tie em off with a rubber band.
Never tried it. Does it work? I know that shoving ice cubes up my anus doesn't do much.
The damned cream is icky slimy too. Plus it stinks, and makes lousy toothpaste.
It depends how bad they are.
A number of methods may be used to remove or reduce the size of internal hemorrhoids. These techniques include:
Rubber band ligation. A rubber band is placed around the base of the hemorrhoid inside the rectum. The band cuts off circulation, and the hemorrhoid withers away within a few days.
Sclerotherapy. A chemical solution is injected around the blood vessel to shrink the hemorrhoid.
Infrared coagulation. A special device is used to burn hemorrhoidal tissue.
Hemorrhoidectomy. Occasionally, extensive or severe internal or external hemorrhoids may require removal by surgery known as hemorrhoidectomy.