"Benign Rectal, Anal, and Perineal Problems" ?
excerpt:
Diet and lifestyle modifications. For all patients with grade 1 or 2 hemorrhoids and most patients with grade 3 hemorrhoids, treatment should begin with efforts to correct constipation. Recommendations should include a high-fiber diet, liberal water intake (six to eight 8 oz glasses of water daily), and fiber supplements (e.g., psyllium, methylcellulose, calcium polycarbophyl, and gum). Sitz baths are recommended for their soothing effect and their ability to relax the anal sphincter muscles. Topical creams may reduce some of the associated symptoms, though they do not affect the hemorrhoids themselves. Suppositories are not helpful, because they deliver medication to the rectum, not the anus. Patients are instructed to avoid prolonged trips to the bathroom and to read in the bathroom only when sitting atop the toilet lid.