Does putting ice on hemorrhoids help?
In adults with symptomatic hemorrhoids, does topical application of ice or cold packs to the anal area reduce pain, swelling, or bleeding compared with no treatment or usual care?
Evidence review in plain language · compiled 2026-10-14 · checked 2026-10-14 · next 2026-11-14 · automated review, how it works
What the evidence says
Bottom line
No study has directly tested whether ice helps the pain, swelling, or bleeding of ordinary hemorrhoids.
The four trials found here tested things close to this question but not the same thing: ice packing after hemorrhoid surgery, a cooling device after other procedures, and cold versus hot sitz baths for anal pain. One trial found ice packing lowered pain and swelling more than warm sitz baths after surgery, but three other trials found cold application gave no more relief than the comparison treatment. None of this tells us whether using ice on an ordinary hemorrhoid, at home, helps compared with doing nothing.
How certain
Very low
The 4 human studies found measure a related question rather than this one, so they can only be read indirectly.
What it shows
Not studied
No study has measured this in people with this condition.
- answer it directly
- 0answer it directly
- studies found
- 7studies found
- randomised trials
- 4randomised trials
- people studied
- 476people studied
- years covered
- 1986–2025years covered
What the research shows
Pain score reduction
One trial found ice packing lowered pain scores more than warm sitz baths after hemorrhoid surgery. Three other trials found no difference in pain between cold application and a comparison treatment, in people after rubber-band ligation, postpartum women, and people with anal pain from hemorrhoids or fissures. These results conflict and come from different situations, so they don't answer the question for someone with ordinary hemorrhoid pain at home.[1,2,3,4]
Insufficient evidence
Swelling or edema reduction
Only one trial measured swelling, and only after surgery: ice packing reduced swelling at 24 hours more than warm sitz baths. No study measured swelling in people with ordinary, non-surgical hemorrhoids.[1]
Insufficient evidence
Bleeding frequency or severity
The only trial that measured bleeding found no difference between a cooling device and no device in postpartum women with hemorrhoids. No other study measured bleeding.[1]
No improvement shown
Time to symptom resolution
One trial measured wound healing speed and found faster healing with ice packing than warm sitz baths, but only after surgical removal of hemorrhoids. No study measured how quickly symptoms resolve when someone uses ice for an ordinary hemorrhoid flare-up.[1]
Insufficient evidence
No improvement shown
What it may help with
- After hemorrhoid surgery, ice packing lowered pain scores, reduced swelling, and sped wound healing compared with warm sitz baths, in one moderate-quality trial. This is the only clear benefit found in these studies, and it was tested in people recovering from surgery, not people with ordinary, non-surgical hemorrhoid symptoms.[1]
Important limitations
- The four trials studied different things: post-surgical ice packing versus warm baths, a frozen cooling device after rubber-band ligation, a postpartum cooling device, and cold versus hot sitz baths for mixed anorectal pain. None used a plain ice pack compared with no treatment in people with a typical hemorrhoid flare-up.[1,2,3,4]
- Two narrative reviews mention ice packs as part of general hemorrhoid care, but report no actual outcome data for ice on its own.[1,2]
- Sample sizes were small, ranging from 24 to 166 people, and study quality ranged from very low to moderate.[1,2,3,4]
What the studies found
- Found a benefit1 · 14%
- Found no clear effect4 · 57%
- Mixed or unclear2 · 29%
What kind of studies
- Randomised trial4 · 57%
- Narrative review2 · 29%
- Laboratory study1 · 14%
The studies that decided it
Chen et al. 2025
Ice Packing Versus Warm Sitz Baths for Post-hemorrhoidectomy Pain Management: A Randomized Controlled Trial
Less post-surgery pain and swellingRandomised trialModerate qualityRelated question
166 people2025
Ice packing group had lower pain scores in the first 16 hours, less swelling at 24 hours, better wound healing at 7 days, and used less morphine than the warm sitz bath group
- Who was studied
- Adults who had surgery (Ferguson hemorrhoidectomy) to remove hemorrhoids
- What they received
- Ice packing applied after hemorrhoid surgery
- Compared with
- Warm sitz baths after hemorrhoid surgery
- Main outcome
- Pain levels and swelling after surgery
- Quality
- It was a randomized trial, but done at only one hospital, with a short follow-up, no validated wound-scoring tool for hemorrhoids, and some sicker patients excluded.
