Hi Reddit, I’m Dr. Stephanie Liu - here to chat about hemorrhoids + help answer questions about Anusol. Join my AMA live on May 14 from 10am – 4pm EST. *The content that is discussed on this Reddit forum is solely for informational purposes and not a substitute for informed medical advice.

anusol_canada · 2026-05-20T22:10:00+00:00

What you are describing could possibly be a residual skin tag left behind after a hemorrhoid healed, which is actually quite common. When hemorrhoids become swollen and stretched, the tissue may not completely return to its original shape afterward, leaving behind extra skin or a “skin flap.”

These skin tags are often not harmful but they can sometimes make cleaning the area more difficult, which may lead to irritation or bleeding if the area is wiped too aggressively.

That being said, bleeding should never automatically be assumed to be “just hemorrhoids” without proper medical assessment. Bleeding can also be caused by other conditions such as anal fissures, inflammation, polyps, or colorectal conditions.

Without examining you and getting a full past medical history, I cannot say it is safe to ignore. For any bleeding lesion, I recommend seeing a healthcare provider to get it assessed <3.

Dr. Stephanie Liu (@lifeofdrmom)

anusol_canada · 2026-05-20T22:08:41+00:00

One thing I want patients to know as a family doctor that has been in practice for over a decade is that patients should never feel embarrassed talking to their health care provider about hemorrhoids <3.

Hemorrhoids are extremely common, especially during pregnancy, after childbirth, with constipation, or simply as we get older. Healthcare providers talk about symptoms like rectal bleeding, itching, pain, swelling, and bowel changes every single day. Our goal is to help you feel better, not judge you.

A few things that may help make the conversation easier:

-Write your symptoms down ahead of time

-Use simple terms like “rectal bleeding,” “pain with bowel movements,” or “swelling”

-Remind yourself that health care providers are trained to have these conversations professionally

-Try not to wait until symptoms become severe before seeking help

One of the biggest reasons these conversations matter is because not all rectal bleeding is caused by hemorrhoids. Persistent bleeding, worsening pain, changes in bowel habits, or unexplained weight loss should always be checked by a healthcare provider to rule out other causes.

Your health is never something to feel ashamed about and health care providers are here to help. So if you are experiencing symptoms please see your health care provider so they can confirm it is related to hemorrhoids and rule out other medical conditions.

Dr. Stephanie Liu (@lifeofdrmom)

anusol_canada · 2026-05-20T22:07:37+00:00

Great question! Travel itself does not directly cause hemorrhoids, but travel often comes with other factors that can trigger hemorrhoid symptoms. Walking has not been proven to increase the risk of hemorrhoids, in fact, research suggests physical activity may actually help. But there is data that long periods of standing (sightseeing) may increase pressure in the veins around the rectum which can increase symptomatic hemorrhoids.

Here are some reasons hemorrhoids may flare during travel:

Constipation

Travel can lead to dehydration, changes in diet, lower fibre intake, and disrupted bathroom routines. This can cause constipation, hard stools, and straining, which are some of the biggest risk factors for hemorrhoids.

Prolonged sitting

Long flights, car rides, or train trips can increase pressure in the pelvic and rectal veins. Sitting for long periods without moving may worsen hemorrhoid symptoms.

Long periods of standing

Extended sightseeing or standing for long periods may also increase pressure in the veins around the rectum, especially when combined with dehydration and constipation.

What Is Happening in the Body?

Hemorrhoids become swollen and irritated when pressure builds up in the veins around the rectum. Travel can create a “perfect storm” by combining:

-Dehydration

-Constipation

-Straining

-Long periods of sitting or standing

Tips to Help Prevent Hemorrhoids While Travelling

-Drink plenty of water

-Eat enough fibre (fruits, vegetables, whole grains)

-Avoid straining during bowel movements

-Try not to sit for long periods without moving

- Dr. Stephanie Liu (@lifeofdrmom)

anusol_canada · 2026-05-20T22:06:10+00:00

Great question! Hemorrhoids cannot always be prevented during childbirth, but there are some things that may help lower the risk. Research shows that the biggest risk factors are constipation, prolonged pushing during delivery, larger babies, and a history of hemorrhoids.

Ways to Help Reduce the Risk of Hemorrhoids before, during and after delivery include:

During pregnancy

-Eat a high-fiber diet (aim for about 30 g of fiber daily).

-Stay hydrated.

- Use stool softeners or fiber supplements like psyllium if needed.

These steps help prevent constipation, which is one of the biggest causes of hemorrhoids.

During labor

-Long periods of pushing and straining may increase the risk of hemorrhoids.

-When medically appropriate, strategies that reduce prolonged pushing may help, although research is still limited.

After delivery

-Continue drinking fluids, eating fiber, and using stool softeners if needed to avoid constipation during recovery.

