Hello and Welcome to ‘Ask A Doctor’ service. I have reviewed your query and here is my advice. It is very important not to excess strain in hemorrhoids, as straining increases vein pressure and causes stretching and bulging of the anal veins. Hemorrhoids may cause pain, itchiness or bleeding. Bleeding is more suggestive of internal hemorrhoids and pain is a suggestive symptom of external hemorrhoids. For now to relieve the pain use Lidocaine-Hydrocortisone cream. Apply the cream on the skin around the anus. You also can use Tucks Medicated Witch Hazel Hemorrhoidal Pads for pain relief. Treatment of hemorrhoids includes diet and life style modifications: You should increase the amount of fiber in your diet and should drink plenty of fluids. Eat more fresh fruits, beans, vegetables, seeds. Add fiber supplements in your diet up to 30 gr a day. Fibers with fluids soften stools and decrease the strain during bowel movement and make it easy to pass. Exercise regularly and try to decrease your body weight. Exercises stimulate your bowel movements. When you feel urge use toilet without waiting. Make a habit to use certain time of the day to sit on the toilet for regular bowel movements. But avoid prolonged sitting or straining. Use a warm water sitting bath (sitz bath) every day after each bowel movement for about 20 minutes. But if these measure do not help and you experience persistent pain despite conservative treatment or prolapsed internal hemorrhoids, surgery should be considered. Surgical treatment varies from minimally invasive (such as rubber band ligation) to traditional incision hemorrhoidectomy. Hope I have answered your query. Let me know if I can assist you further. Thank you.