Hemorrhoids: Fiber, Fluid and Off the Toilet, Not the Cream Aisle

Summary

The genuine first line for hemorrhoids is unglamorous and cheap: soften the stool so you stop straining (fiber at 25 to 35 g/day plus fluid), get off the toilet in under a few minutes instead of scrolling, and use warm sitz baths for pain — fiber alone roughly halves bleeding and persistent symptoms in the trials, while the entire cream-and-suppository aisle is symptomatic relief at best with no guideline evidence that it reduces swelling, bleeding, or protrusion (and corticosteroid products carry a hard 7-day ceiling); band ligation and surgery are the real escalation when conservative care f