- Limitations
- Single-center design, short follow-up period, lack of validated hemorrhoid-specific wound assessment tools, and exclusion of ASA III patients limit the present study's generalizability.
Taken word for word from the abstract
- population
A total of 166 patients undergoing Ferguson hemorrhoidectomy were included.
- intervention
ice packing (n = 82)
- comparator
warm sitz bath (n = 84)
- primaryOutcome
Primary outcomes were pain (visual analog scale) and swelling.
- result
The ice packing group showed lower pain scores within 16 hours postsurgery ( p < 0.01), reduced swelling at 24 hours (76.8% vs 56.0% with no or mild swelling, p = 0.03), superior wound healing at 7 days (Redness, Edema, Ecchymosis, Discharge, Approximation score: 2.56 ± 1.89 vs 3.27 ± 2.12, p = 0.02), and lower 24-hour morphine consumption (4.58 ± 2.56 vs 6.39 ± 2.7 mg, p < 0.01).
- n
A total of 166 patients undergoing Ferguson hemorrhoidectomy were included.
Dis Colon Rectum · PMID 40145987 · Read it on PubMed ↗
Lam et al. 2012
A novel device reduces anal pain after rubber band ligation: a randomized controlled trial
No clear pain relief shown.Randomised trialLow qualityRelated question
100 people3-6 weeks
no significant difference in need for pain medication between the cooler group and control group; among the subset who actually used the cooler, higher pain scores were seen compared to those who didn't use it
- Who was studied
- adults who had rubber band ligation treatment for hemorrhoids
- What they received
- a frozen anal cooler device applied to the anal area for pain
- Compared with
- no anal cooler (standard care)
- Main outcome
- need for oral pain medication and pain scores after the procedure
- Quality
- although randomized, the main efficacy claim comes from a non-randomized comparison between patients who chose to use the device and those who didn't, which can be misleading.
- Limitations
- the key comparison reported (cooler users vs non-users) was not based on the original randomization, and patients studied had post-procedure pain after a hemorrhoid treatment rather than general symptomatic hemorrhoid pain
Taken word for word from the abstract
- population
100 patients who underwent RBL were prospectively randomized
- intervention
a plastic device, the anal cooler which can be frozen in a freezer
- comparator
an anal cooler group (n = 50) or a control group (n = 50)
- primaryOutcome
patients were asked to keep a pain diary (0 = no pain; 10 = extreme pain)
- result
24/50 patients (48 %) in the anal cooler group and 31/50 (62 %) in the control group needed oral analgesics (NS)
- result
The 14/50 patients (28 %), who did not use the cooler, had a lower post-banding pain score compared with patients who used the cooler (1.4 vs 6.4; P < 0.001)
- n
100 patients who underwent RBL were prospectively randomized into an anal cooler group (n = 50) or a control group (n = 50)
Tech Coloproctol · PMID 22527920 · Read it on PubMed ↗
Maestre et al. 2010
[Cold or hot sitz baths in the emergency treatment of acute anal pain due to anorectal disease? Results of a randomised clinical trial]
No difference between cold and hot baths.Randomised trialVery low qualityRelated question
24 people7 days
no significant difference in pain control between cold and hot sitz baths from day 1 to day 7
- Who was studied
- adults with sudden anal pain from hemorrhoids or anal fissures
- What they received
- cold water sitz baths (under 15°C)
- Compared with
- hot water sitz baths (over 30°C)
- Main outcome
- pain level after 7 days, quality of life, anal pressure, and disease progress
- Quality
- only 24 patients were randomised, which is too few to reliably detect a difference between the treatments.