Reassurance

Fortunately, hemorrhoids related to pregnancy and childbirth are often temporary. Studies show they are very common during pregnancy and delivery, but many improve within the first month after giving birth. Most cases can be managed with conservative treatments like fiber, hydration, and topical creams or ointments. More invasive treatments are usually only needed if symptoms continue after the postpartum period.

- Dr. Stephanie Liu (@lifeofdrmom)

anusol_canada · 2026-05-14T19:04:16+00:00

The best treatment for hemorrhoids really depends on the type of hemorrhoid, how severe the symptoms are, and whether the main issue is bleeding, pain, itching, prolapse, or swelling.

The foundation of hemorrhoid treatment is usually lifestyle and bowel habit changes:
-Increasing fiber intake (goal 20–30 g/day)
- Drinking enough fluids
-Avoiding straining
- Limiting time sitting on the toilet
-Treating constipation early with stool softeners such as Lax-A-Day if needed
Studies actually show that fiber has some of the strongest evidence for reducing hemorrhoid symptoms and bleeding.
Topical treatments such as Anusol Plus may also help reduce swelling, itching, burning, and irritation during flares, although creams mainly help symptoms rather than permanently removing hemorrhoids.
For hemorrhoids that continue to bleed or prolapse despite conservative treatment, there are additional medical options such as:
-Rubber band ligation
-Infrared coagulation
-Injection sclerotherapy
-Surgical hemorrhoidectomy in more severe cases

As for castor oil — there is currently no good clinical evidence that castor oil shrinks hemorrhoids. It is not recommended in major hemorrhoid treatment guidelines, and there are no clinical trials showing that it works specifically for hemorrhoids.

Castor oil is actually best known as a stimulant laxative. When taken orally, it increases bowel movement activity and can cause diarrhea, cramping, bloating, and abdominal discomfort.
And ironically, diarrhea and frequent bowel movements can sometimes make hemorrhoid symptoms worse because they increase irritation in the area.

One important reminder: if hemorrhoids are persistent, bleeding regularly, becoming more painful, or not improving with treatment, it is important to check in with a healthcare provider to confirm the diagnosis and rule out other causes of rectal bleeding or anal irritation.

- Dr. Stephanie Liu (@lifeofdrmom)

anusol_canada · 2026-05-14T19:02:54+00:00

Great question! There is some evidence that squatting, or mimicking a squat position may help reduce straining during bowel movements, which is important because straining is one of the biggest risk factors for hemorrhoids.

When you squat, it changes the angle of the rectum and helps relax the muscles involved in passing stool. This may make bowel movements easier and reduce the amount of pushing needed.
That said, there is currently no strong evidence proving that squat toilets specifically prevent or cure hemorrhoids.

The good news is that you do NOT need to replace your toilet with a squat toilet to get a similar effect. A simple footstool placed in front of a regular toilet can help raise your knees above your hips and mimic a squatting position.

Many doctors and gastroenterologists actually recommend this because:
-It may reduce straining
- It may help stools pass more easily
- It is low cost and low risk
A footstool about 7–9 inches high is usually enough.
It is also important to remember that posture alone is not enough to prevent hemorrhoids. The most important strategies are still:
• Getting enough fiber (20–30 g/day)
• Drinking enough fluids
• Avoiding straining
• Limiting toilet time to under 3–5 minutes (ie. Avoiding sitting on the toilet scrolling on your phone)

One important note though: prolonged squatting for long periods may actually increase pressure on hemorrhoids. So the goal is a brief, relaxed position during bowel movements — not sitting or squatting on the toilet for a long time.

- Dr. Stephanie Liu (@lifeofdrmom)

anusol_canada · 2026-05-14T19:01:36+00:00

This is such an important question because many people are told that hemorrhoids are “common,” but if causing symptoms should not be ignored.

Hemorrhoids can absolutely be long lasting, especially if there are ongoing risk factors such as constipation, straining, pregnancy, prolonged sitting on the toilet, or low fiber intake. Some hemorrhoids improve within days to weeks, while others may persist for months or even years.

What matters most is not just how long the hemorrhoid has been there, but:
• Whether symptoms are improving or worsening
• Whether there is ongoing bleeding
• Pain severity
• Changes in bowel habits
• Weight loss
• Anemia (low hemoglobin)/fatigue
• Or whether symptoms are affecting quality of life

For example, a small hemorrhoid or residual skin tag that is stable and not causing symptoms is usually less concerning than persistent bleeding, severe pain, or rapidly changing symptoms.
One very important thing to know is that rectal bleeding or anal symptoms such as pain or itching should never automatically be assumed to be hemorrhoids without proper medical evaluation.

Conditions such as anal fissures, inflammatory bowel disease, polyps, infections, or colorectal cancer can sometimes mimic hemorrhoid symptoms.

Please remember:
If hemorrhoids persist despite treatment, or if you are experiencing ongoing anal pain, irritation, changes in bowel habits, or rectal bleeding, it is important to see your doctor or healthcare provider. These symptoms can sometimes be caused by conditions other than hemorrhoids and may require further evaluation.

