9 Main Causes of Hemorrhoids (& What To Do)

Hemorrhoids happen when there is an increase in pressure on the blood vessels around the anus, which makes the veins dilate and get inflamed, leading to pain and bleeding. 

This problem is more frequent in people who need to push very hard in order to pass stool, which is more common due to constipation.

However, hemorrhoids can also appear due to other factors such as pregnancy, excess weight, dietary choices or age.

9 Main Causes of Hemorrhoids (& What To Do)

Main causes for hemorrhoids include:

1. Chronic Diarrhea 

Chronic diarrhea is characterized by an increase in passing stool, which can last more than four weeks. Chronic diarrhea can cause hemorrhoids due to the inflammation that it causes on the anal mucosa.

What to do: the secret is to regulate your bowels. People who have soft feces or regular diarrhea need a medical evaluation, to determine the cause. Most of the times, chronic diarrhea is being caused by irritable bowel syndrome (IBS), which needs appropriate treatment in order to avoid complications.

2. Excess Weight

Hemorrhoids are often a consequence of excessive weight. In addition, the habits of the person who is overweight such as sedentarism, and a fat-rich diet usually lead to a decrease in bowel movements, causing constipation and difficulty passing stool.

What to do: it is recommended that you get to your ideal weight. To do so, you will need to make changes to your diet and start exercising regularly. It is ideal to consult with a dietitian and/or an endocrinologist.

3. Not Passing Stool When If Feel Like

Not passing stool when you feel the need to can cause the feces to get dry and hard, causing abdominal discomfort and consequently difficulty evacuating, increasing the risk of hemorrhoids.

What to do: the most important thing to do is pass stool whenever you feel the need to.  

4. Weight Lifting

Lifting a lot of weight in the gym, or looking after elderly people who need to be lifted frequently, can lead to an increase in pressure in the veins of the anal region, causing hemorrhoids.

What to do: avoid lifting a lot of weight whenever possible, but whenever you do have to lift weight, contract the muscles of the perineum at the same time. 

5. Pregnancy 

It’s normal to have hemorrhoids during pregnancy as these normally happen due to the increase in body weight, increase in pressure on the pelvic area, and constipation, which are common physiological alterations that happen during pregnancy.

What to do: it’s important to do some regular light exercises, such as walking, and drinking a lot of fluids.

6. Fiber Poor Diet

Fibers are very important for the good functioning of the body, being responsible for regulating the bowels. Thus, a diet poor in fiber can lead to a decrease in intestinal movements and dry, hard feces, which results in pain when passing stool.

What to do: the solution is to increase the consumption of fiber-rich foods, such as whole grains, leafy greens, and fruit with peel. See a list of high fiber foods.

7. Working Standing Up 

Another important factor is when you work for a long time standing up, which encourages vascular stasis in people who are pre-disposed to that, increasing pressure on the blood vessels of the anal region and increasing hemorrhoid risk.

What to do: a good way to prevent this is to do stretches every two hours. You can also do pelvic floor exercises, keeping the contraction of the perineum when standing. To do this contraction of the perineum it is recommended that you imagine you are sucking something in with the vagina. Another tip is to do exercise regularly, and it’s also important to do Kegel exercises. 

8. Age 

Even though it can appear at any age, hemorrhoids are more frequent in people over 45 years old, because the tissues that support the veins of the rectum and anus weaken and stretch with age.

In addition, a person who has had a hemorrhoid crisis in the past has greater chances of having a new crisis. 

9. Eating Spicy or Condimented Food

A diet rich in spicy foods or that is too condimented can also lead to the inflammation of the hemorrhoids. In addition, an excessive consumption of alcoholic drinks also increases the risk of developing a hemorrhoid.  

What to do: only have spicy foods or foods that are very condimented sporadically, and do not have these foods at all during a hemorrhoid crisis. 

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  • PHILLIPS, R.K.S; CLARK, S. Cirurgia Colorretal. 5 ed. Rio de Janeiro: Elsevier, 2017.
  • DE PAULA, Pedro Roberto. Doença Hemorroidária. 2016. Available on: <https://cbcsp.org.br/wp-content/uploads/2016/aulas/doencahemorroidaria.pdf>.
  • SOCIEDADE BRASILEIRA DE COLOPROCTOLOGIA. Hemorróida: Diagnóstico. 2005. Available on: <https://diretrizes.amb.org.br/_BibliotecaAntiga/hemorroida-diagnostico.pdf>. Access in 31 Dec 2019
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