At 3am, everything feels dramatic.
I’ve done it before—not gonna lie. I was called to the emergency room for a patient with “strangulated hemorrhoids.” When I examined them, what I actually saw was a non-reducible rectal prolapse.
I tried to gently push it back in. It didn’t work.
I called the senior resident.
She said: “Go to the cafeteria and get sugar packets.”
So I did.
I slathered granulated sugar directly onto the swollen tissue and let it sit for a few minutes to draw the swelling down. Then I tried again.
Still didn’t work.
What finally did it?
An anesthetic nerve block.
Pain relief plus muscle relaxation allowed the prolapsed rectum to slide back in.
Let’s unpack what happened there—because this story is often misunderstood.
What I reduced (pushed back in) was the rectum, not hemorrhoids.
People often confuse large, pink, protruding tissue from the anus with “hemorrhoids.” That’s why a physical exam matters.
Here’s a critical rule:
PINK and healthy-looking tissue → may be reducible temporarily
Purple or black tissue → DO NOT push back in
Dark, dusky tissue suggests compromised blood supply. Pushing that back inside can make someone very sick.
Now we get to the internet myth.
There are a few small case reports describing the application of granulated sugar to prolapsed internal hemorrhoids to reduce swelling via osmotic effect.
The physiology makes sense.
In basic science terms:
Water follows solute.
Sugar (like salt) is a solute. When applied to edematous tissue, it can draw fluid outward via osmosis.
Yes, it’s similar to salting meat before cooking.
Yes, I realize that’s a mildly unhinged comparison.
But the principle is the same.
This osmotic shrinkage can sometimes temporarily reduce swelling enough to facilitate manual reduction of prolapsed tissue.
Here’s the important part:
There are no large clinical trials
No systematic reviews
No major guideline endorsements
No standard recommendations supporting sugar as routine treatment
Most colorectal specialists would not recommend doing this at home.
Why?
Because the bigger risk isn’t infection.
It’s misdiagnosis.
You don’t know what you’re sugaring.
✘ Thrombosed external hemorrhoids
Sugar will not penetrate intact skin and has no documented benefit for thrombosis.
✘ Routine itching or irritation
There’s no evidence sugar reliably improves standard hemorrhoid symptoms—and it may irritate tissue.
✘ As a standard hemorrhoid treatment
Current guidelines emphasize:
Fiber optimization
Stool softeners
Topical anesthetics and corticosteroids
Office procedures (rubber band ligation, infrared coagulation)
Surgical options when needed
Sugar is not on that list.
In rare, acute settings—like prolapsed internal hemorrhoids or rectal prolapse with significant edema—under medical supervision, osmotic agents may help temporarily reduce swelling.
But that’s a clinical decision.
Not a Tiktok hack.
Is sugar biologically plausible?
Yes.
Is it standard treatment?
No.
Is it something I’ve done in the hospital under supervision?
Yes.
Should you be sprinkling Domino on every bump you see?
Absolutely not.
If something is protruding, painful, purple, or not going back in—get examined.
Because sometimes it’s not hemorrhoids.
And sometimes the trick isn’t sugar.
References
Lohsiriwat V. Hemorrhoids: From basic pathophysiology to clinical management. World J Gastroenterol. 2012;18(17):2009–2017.
Riss S, et al. The prevalence of hemorrhoids in adults. Int J Colorectal Dis. 2012;27:215–220.
Gaj F, et al. Osmotic reduction of prolapsed internal hemorrhoids: case observations. Tech Coloproctol. 2008;12(3):231–233.
American Society of Colon and Rectal Surgeons (ASCRS). Clinical Practice Guidelines for the Management of Hemorrhoids. Dis Colon Rectum. 2018.
