Hemorrhoids can make your life very uncomfortable, especially when you sit or lie down. Some people find their symptoms worsen at night.
So, why is your hemorrhoids pain worse at night, and how can you ease your discomfort?
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Hemorrhoids are swollen veins in the anus and the lower rectum. They are similar to varicose veins. They can develop inside the rectum or under the skin around the anus.
The condition is common in men and women, especially people over the age of 50. One in 20 Americans has hemorrhoids.¹
Hemorrhoids can be classified as:
Internal hemorrhoids form in the lining of the anus and lower rectum. External hemorrhoids occur under the skin around the anus.
Hemorrhoids are often caused by built-up pressure in the lower rectum. This affects blood flow and makes the veins swell. Excess pressure on the veins may be caused by²
Consuming a low-fiber diet
Straining while going to the toilet
Sitting on the toilet for a long time
Chronic diarrhea or constipation
Lifting heavy weights often
These conditions and behaviors can generate pressure in the pelvic area, which may eventually cause hemorrhoids.
You are also more likely to develop hemorrhoids if your parents have them. A study identified genes in more than 100 regions of the genome that increase the risk of developing the condition.³
Some experts believe high body mass index (BMI) is associated with increased risk for hemorrhoids. However, more studies are needed to prove this as existing research is conflicting.⁴
Symptoms vary depending on the type of hemorrhoids you have.
Symptoms of external hemorrhoids include the following:⁵
Itching around the anus
Pain around the anus — this might get worse when you sit down
Lumps around the anal opening — these might feel tender or itchy
Symptoms of internal hemorrhoids include the following:
Bleeding during bowel movements
Prolapsed hemorrhoids — you might notice lumps around the opening of the anus and discomfort
Hemorrhoids can be uncomfortable and make bowel movements painful, especially if blood clots develop around the anus. It can be hard to lie down or sit if you have hemorrhoids.
There is no scientific backing for hemorrhoids being more painful at night. Your sleeping position could cause any worsening pain and irritation you experience.
Pain in and around the anus can be disruptive since the soft tissues in this region are highly sensitive. As such, any sleeping position that exerts pressure on these soft tissues can worsen your hemorrhoids pain. This can occur at any time of day.
How you sleep can affect your hemorrhoids pain. For example, lying on your pack exerts pressure on the anal area.
Other factors that can cause your hemorrhoids to hurt more at nighttime include the following:
The texture of your mattress
The clothes you wear
The food you consume before bed
The following tips can help you manage your hemorrhoids pain at night:
Sleep on a soft mattress — hard surfaces can worsen your pain.
Avoid eating spicy foods before going to bed, as some experts believe they can worsen hemorrhoids.⁶
Wear comfortable clothes while sleeping as tight-fitting garments can irritate your skin or exert pressure on the anal region. You might want to avoid wearing underwear.
Avoid sleeping on your back.
Apply an over-the-counter topical cream or ointment, like hydrocortisone, lidocaine, or zinc oxide. Although you don’t need a prescription for some formulations of these medicines, it’s best to check with your doctor before using them as they may be unsuitable for you.
You may be able to ease your pain with an over-the-counter pain reliever like acetaminophen (Tylenol) or non-steroidal anti-inflammatory drugs (NSAIDs) like naproxen (Aleve, Naprosyn), aspirin, and ibuprofen (Motrin, Advil).
Take a sitz bath before going to bed. This is a shallow bath with warm water that you sit in. A sitz bath can help relax the muscles, soothe irritation, and promote blood flow.
The following tips are recommended for easing hemorrhoids symptoms:
Drink plenty of water. This is important as dehydration can cause constipation and aggravate hemorrhoids.
Avoid alcohol and caffeinated beverages.
Exercise can help keep your bowel movements regular. It can also help you lose excess weight, which is considered a risk factor for hemorrhoids.
Consume a high-fiber diet. This can help soften your stools, which avoids aggravating your hemorrhoids. Foods rich in fiber include vegetables, such as broccoli, Brussels sprouts, and artichokes; whole grains, such as oatmeal, quinoa, and brown rice; legumes, such as green peas, beans, and lentils; fruits, such as avocados, berries, and pears; nuts; and seeds. Your doctor may recommend taking a fiber supplement if you’re having trouble with your dietary fiber intake.
Avoid long periods of sitting, especially when you go to the toilet.
Go to the bathroom as soon as you feel the urge.
Avoid straining or holding your breath during bowel movements.
Standing or sitting for extended periods can worsen your hemorrhoids since they exert pressure on your blood vessels. However, lying down isn’t always the answer because certain positions can also worsen your symptoms.
The best sleeping position to manage hemorrhoids pain is lying down on your side and placing a soft pillow between your knees. Alternatively, try sleeping on your stomach. Both sleeping positions take pressure off the anal region, relieving hemorrhoids pain at night.
Your sleeping position could be making your hemorrhoids pain worse at night. Other contributing factors can include what you wear to bed and what you eat or drink during the day.
Hemorrhoids can be uncomfortable and worsened by exerting external pressure on the anal area. If you suffer extreme hemorrhoid pain at night, consider changing your sleeping position to sideways or on your stomach.
You could also try using pain-relief medication and topical creams to help ease your symptoms.
Speak to your doctor about your symptoms. They may be able to recommend alternative medications or treatment options to make sleeping easier.
Definition & facts of hemorrhoids | National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Hemorrhoids | MedlinePlus
Hemorrhoids | MedlinePlus