Can Alcohol Make Hemorrhoids Worse?

Hemorrhoids are a common condition. In the US, it’s the third most common gastrointestinal diagnosis in outpatients.¹

There are many risk factors for hemorrhoids, including consuming a low-fiber diet, straining while using the toilet, and older age. But is alcohol a risk factor for developing the condition? And can alcohol make hemorrhoids worse?

Hemorrhoids explained

Hemorrhoids are swollen veins in the anus and lower rectum that vary in severity. The condition is also known as piles.

There are three types of hemorrhoids: internal, external, and prolapsed.

Internal hemorrhoids may cause bleeding during bowel movements, discomfort, and lumps around the opening of the anus (if the hemorrhoids have prolapsed).

External hemorrhoids may cause itching or pain around the anus that might worsen when you sit down or lumps around the anal opening, which may feel itchy or tender.²

Prolapsed hemorrhoids are usually considered to be more serious. They are different from external hemorrhoids in how they form. External hemorrhoids develop outside the anus, while prolapsed hemorrhoids form on the inside but are pushed outside by passing stool.

Hemorrhoids can be classified by severity (grade 1–4). With prolapsed hemorrhoids, issues can become more severe because of complications. They might be classified as grade 2 (slightly more severe than grade 1) to grade 4 (very severe).

Grade 2 prolapsed hemorrhoids will generally heal and recede inside on their own. Grade 3 hemorrhoids will not be able to recede back inside on their own and will have to be manually pushed back in. In a grade 4 situation, the hemorrhoids are prolapsed with part of the anal lining, which is known as rectal prolapse. Hemorrhoids that are this severe cannot be positioned back inside at all.³

What causes hemorrhoids?

Hemorrhoids generally occur when something causes excess pressure to be applied to the veins around the anus.

The condition may be caused by chronic constipation or diarrhea, straining during bowel movements, and sitting on the toilet for long periods.

Other risk factors include consuming a low-fiber diet, pregnancy, older age, and lifting heavy weights often.⁴

Does alcohol cause hemorrhoids?

Most people know that drinking excess amounts of alcohol can contribute to the development of all kinds of chronic diseases and health problems. These include liver disease, high blood pressure, and various cancers (including those that affect the liver, colon, and rectum).⁵

There is no direct relationship between alcohol consumption and the development of hemorrhoids. However, alcohol can lead to increased waist circumference, which has been identified as a risk factor for hemorrhoids.⁶

Historically, experts have assumed that obesity and high body max index (BMI) are linked to hemorrhoids. However, a review published in 2021 summarizing the latest evidence from clinical trials, observational studies, and systematic reviews concluded that waist circumference should be reevaluated as a risk factor for hemorrhoids.⁷ This is because it more accurately predicts factors that may cause the development of hemorrhoids, including venous congestion and high intra-abdominal pressure.

Alcohol is also linked to high blood pressure — another risk factor for hemorrhoids.⁸

It can also contribute to constipation due to its diuretic effects. Consuming alcohol can make it harder for your body to stay properly hydrated.⁹ Constipation is a risk factor for hemorrhoids as it can cause you to strain during a bowel movement. Passing hard stools can also aggravate hemorrhoids.

The liver, alcohol, and hemorrhoids

Research indicates that hemorrhoids are more common in people with liver cirrhosis.¹⁰ However, the link between the two conditions is unclear.

Liver cirrhosis is a condition that occurs when healthy liver tissue is replaced by scarred tissue, which permanently damages the liver and prevents it from working properly.

Alcoholic liver disease is among the most common causes of liver cirrhosis.¹¹ Since alcohol consumption is a risk factor for both hemorrhoids and liver cirrhosis, this may explain the higher incidence rate of hemorrhoids in people with liver cirrhosis.

Can drinking alcohol make hemorrhoids worse?

Not only is alcohol linked to many risk factors for developing hemorrhoids, but it can also cause your symptoms to worsen.

For example, consuming alcohol may cause you to develop constipation. With constipation, you might find that your hemorrhoids are more painful because you are straining on the toilet and/or passing hard stools.

