What causes hemorrhoids?

Hemorrhoids happen when pressure causes veins in your rectum and anus to stretch, swell, and bulge. Sleep with hemorrhoids by pushing them back in, taking a sitz bath before bed, using topical creams and using other strategies.
Hemorrhoids happen when pressure causes veins in your rectum and anus to stretch, swell, and bulge. Sleep with hemorrhoids by pushing them back in, taking a sitz bath before bed, using topical creams and using other strategies.

Hemorrhoids happen when pressure causes veins in your rectum and anus to stretch, swell, and bulge. Internal hemorrhoids occur inside the rectum, and external hemorrhoids occur in the skin outside your anus.

Some activities and conditions can lead to extra pressure in your rectum and cause hemorrhoids, including:

Hemorrhoids can be uncomfortable and make bowel movements painful, especially if you get blood clots outside around your anus. Other common hemorrhoids symptoms include:

  • Itchy skin around your anus
  • Swelling around anus
  • Hard lump around your anus
  • Bleeding without pain during a bowel movement
  • Pain and irritated skin around your anus

How to make hemorrhoids and sleeping more comfortable

It can be hard to get comfortable when you have hemorrhoids, and sleep can be affected. You can manage hemorrhoids at home with some personal care and lifestyle changes in most cases. There are some simple ways to relieve your symptoms.

Push hemorrhoids back in

Sometimes hemorrhoids will stick out of your anus, especially after a bowel movement. If you pass stool before bed, gently push the hemorrhoid back in. With the vein back inside your rectum, the skin is protected, which can help lower your risk of getting a blood clot or a hemorrhoid trapped outside your rectum. 

Take a sitz bath before bed

During a sitz bath, you sit in warm, shallow water. Hemorrhoids tend to have crevasses where stool can get stuck and cause skin irritation and itching. A sitz bath can help gently clean the area without having to rub or irritate your skin. The warm water also relaxes your muscles, promotes blood flow, and can ease pain. 

Before bed, take a warm sitz bath, then gently pat the area dry with a towel. Don’t rub or wipe.

Topical cream

Once you get out of the bath, apply a soothing hemorrhoid cream. You can buy over-the-counter creams and suppositories at your pharmacy. Creams with aloe vera can soothe the skin. A numbing hemorrhoid cream can help with pain.

You can also use soothing hemorrhoid cleansing pads throughout the day when you use the restroom. Witch hazel cleansing pads can help ease skin discomfort and reduce irritation. Creams and cleansing pads can also help with itching. Try not to scratch the area as it can cause more damage and irritation to your skin. 

Clean underwear and loose pajamas

After you’ve treated your hemorrhoids, put on a clean pair of underwear and loose pajamas. You may want to use a liner in your underwear to stay dry and absorb any extra cream you apply. Loose pajamas keep pressure off your abdomen and anus and keep you comfortable.

Pain relievers

If you have a lot of pain or your hemorrhoid cream doesn’t numb the area enough, you can take an over-the-counter pain reliever to help. A non-steroidal anti-inflammatory drug, called an NSAID, can help lower inflammation and ease pain. Very painful hemorrhoids are a sign you should talk to your doctor, though. 

Stomach sleeping

Sitting or standing for a long time can make your hemorrhoids worse because they put extra pressure on your blood vessels. In general, laying down can help your symptoms, but you might find it’s hard to get comfortable. You can try sleeping on your stomach, which can also take pressure off your anus and give you some relief. 

Pillow between your legs

Lying on your back might put extra pressure on your anus and cause additional pain for hemorrhoids and sleeping. To prevent this, you can lay on your side with a pillow between your legs. 

Other treatments for hemorrhoids

Lifestyle changes can help you manage hemorrhoids and stop them from coming back. 

Eat a healthy diet 

Constipation is a common cause of hemorrhoids. Adjusting your diet can soften stools and make your bowel movements easier. Include 20 to 35 grams of fiber in your diet every day and drink plenty of water. Both fiber and water help keep your stools soft and make them easier to pass. You can eat:

  • Fresh fruits and vegetables
  • Whole grain pasta, bread, and rice
  • A few meals of beans and lentils a week instead of meat 
  • Nuts and seeds 

Get regular exercise

Regular exercise helps you maintain a healthy weight, taking off some of the pressure on your rectum. It also encourages waste to move through your colon and helps avoid constipation.

When to see your doctor

Hemorrhoids usually go away after a week or two. If they don’t get better, or you’re in a lot of pain and are having trouble with hemorrhoids and sleeping, talk to your doctor about other treatments.

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Medically Reviewed on 12/28/2021
References
SOURCES:

American Academy of Family Physicians FamilyDoctor.org: "Hemorrhoids."

GI Society: Canadian Society of Intestinal Research: "Hemorrhoids."

JOHNS HOPKINS MEDICINE: "Hemorrhoids."

Mayo Clinic: "Hemorrhoids."

Midwest Hemorrhoid Treatment Center: "What to Wear, How to Sleep, and Other Practical Tips for Hemorrhoid Sufferers."

University of Texas at Austin University Health Services: "Hemorrhoids.”