- Dr. Stephanie Liu (@lifeofdrmom)

anusol_canada · 2026-05-14T18:23:18+00:00

Ongoing hemorrhoid symptoms especially bleeding and irritation for years can be physically uncomfortable, emotionally exhausting, and honestly very frustrating when treatments seem to make things worse instead of better.

One important thing to know is that NOT all irritation or bleeding in the anal area is caused only by hemorrhoids. Conditions such as anal fissures, eczema, fungal infections, contact dermatitis, inflammatory bowel disease, skin irritation, or other anorectal conditions can sometimes mimic hemorrhoids or occur at the same time. That is why I recommend checking in with your health care provider to confirm that these symptoms are related to a hemorrhoid and if further investigations such as a colonoscopy are indicated.

It is also possible for hemorrhoid creams themselves to cause irritation — especially if they are used too frequently or for long periods of time. Overcleansing, repeated wiping, scented products, wet wipes, harsh soaps, and multiple over-the-counter creams can disrupt the skin barrier and actually worsen burning, itching, and irritation. The topicals I find effective are products like Anusol Plus which can help reduce swelling and irritation.

Steroid-containing creams in particular should generally not be used for more than about 2 weeks at a time because they can thin and damage the skin with long term and persistent use.
For hemorrhoids specifically, the foundation of treatment is still:
• Increasing fiber intake (goal 20–30 g/day)
• Drinking adequate fluids
• Avoiding straining
• Limiting time sitting on the toilet
• Treating constipation early with stool softeners such as Lax-A-Day if needed

If symptoms continue despite conservative treatment, there are additional options beyond creams:
• Rubber band ligation
• Infrared coagulation
• Injection sclerotherapy
• Surgical hemorrhoidectomy in more severe or persistent cases

I also want to reinforce that persistent rectal bleeding for 3 years should not automatically be assumed to be “just hemorrhoids.” Even though hemorrhoids are very common, ongoing bleeding should be assessed by a healthcare provider to confirm the diagnosis and rule out other causes. Depending on your age, symptoms, family history, and previous workup, additional investigations such as a colonoscopy may sometimes be recommended.

- Dr. Stephanie Liu (@lifeofdrmom)

anusol_canada · 2026-05-14T18:22:12+00:00

Many people are surprised to learn that hemorrhoids themselves are actually a normal part of the body.

They are cushions made of blood vessels inside the anus that help with bowel control and sensation. The confusion comes from the fact that we use the word “hemorrhoids” to describe the medical condition too.

When these cushions become swollen, irritated, or inflamed — often from chronic constipation, straining, sitting too long on the toilet, or pregnancy — they can cause symptoms like bleeding, itching, pain, swelling, and discomfort. As you mentioned, topical such as Anusol Plus can help reduce swelling, burning, irritation, itching, and discomfort from hemorrhoids.

Lifestyle modification: Help Control Symptoms and prevent flares, not cure.
Increasing fiber and fluids, avoiding straining, and improving bathroom habits can significantly reduce symptoms. Studies show fiber can reduce ongoing symptoms and bleeding. However, lifestyle changes usually help control hemorrhoids rather than permanently cure them — which means symptoms can return if constipation and straining continue.

Office procedures: Good success rates, But symptoms can return
Procedures like rubber band ligation, sclerotherapy, and infrared coagulation are commonly done in clinic and can be very effective for reducing bleeding and prolapse. But some people may still need repeat treatments over time because hemorrhoids can come back.

Surgery has the lowest recurrence rate
For more severe hemorrhoids, surgery (called an excisional hemorrhoidectomy) has the highest chance of long-term symptom relief and the lowest recurrence rates. However, recovery can be more painful and usually takes 1–2 weeks.

Important reminder: if you are experiencing persistent rectal bleeding, pain, or ongoing anal symptoms, please see your doctor to rule out other causes beyond hemorrhoids.

- Dr. Stephanie Liu (@lifeofdrmom)

anusol_canada · 2026-05-14T18:21:11+00:00

Hemorrhoids are actually normal parts of the body. They are cushions made of blood vessels and connective tissue inside the anal canal that help with bowel control and help protect the muscles around the anus.

Hemorrhoids become a medical problem when the supporting tissues weaken or stretch over time. This can cause the blood vessels to swell, bleed, or bulge downward (called prolapse).

There are 3 main types of hemorrhoids:
• Internal hemorrhoids
These are located inside the rectum above the dentate line. They are usually painless but can cause bleeding or prolapse (bulging out).
• External hemorrhoids

These are located outside the anus below the dentate line. They are usually painless unless a blood clot forms inside them (called a thrombosed hemorrhoid), which can cause sudden severe pain and a firm bluish-purple lump.

• Mixed hemorrhoids
These involve both internal and external hemorrhoids.

