If you have ever reached for a topical cream or spent extra time on your phone in the bathroom, new clinical guidance from one of the country’s top gastroenterology organizations suggests you may want to rethink both habits. The American Gastroenterological Association (AGA) has published an updated clinical practice review outlining the most evidence-based approaches to diagnosing and treating hemorrhoids \u2014 and the answers are simpler than many people expect.<\/p>\n\n\n\n
Hemorrhoids are swollen veins in the lower rectum or around the anus. They can cause itching, discomfort, pain and bleeding, and while the topic tends to be avoided in casual conversation, the condition is remarkably widespread. According to the AGA update, approximately 50% of people will experience hemorrhoids by the time they reach age 50. Among college students and young adults, factors like low-fiber diets, sedentary lifestyles and irregular bathroom habits can increase risk earlier than many realize.<\/p>\n\n\n\n
The AGA’s updated guidance, published<\/a> in the journal Clinical Gastroenterology and Hepatology<\/em>, places dietary fiber at the top of the treatment ladder. Increasing fiber intake \u2014 through fruits, vegetables, legumes and whole grains \u2014 helps soften stool, reduces straining during bowel movements, and relieves pressure on hemorrhoidal tissue. Hydration plays a supporting role as well.<\/p>\n\n\n\n Equally important, the update stresses reducing the amount of time spent straining on the toilet. Prolonged sitting and straining are among the most significant contributors to hemorrhoid development and worsening. Experts recommend responding to the urge to go rather than delaying or forcing, and avoiding distractions \u2014 like scrolling through a phone \u2014 that extend bathroom visits.<\/p>\n\n\n\n Many people instinctively turn to over-the-counter topical treatments or sitz baths when hemorrhoid symptoms flare up. The AGA acknowledges these options may offer some symptomatic relief, but cautions that the scientific evidence supporting their effectiveness is limited. They should not be viewed as primary treatments.<\/p>\n\n\n\n The guidance is especially pointed about topical steroid products, which are commonly found in hemorrhoid creams. The AGA recommends against using them for more than two weeks because extended use can cause skin thinning and irritation \u2014 potentially making symptoms worse over time rather than better.<\/p>\n\n\n\n Before beginning any treatment, the AGA recommends that patients receive a proper physical examination \u2014 often including a procedure called anoscopy, in which a small instrument is used to view the inside of the anal canal. This step matters because rectal bleeding and discomfort can sometimes signal conditions other than hemorrhoids, and an accurate diagnosis ensures the right treatment is pursued from the start.<\/p>\n\n\n\n For hemorrhoids that do not respond to dietary and behavioral adjustments, the AGA outlines a progression of care. Office-based procedures such as rubber band ligation \u2014 commonly called banding \u2014 are considered effective for more persistent cases. In severe or treatment-resistant situations, surgical options may be warranted. The update encourages providers to discuss the potential risks of any procedure with patients, even though serious complications are rare.<\/p>\n\n\n\n Hemorrhoids are also particularly common during pregnancy due to increased pressure on pelvic blood vessels. The AGA recommends conservative management for pregnant patients, focusing on dietary changes and symptom relief rather than invasive interventions, in keeping with the general priority of minimizing risk during pregnancy.<\/p>\n\n\n\n It can be easy to dismiss hemorrhoids as a condition that only affects older adults, but lifestyle patterns common among college students \u2014 low dietary fiber, long sedentary periods, irregular eating schedules and stress \u2014 can accelerate their development. Understanding that simple changes like eating more fiber, drinking enough water, and not lingering on the toilet can both prevent and treat this condition puts meaningful control in the hands of young people.<\/p>\n\n\n\n Patient education is a central theme of the AGA update. The organization encourages people to understand their symptoms, know when to seek care, and recognize that effective treatment does not always require a prescription or a procedure.<\/p>\n\n\n\n More information is available through the AGA GI Patient Center<\/a>. <\/p>\n\n\n\nThink Twice Before Reaching for That Cream<\/h2>\n\n\n\n
Getting the Right Diagnosis First<\/h2>\n\n\n\n
When Lifestyle Changes Aren’t Enough<\/h2>\n\n\n\n
Special Considerations for Pregnancy<\/h2>\n\n\n\n
Why This Matters for Students and Young Adults<\/h2>\n\n\n\n