- Limitations
- very small sample size (only 24 patients), and population mixed hemorrhoids with anal fissures rather than hemorrhoids alone; intervention is sitz bath water immersion rather than ice/cold pack application.
Taken word for word from the abstract
- population
patients with acute anal pain due to haemorrhoids or anal fissures
- intervention
Group 1: Sitz baths with water at a temperature of less than 15 degrees C
- comparator
Group 2: Baths with a water temperature above 30 degrees C
- primaryOutcome
An analysis was made of the pain at 7 days (visual analogue scale), quality of life (SF-36), anal at-rest pressure and disease progress.
- result
There were no statistical differences in pain, but it remained stable in Group 1, but gradually decreased in the patients of Group 2
- result
There were no statistically significant differences in pain control from day 1 to day 7 in the Group with sitz baths with hot water.
- n
Of the 27 eligible patients, 24 were randomised (Group 1: n=12 y Group 2: n=12).
Cir Esp · PMID 20580349 · Read it on PubMed ↗
Thomas et al. 1993
Postpartum haemorrhoids--evaluation of a cooling device (Anurex) for relief of symptoms
No benefit over no treatment.Randomised trialModerate qualityRelated question
129 people1993
no significant difference in pain resolution, bleeding, or itching between the device and control groups
- Who was studied
- women with hemorrhoids after childbirth
- What they received
- a cooling device (Anurex) applied to the anal area
- Compared with
- no cooling device (control group)
- Main outcome
- how much pain relief and symptom improvement occurred
- Quality
- it was a randomized trial but tested a specific commercial device only in postpartum women, so results may not apply to all hemorrhoid sufferers or to plain ice.
- Limitations
- many participants had trouble inserting the device, and the population was limited to postpartum women rather than general hemorrhoid sufferers.
Taken word for word from the abstract
- population
Postpartum haemorrhoids are a common problem
- n
129 women randomly allocated to treatment and control groups
- intervention
the recently marketed cooling device, Anurex
- comparator
129 women randomly allocated to treatment and control groups
- primaryOutcome
There was no difference in the rate of resolution of pain between the groups.
- result
There was no difference in the rate of resolution of pain between the groups. The test group estimated a greater duration of pain relief, but this was not statistically significant. Anal bleeding and itching were not significantly reduced in the test group.
Med J Aust · PMID 8412917 · Read it on PubMed ↗
Dodi et al. 1986
Hot or cold in anal pain? A study of the changes in internal anal sphincter pressure profiles
No effect on muscle pressureLaboratory studyLow qualityRelated question
57 people30 minutes
Cold water immersion at 5°C did not change anal canal resting pressure, while warm water at 40°C significantly reduced it
- Who was studied
- Adults with anorectal problems (including hemorrhoids, anal fissure, proctalgia fugax) and healthy volunteers without anorectal complaints
- What they received
- Cold water immersion of the anus (5°C) compared to baseline
- Compared with
- Room temperature (23°C) water immersion and warm water immersion (40°C)
- Main outcome
- Anal canal resting pressure measured by manometry
- Quality
- This is a small physiology study measuring muscle pressure with a machine, not whether people's hemorrhoid symptoms actually improved, and it mixed several different anorectal conditions together.
- Limitations
- Small number of participants, outcome was sphincter pressure measured by manometry rather than symptom relief, and the population combined multiple different anorectal conditions rather than hemorrhoids alone; cold was delivered as water immersion rather than an ice pack.