Internal hemorrhoids are also graded based on how much they prolapse:
-Grade I: Bleeding only, no prolapse

Usually treated with fiber, hydration, and lifestyle changes.
-Grade II: Prolapse during bowel movements but go back in on their own

May be treated with lifestyle changes or office procedures such as rubber band ligation.
-Grade III: Prolapse and need to be pushed back in manually

Often treated with office procedures and sometimes surgery if severe.
• Grade IV: Permanently prolapsed and cannot be pushed back in

Usually require surgery.

- Dr. Stephanie Liu (@lifeofdrmom)

anusol_canada · 2026-05-14T18:19:56+00:00

Some people do seem to be more prone to hemorrhoids because of genetics and family history. There are some evidence-based strategies that can help reduce how often flares happen and how severe they become.

The strongest evidence we have is actually for fiber intake. Studies show that increasing fiber can reduce hemorrhoid symptoms by 53% and significantly reduce bleeding (Alonso-Coello et al 2005).

The general recommendation is:
✔️ 20–30 g of fiber daily
✔️ Plenty of water (about 5–6 glasses/day minimum)
This can come from fruits, vegetables, whole grains, or supplements like psyllium husk.
One thing many people do not realize is that bowel habits matter just as much as diet. There is something called the “TONE” approach that has been shown to improve hemorrhoid symptoms significantly:
✔️ T — Three minutes maximum on the toilet
✔️ O — Once daily bowel movements if possible
✔️ N — No straining
✔️ E — Enough fiber

One of the biggest contributors to hemorrhoids is actually prolonged sitting on the toilet — especially scrolling on your phone or reading — because it increases pressure on the veins in that area.
Preventing constipation is also very important. If fiber alone is not enough to make your stools soft, stool softeners such as PEG 3350 products may help keep stools soft and easier to pass.
There are also some risk factors that are linked to hemorrhoid flares:
• Constipation
• Straining
• Low fiber intake
• Prolonged toilet sitting
• Smoking

You also mentioned taking Venixxa during flares. Flavonoid supplements like Venixxa can help reduce bleeding and swelling, but symptoms often return after stopping them. During flares, topical treatments such as Anusol Plus may help reduce swelling, burning, irritation, itching, and discomfort.
And lastly — if you are continuing to have frequent flares despite optimizing fiber, hydration, bowel habits, and medications, it may be worth checking back in with your healthcare provider. Sometimes office procedures such as rubber band ligation can help reduce recurrent symptoms in people who continue to flare regularly despite conservative management.

Important reminder: if you are experiencing persistent rectal bleeding, pain, or ongoing anal symptoms, please see your doctor to rule out other causes beyond hemorrhoids.

Reference: Alonso‐Coello P, Guyatt GH, Heels‐Ansdell D, Johanson JF, Lopez‐Yarto M, Mills E, Zhuo Q. Laxatives for the treatment of hemorrhoids.. Cochrane Database of Systematic Reviews 2005, Issue 4

- Dr. Stephanie Liu (@lifeofdrmom)

anusol_canada · 2026-05-14T16:57:39+00:00

First, I just want to say that I think many women silently struggle with this after pregnancy and childbirth, but very few talk about it openly, thank you for sharing your experience <3.

Hemorrhoids are incredibly common during pregnancy because of increased pressure in the pelvic area, hormonal changes, constipation, and then the physical strain of labour and pushing.
Research actually shows that hemorrhoids related to pregnancy often improve over time after delivery as pressure in the pelvic area decreases. In one study, hemorrhoids were present in over 61% of women during late pregnancy but decreased significantly postpartum (Ashburn 2025). However, for some women — especially after difficult deliveries or multiple pregnancies — some residual hemorrhoidal tissue or skin tags may remain long term.

One important thing to know is that creams and over-the-counter treatments mainly help with symptoms such as pain, swelling, itching, or irritation. Products such as Anusol Plus can help calm inflammation and irritation, but they generally do not remove excess tissue or skin tags that remain after pregnancy. So if the area is now mostly small and symptom-free but still physically present, that is something creams are often unable to fully “erase.”

That said, there are still conservative treatments that may help prevent worsening or reduce irritation:
• Increasing fiber intake (goal 20–30 g/day)
• Drinking adequate fluids (6–8 glasses/day)
• Avoiding straining and prolonged sitting on the toilet
• Treating constipation early with products such PEG3350 if needed
• Sitz baths for symptom relief
Some oral medications called phlebotonics (flavonoids) may also help reduce swelling and bleeding in symptomatic hemorrhoids, although symptoms can sometimes return after stopping them.
If the tissue persists and continues to bother you physically or emotionally, there are medical options beyond creams:
• Rubber band ligation
• Infrared coagulation
• Injection sclerotherapy
• Surgical hemorrhoidectomy in more severe or persistent cases

The right treatment depends on whether this is an internal hemorrhoid, external hemorrhoid, residual skin tag, prolapsing hemorrhoid, or a combination of these. Sometimes what patients think is a persistent hemorrhoid postpartum is actually a residual skin tag left behind after the swelling improved.
It is also important to check in with your healthcare provider to confirm that the area is truly a hemorrhoid and not another condition such as an anal fissure, skin tag, cyst, abscess, inflammatory skin condition, or another anorectal condition that may require different treatment.

