 days (American Family Physician). After that, when the pain is already easing, home care is usually the better route (ASCRS). Never try to pop or drain it yourself (Cleveland Clinic).

Once the clot has gone, the stretched skin can stay behind as a soft, painless skin tag. These are harmless and usually need no treatment (ASCRS).

During pregnancy and after birth

Hemorrhoids are common in pregnancy, especially in the last three months. They usually improve a lot or go away completely after the baby is born. Pushing during labour can make them worse at first, but they should get better within a few weeks (Cleveland Clinic). Do not use a cream or medicine in pregnancy without checking with your doctor, midwife or pharmacist first (NHS). Our guide to hemorrhoids during pregnancy and after birth covers this in more detail.

Do hemorrhoids go away on their own?

Often, yes. The NHS says they often get better on their own after a few days (NHS). Most people never need an operation: fewer than 10% of people assessed for hemorrhoid symptoms need surgery (ASCRS).

It helps to know what “go away” means. The swelling and soreness of a flare settle. The cushion of tissue underneath stays, because everyone has it. That is why hemorrhoids can come back when the things that caused them, like constipation and straining, come back.

The exceptions are internal hemorrhoids that need pushing back in or stay out (grades 3 and 4). These usually need a procedure to fix them. Home care still matters, because it eases symptoms and helps stop them getting worse.

How long does a hemorrhoid flare-up last?

Most flare-ups settle within a few days to about a week. Pain and bleeding may last a week or slightly longer (Cleveland Clinic).

A flare usually starts after a spell of constipation, diarrhoea, heavy lifting or long sitting. Itching, a hard stool or a spot of blood are good cues to go back to the basics below for a few days.

If you still have symptoms after a week of home care, see a doctor (NIDDK).

How to make hemorrhoids go away faster

Nothing makes a hemorrhoid vanish overnight. These steps take pressure off the area so it can heal, and they are what doctors recommend first.

Keep your stools soft. Eat more fibre (wholegrain bread, fruit, vegetables, beans and oats) and drink plenty of water (NHS). The American Society of Colon and Rectal Surgeons suggests 20 to 35 grams of fibre a day, and a fibre supplement such as psyllium can help you get there (ASCRS; NIDDK). A pharmacist can suggest a laxative to soften stools if you are constipated (NHS).

Do not strain, and keep toilet visits short. Go when you feel the urge, do not push hard, and do not sit on the toilet longer than you need to (NHS; NIDDK).

Sit in warm water. A warm bath eases itching and pain. A sitz bath, a shallow bath of warm water just for your bottom, several times a day can help with pain (NHS; NIDDK). See how to take a sitz bath for a step-by-step guide.

Use a cold pack for swelling. An ice pack wrapped in a cloth can ease discomfort (NHS).

Clean gently. Keep the area clean and dry, and pat rather than rub (NHS).

Choose pain relief carefully. Paracetamol can help. Avoid painkillers containing codeine, because they cause constipation, and do not take ibuprofen if your hemorrhoids are bleeding (NHS).

Use creams for a short time only. Pharmacy creams and suppositories can ease pain, swelling and itching. Doctors usually recommend using them for about a week. If they have not helped after a week, or cause a rash or dry skin, see your doctor (NIDDK). Long-term use can cause skin allergies and has no proven benefit (ASCRS guideline).

Cut down on alcohol and caffeine, which can make constipation worse (NHS). Regular exercise and not standing or sitting for long periods also help (NHS).

Get a sudden painful lump seen early. For a thrombosed hemorrhoid, seeing a doctor in the first 2 to 3 days gives you the option of having the clot removed, which is the fastest route to relief.

Ask about treatment if habits are not enough. Banding cuts off the blood supply to an internal hemorrhoid, and it falls off with the band after about 5 to 7 days. There may be a dull ache or pressure for 1 to 3 days, but for most people there is no real recovery time (ASCRS).

It can be hard to tell which of these is actually helping. Keeping a simple daily note of your symptoms, stools and habits makes the pattern clear, and the Sitwell app is built to do exactly that.

Signs a hemorrhoid is not healing

Most hemorrhoids get a little better each day. These are signs that yours is not settling and needs a doctor to look at it:

• Symptoms are no better after a week of home care, or are getting worse (NIDDK; NHS).
• Pharmacy creams have not helped after a week (NIDDK).
• A thrombosed lump is still very painful after a few days of home care (Cleveland Clinic).
• A lump that used to go back in now stays out.
• They keep coming back (NHS).
• Symptoms are getting in the way of your daily life or sleep (Cleveland Clinic).

A doctor can confirm it really is hemorrhoids, because other conditions can cause the same symptoms, and offer treatments that work when home care has not.

Why hemorrhoids come back

Things that make hemorrhoids more likely include constipation, pushing too hard on the toilet, heavy lifting, pregnancy, getting older and being overweight (NHS). If those stay the same, hemorrhoids often return. Even after treatment in hospital, they can come back (NHS), so the fibre, fluid and toilet habits above are worth keeping long after a flare has gone. If symptoms return after banding, it can be repeated (ASCRS).

When to see a doctor

Bleeding from the bottom and lumps are usually hemorrhoids. But the same symptoms can come from other conditions, including bowel cancer, so any rectal bleeding is worth getting checked (NIDDK). For more on this, read bleeding hemorrhoids: when to see a doctor.

Get medical help today (emergency department, urgent care or your local emergency number) if you have:

• Heavy bleeding that does not stop, or you are passing blood clots (NHS)
• Bleeding along with feeling faint, dizzy or short of breath
• Severe pain, especially with a fever (NHS; NIDDK)
• A lump that is quickly getting bigger, darker or harder, or a prolapsed hemorrhoid that will not go back in and turns dark, hard or very painful

Book a doctor’s appointment in the next few days if you have:

• Black or tar-like stools, or dark blood mixed into your stool (NHS)
• Weight loss without trying, or unusual tiredness (NHS)
• A change in your bowel habit that lasts more than 3 weeks, such as looser stools, going more often or new constipation
• Bleeding that no doctor has examined, and you are over 45 or bowel cancer runs in your family
• A high temperature or pus leaking from the area (NHS)
• Symptoms that are no better after a week of home care

Try not to feel embarrassed. Doctors see hemorrhoids every day, and a quick examination is often all it takes to put your mind at rest and get you on the right treatment.