Taken word for word from the abstract
- population
In 26 volunteers without anorectal complaints, and in 31 patients with anorectal problems such as hemorrhoidal disease, anal fissure, and proctalgia fugax
- intervention
anorectal manometry was then performed while the anus was immersed in water at varying temperatures (5 degrees C, 23 degrees C, and 40 degrees C)
- comparator
resting anal canal pressures were recorded manometrically for 5 minutes at room temperature (23 degrees C)
- primaryOutcome
baseline resting anal canal pressures were recorded manometrically
- result
resting anal canal pressures diminished significantly from baseline after immersion at 40 degrees C, but remained unchanged in all subjects after immersion at 5 degrees C and 23 degrees C
- n
In 26 volunteers without anorectal complaints, and in 31 patients with anorectal problems
Dis Colon Rectum · PMID 3948615 · Read it on PubMed ↗
What actually helps, on this site
More about the condition:
All 7 studiesEvery study that answered the question, with its design, size and result.
The other 2 studiesEverything else the search returned, including anything retracted.
Fox et al. 2014
Anorectal conditions: hemorrhoids
No evidence reported either wayNarrative reviewVery low qualityRelated question
size not given2014
the abstract recommends ice packs as part of combined management for prolapsed and strangulated hemorrhoids but reports no outcome data or comparison for ice specifically
- Who was studied
- adults with prolapsed and strangulated hemorrhoids
- What they received
- ice packs, used alongside stool softeners, analgesics, rest, and warm soaks
- Compared with
- none reported
- Main outcome
- no specific outcome measured; this is a general management recommendation
- Quality
- this is a general review article that mentions ice packs as part of a bundle of treatments without any study data, comparison group, or outcome measurement.
- Limitations
- no original research, no outcome data, ice is combined with multiple other treatments (stool softeners, analgesics, rest, warm soaks) so its individual effect cannot be judged
Taken word for word from the abstract
- population
Prolapsed and strangulated hemorrhoids are best managed with stool softeners, analgesics, rest, warm soaks, and ice packs until recovery
- intervention
warm soaks, and ice packs until recovery
- comparator
Prolapsed and strangulated hemorrhoids are best managed with stool softeners, analgesics, rest, warm soaks, and ice packs until recovery; residual hemorrhoids are banded or excised later.
- primaryOutcome
residual hemorrhoids are banded or excised later
- result
Prolapsed and strangulated hemorrhoids are best managed with stool softeners, analgesics, rest, warm soaks, and ice packs until recovery; residual hemorrhoids are banded or excised later.
FP Essent · PMID 24742083 · Read it on PubMed ↗
Dennison et al. 1996
New thoughts on the aetiology of haemorrhoids and the development of non-operative methods for their management
Abstract doesn't mention ice treatment.Narrative reviewVery low qualityRelated question
size not given1996
The abstract discusses conservative treatment options generally and surgery for large hemorrhoids, but does not mention ice or cold application specifically, nor report any findings about it
- Who was studied
- Adults with hemorrhoids
- Quality
- This is a general narrative review that does not even mention ice or cold therapy, so it gives no usable evidence on this specific question.
- Limitations
- The abstract does not describe methodology, does not mention ice/cold treatment specifically, and provides no outcome data.
Taken word for word from the abstract
- result
A variety of conservative treatment options have been proposed, the majority of which can be safely performed on an outpatient basis.
- population
Haemorrhoids constitute a frequent clinical problem.
Minerva Chir · PMID 8783861 · Read it on PubMed ↗
How we searchedThe exact query, the date it ran, and what came back — so you can run it yourself.
- Searched
- PubMed · ClinicalTrials.gov · Crossref on 2026-10-14
- The exact search — paste this into PubMed to repeat it
(hemorrhoids[MeSH] OR hemorrhoid*[tiab] OR piles[tiab]) AND (cryotherapy[MeSH] OR ice[tiab] OR "cold application"[tiab] OR "cold therapy"[tiab] OR "cold pack"[tiab] OR cryotherapy[tiab])- PubMed expanded that to:
("hemorrhoids"[MeSH Terms] OR "hemorrhoid*"[Title/Abstract] OR "piles"[Title/Abstract]) AND ("cryotherapy"[MeSH Terms] OR "ice"[Title/Abstract] OR "cold application"[Title/Abstract] OR "cold therapy"[Title/Abstract] OR "cold pack"[Title/Abstract] OR "cryotherapy"[Title/Abstract]) - What came back
- 76 records found · 76 read · 7 answered the question
- Included
- Human, animal or laboratory studies reporting an outcome relevant to the question
- Excluded
- Records about a different condition or intervention
- Studies of cryotherapy or cryosurgery (freezing to destroy tissue) — a different treatment from the one asked about
- Records reporting no outcome
- Retracted publications, which are listed but excluded from every count
- Limits
- Details were read from abstracts, not full papers, so anything reported only in a paper's methods section is not captured here.