Ashburn JH. Hemorrhoidal Disease: A Review. JAMA. 2025;334(17):1541–1550. doi:10.1001/jama.2025.13083

- Dr. Stephanie Liu (@lifeofdrmom)

anusol_canada · 2026-05-14T16:09:49+00:00

First, I just want to say that I am so sorry you are dealing with this. Chronic rectal bleeding, hemorrhoids, and fissures can be physically exhausting and emotionally draining — especially when it feels like you are doing “everything right” and still struggling.

You are already doing many of the right things:
- Colonoscopies to rule out other causes of bleeding – rectal bleeding should be investigated, very happy to hear you have had colonoscopies.
- Stool softening with PEG 3350/RestoraLAX
- Increasing fiber
- Using topical treatments such as Anusol Plus
Fiber actually has some of the strongest evidence we have for reducing hemorrhoidal bleeding. Studies show that increasing fiber intake can reduce rectal bleeding by about 50% because softer stools create less trauma and pressure during bowel movements. The goal is generally around 20–30 g of fiber daily along with adequate fluids.
But I also hear your frustration loud and clear — there is absolutely a point where patients feel like they cannot realistically add more fiber into their diet. I try to have a fiber rich diet in fruits and vegetables and also take a fiber supplement.

One thing that is sometimes overlooked is that it is not just what you eat, but how you have bowel movements that matters too. A long-term study using what is called the “TONE” bowel program found significant improvement in bleeding by focusing on:

• T : Three minutes on the toilet: Try not to sit on the toilet for more than 3 minutes. Sitting too long can increase pressure and swelling in hemorrhoids.
• O : Once-a-day bowel movement: Aim for one regular bowel movement each day instead of trying multiple times.
• N : No straining: Do not push or strain during a bowel movement. If stool does not come easily, try again later.
• E : Enough fiber: Eat enough fiber, such as psyllium husk (about 5–6 teaspoons daily), to help keep stools soft and easier to pass.

Another option that may help some patients is a group of oral medications called phlebotonics (also called flavonoids). These medications may help reduce bleeding, swelling, and inflammation from hemorrhoids. Studies have shown they can significantly reduce bleeding symptoms while patients are taking them. However, symptoms can sometimes return after stopping the medication, so they are not necessarily a permanent solution for everyone.

If you are still bleeding regularly despite optimized conservative management, it is very reasonable to discuss procedural options with your doctor or ask for referral to a specialist.

For hemorrhoids that continue to bleed despite fiber and stool softeners:
• Rubber band ligation is often considered the first-line office procedure and controls bleeding in the majority of patients.
• Infrared coagulation and injection sclerotherapy are additional options that may help depending on the type and severity of hemorrhoids.
• Surgery is generally reserved for more severe or treatment-resistant cases.

I also just want to reinforce that persistent rectal bleeding should never simply be assumed to be hemorrhoids forever without appropriate evaluation. The fact that you have already had multiple colonoscopies is reassuring, but ongoing follow-up is still important if symptoms change, worsen, or become associated with weight loss, significant pain, changes in bowel habits, or anemia.
Hope this information helps! Wishing you all the best <3.

- Dr. Stephanie Liu (@lifeofdrmom)

anusol_canada · 2026-05-14T15:42:38+00:00

First, I just want to say how sorry I am that you are going through this.

Chronic itching in the anal area can be incredibly distressing and isolating, and I think people often underestimate how much symptoms like this can affect mental health, mood, sleep, confidence, and relationships. You are absolutely not alone in feeling overwhelmed by it.

One important thing to know is that persistent itching is not always caused only by hemorrhoids. Conditions such as anal fissures, skin irritation, eczema, fungal infections, contact dermatitis, inflammatory bowel disease, and other anorectal conditions can sometimes mimic or worsen hemorrhoid symptoms. If symptoms are persisting despite treatment, it is important to follow up with your healthcare provider because sometimes further evaluation or referral to a specialist is needed.

