Hemorrhoid Pain? Why It Won't Heal & Medically Approved Next Steps

Hemorrhoid pain can be frustrating, uncomfortable, and sometimes alarming. If your hemorrhoid doesn't seem to be healing, you're not alone. Hemorrhoids are extremely common, affecting millions of adults each year. While many improve within a few days to weeks, some persist longer — and understanding why can help you take the right next steps.

This guide explains why hemorrhoid pain may not be healing, what medically approved treatments are available, and when it's important to speak to a doctor.

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What Is a Hemorrhoid?

A hemorrhoid is a swollen vein in the lower rectum or anus. It's similar to varicose veins but located internally or externally around the anus.

There are two main types:

• Internal hemorrhoids – Located inside the rectum. They may bleed but usually don't cause pain unless they prolapse (bulge outward).
• External hemorrhoids – Located under the skin around the anus. These are more likely to cause pain, itching, and swelling.

In some cases, a hemorrhoid can become thrombosed, meaning a blood clot forms inside it. This often causes significant pain and swelling.

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Why Your Hemorrhoid May Not Be Healing

Most mild hemorrhoids improve within 1–2 weeks with conservative care. If yours hasn't healed, there are several possible reasons.

1. Ongoing Strain During Bowel Movements

Straining is one of the biggest contributors to hemorrhoid pain and delayed healing. Chronic constipation or sitting on the toilet for long periods increases pressure in the rectal veins.

Common causes include:

• Low fiber intake
• Dehydration
• Ignoring the urge to have a bowel movement
• Habitual prolonged sitting on the toilet

If pressure continues daily, healing can stall.

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2. Chronic Diarrhea

Frequent loose stools can irritate the anal area and worsen inflammation. Constant wiping and moisture can prevent the hemorrhoid from calming down.

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3. Thrombosed Hemorrhoid

If the hemorrhoid is very painful, swollen, and possibly bluish, it may be thrombosed. These can take longer to resolve — often 2–3 weeks — and sometimes require medical treatment.

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4. Prolapsed Internal Hemorrhoid

An internal hemorrhoid that protrudes outside the anus (prolapse) may cause discomfort, mucus discharge, and irritation. If it doesn't retract on its own, healing may be delayed.

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5. Infection or Poor Hygiene

While infection is uncommon, persistent moisture, irritation, or improper cleaning can delay healing. Harsh wiping or scented products can make symptoms worse.

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6. Underlying Medical Conditions

Sometimes what seems like a hemorrhoid may actually be:

• An anal fissure (a small tear in the lining of the anus)
• An abscess (a painful infection)
• Inflammatory bowel disease
• Rarely, colorectal cancer

If pain is severe, worsening, or associated with other concerning symptoms, it's important not to assume it's "just a hemorrhoid."

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Medically Approved Steps to Help a Hemorrhoid Heal

If your hemorrhoid isn't healing, there are evidence-based steps that can help.

1. Increase Fiber Intake

Fiber softens stool and reduces straining.

Aim for:

• 25–38 grams of fiber per day (depending on age and sex)

Good sources include:

• Vegetables
• Fruits
• Whole grains
• Beans and legumes

A fiber supplement (such as psyllium) may help if dietary changes aren't enough.

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2. Stay Hydrated

Drink enough fluids daily. Proper hydration helps fiber work effectively and prevents constipation.

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3. Limit Time on the Toilet

Avoid sitting for more than 5–10 minutes. Don't force a bowel movement if it doesn't happen easily.

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4. Use Warm Sitz Baths

Soaking the anal area in warm water for 10–15 minutes several times per day can:

• Reduce pain
• Relax anal muscles
• Improve blood flow and healing

This is a simple and medically supported way to reduce hemorrhoid discomfort.

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5. Apply Over-the-Counter Treatments

Short-term use of topical products may help relieve symptoms:

• Hydrocortisone creams (reduce inflammation)
• Witch hazel pads (soothe irritation)
• Lidocaine creams (reduce pain)
• Protective ointments (like zinc oxide)

Use steroid creams only as directed (usually no more than 1 week unless advised by a doctor), as long-term use can thin the skin.

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6. Improve Bathroom Habits

• Go when you feel the urge.
• Avoid straining.
• Consider elevating your feet on a small stool to improve rectal alignment.
• Gently clean with water or unscented wipes rather than dry toilet paper.

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7. Pain Relief Medication

If approved by your doctor, nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen may help reduce pain and inflammation.

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When Conservative Treatment Isn't Enough

If your hemorrhoid doesn't improve after 1–2 weeks of proper care, medical treatment may be needed.

A doctor may recommend:

• Rubber band ligation – Cuts off blood supply to internal hemorrhoids.
• Infrared coagulation – Shrinks hemorrhoids using heat.
• Sclerotherapy – Injects a solution to shrink the hemorrhoid.
• Hemorrhoidectomy – Surgical removal (usually for severe cases).
• Stapled hemorrhoidopexy – Repositions prolapsed hemorrhoids.

These procedures are common and generally safe when performed by experienced providers.

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Signs You Should Speak to a Doctor Promptly

While most hemorrhoids are not dangerous, some symptoms require medical evaluation.

Seek medical care if you experience:

• Heavy or persistent rectal bleeding
• Black or tarry stools
• Severe or worsening pain
• Fever
• Pus or drainage
• Dizziness or weakness
• Symptoms lasting longer than 2–3 weeks
• Unexplained weight loss
• A change in bowel habits

Rectal bleeding should never automatically be assumed to be a hemorrhoid. Other conditions can mimic hemorrhoid symptoms, including more serious diseases.

If you're experiencing persistent symptoms and want to understand whether they align with hemorrhoid patterns, a free AI-powered symptom checker can help you determine your next steps before scheduling a doctor's visit.

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How Long Should a Hemorrhoid Take to Heal?

Typical healing timelines:

• Mild external hemorrhoid: a few days to 1 week
• Thrombosed hemorrhoid: 2–3 weeks
• After medical procedure: varies (usually 1–3 weeks recovery)

If pain continues beyond this timeframe despite appropriate care, further evaluation is reasonable.

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Preventing Future Hemorrhoids

Once healed, prevention becomes key.

Long-term habits that reduce recurrence:

• Maintain a high-fiber diet
• Drink adequate water
• Exercise regularly
• Avoid prolonged sitting
• Manage weight
• Treat constipation early
• Avoid excessive straining

Hemorrhoids often return when the underlying cause is not addressed.

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The Bottom Line

A hemorrhoid that won't heal is usually due to ongoing strain, constipation, irritation, or thrombosis. Most cases improve with proper home care, but persistent or severe symptoms deserve medical attention.

While hemorrhoids are common and often manageable, rectal bleeding and ongoing pain should never be ignored. If something feels different, more intense, or simply isn't improving, speak to a doctor. Some conditions that mimic hemorrhoid symptoms can be serious, and early diagnosis matters.

Taking action early — whether through lifestyle changes, over-the-counter treatments, or medical care — can help you recover more quickly and reduce the risk of recurrence.

If you have severe symptoms, significant bleeding, or signs of infection, seek medical care immediately. Your health and safety come first.