- Fields were read from abstracts, not full text, so detail reported only in a paper's methods section is not captured.
- Evidence strength is adapted from the GRADE framework. It is not a GRADE assessment and was not produced by a GRADE panel.
Automated evidence review — PubMed, ClinicalTrials.gov, Crossref. Search strategy, grading rules and the checks that must pass before anything publishes were written by Allen Kamrava, MD, MBA, FACS, FASCRS, colon & rectal surgery, Beverly Hills. The pages themselves are compiled by software running that method and are not read one by one before publication — saying otherwise would be the one claim here that could not be checked.
- 76records came back from the search
- 76were read
- 7actually answered the question
Why people try itThe reasoning behind the question — not a claim that it works.
- Ice is a familiar remedy for swelling and pain after an injury, so it feels like a natural thing to try on swollen hemorrhoids.
- It's cheap, available at home, and doesn't require a prescription or a doctor's visit.
- The cold can feel numbing and soothing right away, even if it isn't treating the hemorrhoid itself.
- Older medical texts and home-remedy advice often list ice packs alongside other hemorrhoid self-care measures.
Common questionsShort answers, drawn from the same studies.
- Does ice help shrink hemorrhoids?
- No study has tested whether ice packs shrink or reduce ordinary hemorrhoids. The closest evidence comes from people recovering from hemorrhoid surgery, where ice packing lowered pain and swelling compared with warm sitz baths, but that's a different situation from an everyday flare-up.
- Is ice better than warm sitz baths for hemorrhoids?
- One trial in post-surgical patients found ice packing worked better than warm sitz baths for pain and swelling. But a separate trial comparing cold and hot sitz baths for anal pain found no difference between them. The evidence doesn't agree, so it's hard to say for everyday hemorrhoid pain.
- Can a cooling device help after rubber-band ligation for hemorrhoids?
- A trial testing a frozen cooling device after rubber-band ligation found no benefit for needing pain medication, and people who actually used the device had higher pain scores than those who didn't.
- Should I stop icing my hemorrhoids?
- If ice feels soothing to you, these studies don't suggest it causes harm. But don't expect it to treat the hemorrhoid itself - no study has shown that a plain ice pack improves ordinary hemorrhoid symptoms compared with doing nothing.
- Does a cold sitz bath help anal pain from hemorrhoids?
- One small trial found cold water sitz baths gave no better pain relief than hot water sitz baths over seven days in people with anal pain from hemorrhoids or fissures.
What has changedEvery re-check, and whether it changed the answer.
2026-10-14
Re-reviewed under a revised method: question type, study relevance and the harm rule. 3 new studies · 11 no longer retrieved · evidence strength moderate → very low · conclusion no meaningful benefit → not studied.
How certain we are changed. The conclusion changed.
This is information, not advice
This page summarises published research. It cannot tell you what is happening in your own body, and evidence changes. If something is bleeding, painful, or new, it is worth being looked at — that is a different question from the one on this page, and a better one to bring to a consultation.
Contact the officeAutomated evidence review — PubMed, ClinicalTrials.gov, Crossref. Search strategy, grading rules and the checks that must pass before anything publishes were written by Allen Kamrava, MD, MBA, FACS, FASCRS, colon & rectal surgery, Beverly Hills. The pages themselves are compiled by software running that method and are not read one by one before publication — saying otherwise would be the one claim here that could not be checked.