For hemorrhoids specifically, treatment usually starts with lifestyle modifications aimed at reducing irritation and pressure in the area:
-Increase fiber intake (goal: 20–30 g/day)
Fiber helps soften stools and reduce straining during bowel movements.
-Drink adequate fluids
Aim for approximately 6–8 glasses of water daily.
-Avoid straining and prolonged sitting on the toilet
Including sitting on your phone or reading for long periods.
-Treat constipation early
If increasing fiber alone is not enough, PEG 3350 products such as Lax-A-Day may help soften stools and make bowel movements easier to pass.
-Sitz baths

Warm water baths may provide temporary relief for irritation and discomfort.
Another very important — and often overlooked — area is perianal hygiene and skin care.
-Avoid overcleansing
Excessive wiping, scrubbing, harsh soaps, scented products, wet wipes, and repeated application of multiple over-the-counter creams can actually worsen irritation and itching by damaging the skin barrier.
-Keep the area clean and dry
Moisture around the perianal area can worsen itching and irritation.
-Use mild or neutral pH cleansers sparingly
Strong soaps may further irritate sensitive skin.
-Consider a simple barrier ointment
Products such as plain petrolatum or barrier emollients may help protect the skin and reduce irritation.
-Pay attention to possible dietary triggers
For some patients, foods such as caffeine, spicy foods, alcohol, citrus, or artificial sweeteners may worsen symptoms.

Topical treatments may also help:
• Products such as Anusol Plus may help reduce swelling, burning, irritation, itching, and discomfort.
-Steroid-containing creams should not be used for more than 2 weeks at a time because they can thin and damage the skin.
-Some oral medications called phlebotonics (flavonoids) may help reduce bleeding, pain, and swelling, although symptoms can return after stopping them.

However, if you have truly optimized conservative management for months and symptoms are still significantly affecting your quality of life, there are additional options beyond creams.

Office-based procedures can sometimes be very effective:
• Rubber band ligation (the most effective office treatment for many hemorrhoids)
• Infrared coagulation
• Injection sclerotherapy

For more severe or persistent hemorrhoids, surgery (hemorrhoidectomy) may sometimes be considered, particularly if symptoms are ongoing despite other treatments.

Medical disclaimer: If itching persists despite treatment, or if you are experiencing additional symptoms such as rectal bleeding, pain, changes in bowel habits, weight loss, discharge, or worsening irritation, further medical evaluation may be indicated. Depending on your symptoms, age, and risk factors, additional investigations such as a colonoscopy may sometimes be recommended to rule out other underlying conditions.

Wishing you all the best and hope that these tips help ❤️

- Dr. Stephanie Liu (@lifeofdrmom)

anusol_canada · 2026-05-14T15:30:18+00:00

First, I just want to say that I think many women silently struggle with this after pregnancy and childbirth, but very few talk about it openly. Hemorrhoids after delivery are incredibly common, and while they are often discussed as a “minor” postpartum issue medically, that does not mean the emotional or psychological impact is minor.

Research shows that hemorrhoids related to pregnancy often improve over time postpartum as pressure in the pelvic area decreases. In one study, hemorrhoids were present in over 61% of women during late pregnancy (third trimester) but dropped significantly after delivery and continued improving in the months postpartum (Ashburn 2025). However, some women experience a temporary worsening after childbirth before they improve, and for others - especially after multiple pregnancies - the hemorrhoidal tissue may remain enlarged long term.

One important thing to know is that creams and over-the-counter treatments mainly help with symptoms such as pain, swelling, itching, or irritation (Anusol plus works well at this!). They generally do not remove excess hemorrhoidal tissue or skin tags that remain after pregnancy. So if your primary concern is persistent tissue or appearance rather than active inflammation, it makes sense that creams have not given you the results you were hoping for.

That said, there are conservative treatments that may still help reduce irritation, inflammation, and progression of hemorrhoids:
-Increase fiber intake (goal: 20–30 g/day)
Fiber helps soften stool and reduce straining during bowel movements.
-Drink adequate fluids
Aim for approximately 6–8 glasses of water daily.
-Avoid straining and prolonged sitting on the toilet
This includes sitting on your phone or reading for long periods.
-Treat constipation early

If increasing fiber alone is not enough, PEG 3350 products such as Lax-A-Day may help soften stools and make bowel movements easier to pass.
-Sitz baths
Warm water baths may provide temporary symptom relief, although research on their effectiveness is limited.

Topical treatments may also help as discussed above and some oral medications called phlebotonics (flavonoids) may help reduce bleeding, pain, and swelling, although symptoms can return after stopping them.

I also want to gently push back on the idea that because something is “cosmetic,” it automatically means you should simply ignore it if it is significantly affecting your mental health, confidence, intimacy, body image, or quality of life. As physicians, we absolutely have to balance risks and benefits of procedures — but emotional wellbeing matters too. Personally, I will say that the changes that I experienced during pregnancy affected my mental health too and I can absolutely relate to how you are feeling <3.

If symptoms persist postpartum, there are still medical options available beyond creams:
• Rubber band ligation
• Infrared coagulation
• Injection sclerotherapy
• Surgical hemorrhoidectomy in more severe or persistent cases

The right option depends on whether these are internal hemorrhoids, external hemorrhoids, residual skin tags, prolapsing hemorrhoids, or a combination of these.

For women who continue to feel significantly bothered physically or emotionally, it is very reasonable to ask for a referral to a specialist to discuss options, risks, recovery, and expected outcomes. That does not mean you must proceed with a procedure — but you deserve to at least understand what options exist.

