Hemorrhoids, also known as piles, are a common health condition affecting 1 in 20 Americans. They are more frequent in adults over 50.¹
If you have hemorrhoids, they could be linked to an underlying condition such as constipation. Let’s discuss the link between hemorrhoids and constipation and why addressing these concerns is essential.
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Hemorrhoids are swollen veins that appear as lumps in the anus and lower rectum.
There are two different types of hemorrhoids: External and internal. External hemorrhoids occur in the anus, while internal hemorrhoids form deeper inside the rectum.
Hemorrhoids look like swollen lumps, and they are typically red or purple. The symptoms of external and internal hemorrhoids can vary.
Symptoms of external hemorrhoids:
Itching around the anus
Hard and tender lumps around the anus
Anal pain when sitting or going to the toilet
Symptoms of internal hemorrhoids:
Bright red bleeding from the anus after a bowel movement (pooping)
Typically painless unless they prolapse and strangulate (when the internal hemorrhoid bulges out of the anus and the blood supply cuts off)
There is no single cause of hemorrhoids, and you may notice that more than one contributing factor caused them. Factors associated with hemorrhoids include:
Straining during a bowel movement
Sitting on the toilet for too long
Weakening of the tissues within the anus and rectum (more common with aging)
Research has found a potential link between inflammatory bowel disease and hemorrhoids, as these diseases cause chronic diarrhea or constipation. Diarrhea and constipation are the main risk factors for hemorrhoids.²
Home treatments and remedies:
Try an over-the-counter laxative or stool softener.
Try an over-the-counter hemorrhoid cream or suppository.
Use over-the-counter analgesics, such as acetaminophen or ibuprofen, for pain and swelling.
Eat foods high in fiber.
Avoid sitting on the toilet for too long.
Try a sitz bath—a warm tub of water with Epsom salt.
Apply a wrapped ice pack to reduce swelling.
Switch to wet wipes instead of toilet paper.
If your symptoms persist, seek advice from a doctor. You should also speak to your doctor when home remedies don’t work or when the pain or swelling worsens.
To diagnose your hemorrhoids or determine the best treatment, your doctor will need to examine the area. For some people, this can understandably feel embarrassing and uncomfortable.
However, getting the correct diagnosis is important. Other conditions, such as perianal abscesses, can mimic hemorrhoids, but they require a different treatment.
Constipation occurs when you have difficulty emptying your bowels. The stools are hard and lumpy, making it difficult to pass a bowel movement. However, you may notice some signs of constipation before it reaches this stage.
By definition, constipation typically occurs when you have three or fewer bowel movements in one week. Doctors can use the Rome IV criteria to diagnose functional constipation as follows:
Straining for more than 25% of defecations ]
Lumpy or hard stools in more than 25% of defecations
Feeling like your bowels aren’t empty after 25% of defecations
Feeling like there is a blockage in the bowels in more than 25% of defecations
Needing to manually maneuver to defecate 25% of the time
Having less than three spontaneous bowel movements each week
Only having loose stools when using laxatives
Not meeting the criteria for other types of constipation, such as IBS-related constipation
Before you have fewer than three bowel movements in one week, you may notice your stool is painful and difficult to pass. In that case, you could be on the path to developing constipation. Therefore, it's good to recognize and address constipation early.
Symptoms of constipation include:
Very few bowel movements over a series of days or a week
Hard, dry, and lumpy stools that are difficult or painful to pass
The feeling that you haven’t emptied your bowels completely after going to the toilet
Straining to pass a bowel movement
If you can determine what causes your constipation, you may be able to avoid it in future. Stool moving slowly through the bowels is the primary cause of the condition. However, other factors can contribute to constipation, and sometimes there can be more than one issue.
An overview of the causes of constipation includes:
Nutrition: Low fiber diet, unhealthy eating habits
Medication: Pain relief, antidepressants, calcium channel blockers, iron supplements
Metabolic diseases: Diabetes, gland disorders, and hypercalcemia
Neurological disorders: Parkinson's disease, multiple sclerosis, dementia, Hirschsprung's disease, and spinal cord lesions
Systemic disorders: Scleroderma, myotonic dystrophy, and amyloidosis
Structural changes in the bowel due to disease, such as colon cancer or strictures
Gastrointestinal disorders, such as irritable bowel disease (IBD)
At-home treatments and remedies:
Eat more fiber or try fiber supplements.
Avoid processed foods and foods low in fiber.
Try over-the-counter medications, such as laxatives, stool softeners, or osmotic agents.
Try a lubricant, such as mineral oil.
Before taking laxatives, always read the directions on the label. You need to see your doctor if you cannot have a bowel movement without taking laxatives.
If your symptoms persist or worsen, seek advice from a doctor.
To diagnose your constipation, your doctor will ask questions about your medical history, perform a physical exam, and may order tests. From here, they may address your constipation by offering treatments such as laxatives.
A bowel obstruction occurs when the intestinal flow is mechanically blocked. The blockage could be due to numerous causes, such as:
Volvulus (twisted bowel)
Benign stricture (intestinal narrowing)
A bowel obstruction causes the bowels to become fully or partially obstructed.
A small bowel obstruction occurs when there is a blockage in the small intestine. Small bowel obstructions are more common than large bowel obstructions.
Symptoms of a bowel obstruction include:
Palpable abdominal mass
Distension (abdominal swelling)
A bowel obstruction is a condition where digested material cannot pass through the bowels because it is blocked by something. Bowel obstructions are more severe and often require immediate intervention.
In contrast, constipation is when the stool is slow to pass through the bowels. While a bowel obstruction can cause constipation, other factors can also contribute to constipation.
Hemorrhoids and constipation occur together as excessive straining to pass stool can cause hemorrhoids.
Several treatment options are available. But choosing the appropriate treatment depends on whether or not you have ongoing constipation.
For instance, leaving constipation untreated could worsen your hemorrhoids. It’s possible to treat the underlying cause of the hemorrhoids, preventing them from recurring or worsening. However, some treatments for constipation can also alleviate hemorrhoids.
Your doctor will recommend treatment options if home remedies or over-the-counter products don’t work for you.
Prevention is the best way to reduce the risk of hemorrhoids, and you can try some new habits to reduce the recurrence of constipation.
You can try the following to prevent constipation:
Introducing more fiber into your diet
Do not delay bowel movements
Preventing constipation may prevent hemorrhoids. However, not all hemorrhoids are linked to constipation.
To prevent hemorrhoids, be mindful of the following:
Avoid straining for too long during a bowel motion.
Avoid sitting on the toilet for long periods.
Opt for foods with more fiber.
Straining caused by constipation can lead to hemorrhoids. Therefore, treating constipation may prevent hemorrhoids. However, both conditions usually need separate treatments, and you should see a doctor when symptoms of hemorrhoids or constipation persist.
Hemorrhoids cannot cause a blockage and constipation. However, if you postpone defecating due to anxiety from pain or bleeding from hemorrhoids, you may cause functional constipation.
The feeling of an incomplete bowel movement happens when stool remains in the rectum after a bowel movement. However, this feeling can also be caused by large hemorrhoids, among other causes.
Large hemorrhoids can create the sensation of pressure, making it feel like there is something stuck.
Definition & facts of hemorrhoids | National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Definition & facts for constipation | National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Bowel obstruction (2022)
How to treat internal and external hemorrhoids | GI Associates