Hemorrhoids are located in the rectum and extend to the anus. Internal hemorrhoids are located in the anus and appear as swollen veins. Swollen hemorrhoids may protrude from the inside of the anus to the outside. These are called external hemorrhoids. While pain is evident both with internal and external hemorrhoids it seems worse with external hemorrhoids. Both are swollen veins and require forms of treatment. Protocol for treatment is not to treat unless there is a complaint of pain. Since hemorrhoids do not always present pain - unless swollen - there is no need for immediate medical treatment.

In the event that hemorrhoids start flaring up by excessive swelling and presenting pain then the best plan is to seek a medical professional. It is important to be certain that the problem really is swollen hemorrhoids. There is always a possibility that the problem might be something else such as anal fissures. Some people confuse these as hemorrhoids but a trained professional is able to make that determination easily. Anal fissures are tears in the anus and may require surgery to repair.

Hemorrhoids become swollen due to extra duress is the anal area. Swollen hemorrhoids may be brought on by trying to pass hard stools, excess diarrhea, a low fiber diet and pelvic wall pressure from pregnancy and little or no exercise. The remedy is to eat a high fiber diet with lots of fruits and vegetables, add more water and exercise. When a flare up is occurring it makes a remedy seem unlikely. One of best treatments for swelling and discomfort are to have a 20 minute sitz bath - with Epsom salts if desired - bathing several times per day as needed. A sitz bath can be followed by drying off the affected area very gently and wearing cotton underwear.

What helps swollen hemorrhoids after a sitz bath is to put an ice pack on the affected area for 10 minutes and then a warm compress for 20 minutes, to be repeated as needed. Whenever bowels have moved be sure to clean the area well with baby wipes. Topical ointments or cloths with witch hazel as the active ingredient help to bring swelling down. It is important not to scratch any itch and if itching persists then a hydro-cortisone cream may be most beneficial. Do not use a doughnut seat as this will bring on too much pressure and cut off important blood supply. If hemorrhoids occur frequently - surgery may be in order.