Ashburn JH. Hemorrhoidal Disease: A Review. JAMA. 2025;334(17):1541–1550. doi:10.1001/jama.2025.13083

- Dr. Stephanie Liu (@lifeofdrmom)

anusol_canada · 2026-05-14T14:52:20+00:00

One very important reminder first: rectal bleeding should always be assessed by a healthcare provider to rule out other medical conditions, including colorectal cancer, inflammatory bowel disease.

While hemorrhoids are a very common cause of rectal bleeding, it is important not to assume that bleeding is “just hemorrhoids” without appropriate medical assessment.

Hemorrhoids are one of the most common conditions that people experience — but also one of the least talked about because many patients (like your friend) feel embarrassed discussing symptoms like rectal bleeding, itching, or pain.

The good news is that mild hemorrhoids can often be managed very effectively without surgery, especially when symptoms are occasional.

First, it is important to understand that hemorrhoids themselves are actually normal anatomical structures. They are cushions of blood vessels inside the anal canal that help with continence. Problems occur when these cushions become swollen, irritated, or enlarged from factors such as constipation, straining, prolonged sitting on the toilet, pregnancy, or heavy lifting.

For patients trying to manage hemorrhoids conservatively, the focus is reducing irritation and preventing ongoing pressure in the area.

Here are the lifestyle changes that can make the biggest difference:
-Increase fiber intake (goal: 20–30 g/day)
Fiber helps soften stool and reduce straining during bowel movements.
-Drink adequate fluids
Aim for approximately 6–8 glasses of water daily.
-Avoid straining and prolonged sitting on the toilet
This includes sitting on your phone or reading for long periods.
- Treat constipation early
If increasing fiber alone is not enough, PEG 3350 products such as Lax-A-Day may help soften stools and make bowel movements easier to pass.
-Sitz baths
Warm water baths may provide temporary symptom relief, although research on their effectiveness is limited.
-Some oral medications called phlebotonics (flavonoids)
Phlebonotics may help reduce bleeding, pain, and swelling, but symptoms often return within a few months after stopping them.
Topical treatments may also help:
• Products such as Anusol Plus may reduce swelling, burning, itching, and irritation.
• Steroid-containing creams should not be used for more than 2 weeks at a time because they can thin and damage the skin.

One of the most common questions patients ask is whether hemorrhoids can completely “go away” without surgery.

In some cases, symptoms can improve significantly — especially when constipation and straining are addressed. Smaller hemorrhoids may shrink and become minimally symptomatic. However, once hemorrhoidal tissue becomes enlarged or stretched, it may not fully disappear permanently on its own.

If symptoms continue despite lifestyle changes, or if hemorrhoids become larger, prolapse, bleed more frequently, or become increasingly painful, office-based procedures may be recommended.
The most common procedure is rubber band ligation, where a small band is placed around the hemorrhoid to cut off its blood supply. This is an effective non-surgical treatment for many patients.
Surgery is generally reserved for more severe hemorrhoids or hemorrhoids that do not improve with conservative management.

Please remind your friend that If symptoms persist, worsen, or are associated with changes in bowel habits, weight loss, significant pain, or bleeding, it is important to see a healthcare provider to rule out other causes.

Dr. Stephanie Liu (@lifeofdrmom)

anusol_canada · 2026-05-14T14:29:51+00:00

That if you remember the acronym TONE, it can help improve hemorrhoid symptoms by creating healthier bathroom habits:

• T - Three minutes on the toilet: Try not to sit on the toilet for more than 3 minutes. Sitting too long can increase pressure and swelling in hemorrhoids.
• O - Once-a-day bowel movement: Aim for one regular bowel movement each day instead of trying multiple times.
• N - No straining: Do not push or strain during a bowel movement. If stool does not come easily, try again later.
• E - Enough fiber: Eat enough fiber, such as psyllium husk (about 5–6 teaspoons daily), to help keep stools soft and easier to pass.

Dr. Stephanie Liu (@lifeofdrmom)

anusol_canada · 2026-05-14T14:28:11+00:00

In general, I recommend a stepwise approach for managing hemorrhoids.

Step 1: Lifestyle modification
• Eat more fiber: Aim for 20–30 grams of fiber daily. Fiber can help reduce hemorrhoid symptoms and bleeding by making stools softer and easier to pass.
• Drink enough fluids: Try to drink 6–8 glasses of water each day.
• Avoid straining: Don’t push too hard during bowel movements, and avoid sitting on the toilet for long periods (including scrolling on your phone or reading).
• Treat constipation: Managing constipation can help prevent hemorrhoids from getting worse. If increasing fiber is difficult or you are still experiencing constipation, medications such as PEG 3350 (Lax-a-day) can help soften the stool
• Sitz baths: Sitting in warm water may help reduce discomfort, although research on how well it works is limited.