Treating hemorrhoids

In some cases, hemorrhoids can go away on their own. If the condition continues to cause you pain and discomfort, you can take steps to manage your hemorrhoids at home, such as making changes to your diet and staying hydrated. Alternatively, your doctor may advise you to undergo a medical procedure to treat your hemorrhoids.

At-home treatments

Here are some at-home treatments you might want to try to ease your symptoms.¹² Remember to check with your doctor before significantly adjusting your diet or taking new medications.

• Over-the-counter (OTC) creams and ointments — topical solutions, including hydrocortisone, zinc oxide, and lidocaine, are available to ease your symptoms. They contain ingredients that reduce swelling and inflammation and numb itchy, painful areas.

• OTC pain relievers — ibuprofen, acetaminophen, or other OTC pain medications can help ease your hemorrhoid symptoms.

• Eat more fiber as part of a healthy diet — consuming enough dietary fiber can make it easier to pass stool, improving constipation and reducing straining. Fruits, vegetables, and legumes contain fiber, so try incorporating them into each meal.

• Keep hydrated — drink lots of fluids throughout the day to prevent constipation and soften your stools, making them easier to pass.

• Witch hazel wipes — using witch hazel wipes to gently wipe the rectal area can reduce discomfort and itching and encourage healing. Witch hazel has anti-inflammatory properties.¹³

• Sitz baths — soaking the rectal area in a sitz bath (a shallow bowl of warm water that you sit in) for 10 to 15 minutes once or twice a day can temporarily ease your pain.

Medical procedures

Depending on the severity of your hemorrhoids, your doctor may recommend that you undergo a medical procedure to treat them. Some procedures can be carried out in an office setting, but others will require a visit to a hospital.

Here are some of the surgical treatment options available:

• Sclerotherapy — during this procedure, a chemical solution will be injected into your hemorrhoids that causes the blood vessels inside them to collapse. This causes them to shrink.

• Rubber band ligation — a doctor will locate internal hemorrhoids using a small camera inside the anus. They will then place a rubber band around the base of the hemorrhoids, cutting off their blood supply and causing them to shrink and fall off.

• Hemorrhoidectomy — this procedure involves surgically removing the hemorrhoids. Although this treatment method involves a longer recovery time, it’s more effective at preventing hemorrhoids from recurring.¹⁴

When to visit a doctor

Most hemorrhoid flare-ups heal on their own, but it’s best to see your doctor if you are struggling with your symptoms and your discomfort has continued for longer than a week.

The lowdown

Hemorrhoids are swollen veins that cause pain and irritation in the rectal area.

Older age, living a sedentary lifestyle, increased waist circumference, constipation, straining when passing a stool, and spending long periods sitting on the toilet are all risk factors for developing the condition.

Although alcohol consumption is not a direct cause of hemorrhoids, it is a risk factor. Alcohol consumption is linked to dehydration, which can cause constipation and straining when going to the toilet. It’s also associated with having an increased waist circumference and high blood pressure, both independent risk factors for hemorrhoids.

Hemorrhoid symptoms can be eased at home by taking OTC pain medications, applying topical creams, or making positive changes to your diet to improve your fiber intake and hydration. In some cases, surgical procedures are recommended to remove hemorrhoids, including sclerotherapy, rubber band ligation, and hemorrhoidectomy.

If you are struggling with symptoms of hemorrhoids, make an appointment to see your doctor.

Frequently asked questions

Can beer and wine make hemorrhoids worse?

If you are experiencing symptomatic hemorrhoids, the excessive consumption of any alcoholic beverages, including beer and wine, may cause dehydration and exacerbate your symptoms.

What other drinks should I avoid?

Drinking many caffeinated beverages during the day stimulates the digestive system and can cause diarrhea or constipation in some people. These conditions can exacerbate hemorrhoid symptoms and stop them from healing. Therefore, you might find it helpful to avoid caffeinated coffee, teas, and sodas while your hemorrhoids are symptomatic.