Why Won't My Hemorrhoids Go Away? (The Real Reasons)
 |
| Why Won't My Hemorrhoids Go Away? (The Real Reasons) |
You've tried the creams. You've done the sitz baths. Maybe you've changed your diet. And yet your Hemorrhoids are still there — still itching, still painful, still bleeding.
It's frustrating, and it leads many people to assume there's something uniquely wrong with their body.
In most cases, there isn't. Persistent hemorrhoids are almost always the result of one or more ongoing behaviors or conditions that are actively working against healing.
Here are the most common reasons hemorrhoids won't go away — and what to do about each one.
1. You're Still Straining — Even Without Realizing It
Straining is the primary mechanical driver of hemorrhoid development and the primary obstacle to healing. What many people don't realize is that you don't need to feel like you're straining hard for it to be causing damage.
If every bowel movement requires any effort — even modest effort — that pressure is repeatedly traumatizing the same inflamed tissue that's trying to heal. Healing hemorrhoids need bowel movements that come easily, with zero bearing down.
Fix it: Increase dietary fiber to 25–35g per day, drink 8–10 glasses of water, use a toilet stool to optimize posture, and take a stool softener until stools pass with no effort whatsoever.
2. Your Diet Hasn't Really Changed
Many people make token dietary changes — one more glass of water, slightly more vegetables — while continuing to eat mostly the same constipating foods. Token changes produce token results.
A low-fiber diet consistently keeps stool hard and dry. Hard stool means repeated trauma. Repeated trauma means hemorrhoids don't heal.
Fix it: Be honest about your actual daily fiber intake. Most people eating a Western diet get 10–15g per day. You need 25–35g. That requires deliberate, sustained dietary change — not one extra apple.
3. You're Spending Too Long on the Toilet
Phone scrolling on the toilet is one of the most consistent reasons hemorrhoids persist in people who are otherwise doing everything right. Ten to twenty minutes on the toilet seat, multiple times per day, keeps sustained pressure on the hemorrhoidal vessels and prevents the venous congestion from resolving.
Fix it: Leave your phone outside the bathroom. Toilet visits should last 3–5 minutes maximum.
4. You're Using the Wrong Topical Products
Not all hemorrhoid products are created equal, and some can actually slow healing. Products containing alcohol dry out and irritate sensitive perianal skin. Heavily perfumed products cause contact dermatitis. Some medicated wipes marketed for hemorrhoids contain ingredients that sensitize the skin over time.
Using topical steroids (hydrocortisone cream) for longer than 7–10 days continuously causes skin thinning, which makes the area more vulnerable, not less.
Fix it: Use alcohol-free witch hazel, plain petroleum jelly for moisture barrier protection, or a correctly used hemorrhoid cream for short periods. Keep it simple and clean.
5. You Have a Chronic Fissure as Well as Hemorrhoids
Anal fissures and hemorrhoids frequently co-exist — both caused by the same pattern of hard stool and straining. Fissures are tears in the anal canal lining and require specific treatment. If you have a fissure alongside hemorrhoids, the pain and inflammation from the fissure can make it feel like the hemorrhoids aren't resolving when in fact both conditions are present.
Fix it: See a colorectal specialist who can properly evaluate whether you have a fissure, hemorrhoids, or both, and treat each appropriately.
6. You're Not Giving It Enough Time
Hemorrhoids — especially chronic, long-standing ones — don't resolve in a week. Grade II and III hemorrhoids with consistent home care typically take 4–8 weeks to improve meaningfully, and may take months to resolve fully. Many people start a routine, don't see dramatic results in two weeks, assume it isn't working, and stop.
Fix it: Commit to consistent home care for a minimum of 4–6 weeks before concluding it isn't working. Track your symptoms weekly rather than daily — day-to-day variation is normal.
7. You Need Medical Treatment, Not Just Home Care
Grade III and Grade IV internal hemorrhoids — those that prolapse and either require manual reduction or are permanently prolapsed — typically do not resolve with dietary changes and topical treatment alone. At these grades, the structural changes to the hemorrhoidal tissue are too advanced for home care to fully address.
Fix it: See a colorectal surgeon. Minimally invasive outpatient procedures — rubber band ligation, sclerotherapy, infrared coagulation — have very high success rates for Grade II and III hemorrhoids and are far less dramatic than people expect. Hemorrhoidectomy (surgical removal) is reserved for the most severe cases.
8. Something Else Is Causing Your Symptoms
If you've been diligently treating hemorrhoids for weeks without improvement, it's worth considering whether your symptoms might be caused by something other than — or in addition to — hemorrhoids. Anal fissures, anal skin tags, perianal dermatitis, anal warts, inflammatory bowel disease, and in rare cases more serious pathology can all produce hemorrhoid-like symptoms.
Fix it: See a doctor for proper evaluation. A physical examination, and potentially a colonoscopy depending on your age and symptoms, is appropriate for persistent symptoms that aren't responding to treatment.
Conclusion
Hemorrhoids that won't go away are almost always explained by one of these eight factors — most commonly ongoing straining, insufficient dietary change, or the need for medical treatment beyond home care. Identify which applies to you, address it directly, and give the treatment adequate time to work. If you've genuinely done everything right for 4–6 weeks and aren't improving, it's time to see a specialist.
📑 Reated articles
📚 Medical Sources
- American Society of Colon and Rectal Surgeons (ASCRS) — Clinical Practice Guidelines for the Management of Hemorrhoids (2024)
- Mayo Clinic — Hemorrhoids: Diagnosis & Treatment
- National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) — Hemorrhoids
- American College of Gastroenterology (ACG) — Hemorrhoids Guidelines Summary (via Medscape)