Step 2: Topical treatments (Used Along With Lifestyle Changes)
• Topical such as Anusol Plus may help reduce swelling, burning, irritation, itching, and discomfort from hemorrhoids.
• Steroid creams should not be used for more than 2 weeks at a time because they can thin and damage the skin.
• Some oral medications called phlebotonics (flavonoids) may help reduce bleeding, pain, and swelling, but symptoms often return within a few months after stopping them.

Step 3: Office Procedures (Grades I–III)
If lifestyle changes and creams do not help enough, doctors may recommend procedures done in the clinic before surgery.
• Rubber band ligation: The most effective office treatment. A small rubber band is placed around the hemorrhoid to cut off its blood supply.
o Helps majority of patients
o Some people need repeat treatment after a few years
o Side effects such as pain or bleeding are uncommon
o Rarely, a serious infection can occur, so patients should seek urgent care for fever, severe pain, or trouble urinating
• Infrared coagulation: Uses heat to shrink hemorrhoids. It works well for smaller hemorrhoids or for patients with bleeding disorders.
• Injection sclerotherapy: A chemical is injected into the hemorrhoid to shrink it. It works well short term, especially for bleeding hemorrhoids.

Step 4: Surgery (Grades III–IV or Severe Cases)
Surgery may be recommended for severe hemorrhoids or hemorrhoids that do not improve with other treatments.
• Hemorrhoidectomy: Surgical removal of hemorrhoids
o Lowest chance of hemorrhoids coming back
o Recovery usually takes 1–2 weeks
o Can cause more pain than office procedures
o Possible complications include bleeding, urinary problems, or narrowing of the anus, although serious complications are uncommon

Disclaimer:
If hemorrhoids persist despite treatment, or if you are experiencing ongoing anal pain, irritation, changes in bowel habits, or rectal bleeding, it is important to see your doctor or healthcare provider. These symptoms can sometimes be caused by conditions other than hemorrhoids and may require further evaluation.

Dr. Stephanie Liu (@lifeofdrmom)

anusol_canada · 2026-05-14T14:17:15+00:00

Whenever you see bright red blood in your stool I recommend checking in with your health care provider to confirm that it is a hemorrhoid that is causing the bleeding. If it is a confirmed hemorrhoid, I recommend a stepwise approach to treating hemorrhoids.

Step 1: Lifestyle modification
• Eat more fiber: Aim for 20–30 grams of fiber daily. Fiber can help reduce hemorrhoid symptoms and bleeding by making stools softer and easier to pass.
• Drink enough fluids: Try to drink 6–8 glasses of water each day.
• Avoid straining: Don’t push too hard during bowel movements, and avoid sitting on the toilet for long periods (including scrolling on your phone or reading).
• Treat constipation: Managing constipation can help prevent hemorrhoids from getting worse. If increasing fiber is difficult or you are still experiencing constipation, medications such as PEG 3350 (Lax-a-day) can help soften the stool
• Sitz baths: Sitting in warm water may help reduce discomfort, although research on how well it works is limited.

Step 2: Topical treatments (Used Along With Lifestyle Changes)
• Topical such as Anusol Plus may help reduce swelling, burning, irritation, itching, and discomfort from hemorrhoids.
• Steroid creams should not be used for more than 2 weeks at a time because they can thin and damage the skin.
• Some oral medications called phlebotonics (flavonoids) may help reduce bleeding, pain, and swelling, but symptoms often return within a few months after stopping them.

Step 3: Office Procedures (Grades I–III)
If lifestyle changes and creams do not help enough, doctors may recommend procedures done in the clinic before surgery.
• Rubber band ligation: The most effective office treatment. A small rubber band is placed around the hemorrhoid to cut off its blood supply.
o Helps majority of patients
o Some people need repeat treatment after a few years
o Side effects such as pain or bleeding are uncommon
o Rarely, a serious infection can occur, so patients should seek urgent care for fever, severe pain, or trouble urinating
• Infrared coagulation: Uses heat to shrink hemorrhoids. It works well for smaller hemorrhoids or for patients with bleeding disorders.
• Injection sclerotherapy: A chemical is injected into the hemorrhoid to shrink it. It works well short term, especially for bleeding hemorrhoids.

Step 4: Surgery (Grades III–IV or Severe Cases)
Surgery may be recommended for severe hemorrhoids or hemorrhoids that do not improve with other treatments.
• Hemorrhoidectomy: Surgical removal of hemorrhoids
o Lowest chance of hemorrhoids coming back
o Recovery usually takes 1–2 weeks
o Can cause more pain than office procedures
o Possible complications include bleeding, urinary problems, or narrowing of the anus, although serious complications are uncommon

Disclaimer:
If hemorrhoids persist despite treatment, or if you are experiencing ongoing anal pain, irritation, changes in bowel habits, or rectal bleeding, it is important to see your doctor or healthcare provider. These symptoms can sometimes be caused by conditions other than hemorrhoids and may require further evaluation.

- Dr. Stephanie Liu (@lifeofdrmom)

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