What Causes Hemorrhoids?

Hemorrhoids are one of those conditions nobody wants to talk about, yet millions of people deal with them every single year. They’re uncomfortable, frustrating, and sometimes even downright painful—but the good news is that understanding what causes hemorrhoids is the first big step toward preventing and managing them. When you know the triggers, you can spot the habits, lifestyle factors, and daily routines that might be putting unnecessary pressure on your rectal veins. And honestly, you’d be surprised how many everyday actions quietly contribute to the problem without us even realizing it.

At their core, hemorrhoids are swollen veins in the lower rectum or around the anus. Think of them like varicose veins—but in a much more sensitive location. They form when there is too much pressure on the area, causing veins to stretch, swell, and sometimes even protrude. While some people assume hemorrhoids are only caused by constipation or pregnancy, the truth is that there are many different factors involved. Diet, lifestyle, age, genetics, bathroom habits, medical conditions, and even how much water you drink all play a role.

What’s even more interesting is that hemorrhoids are extremely common, yet very misunderstood. Many people blame the wrong causes or fail to connect their symptoms with behaviors they repeat daily. For example, did you know that sitting on the toilet scrolling through your phone can actually worsen hemorrhoids? Or that dehydration alone can make bowel movements hard enough to trigger them? These are the kinds of details we’ll break down step by step so you can finally understand what’s happening inside your body.

This guide takes a deep, human-centered look at every possible cause—from physical pressure to lifestyle choices—and explains them in a way that’s relatable and easy to apply in real life. So whether you're dealing with hemorrhoids now, hoping to avoid them in the future, or simply trying to understand the condition better, you're in the right place. Let’s dive into what really causes hemorrhoids and how you can take control of your digestive and rectal health starting today.

What Exactly Are Hemorrhoids?

Hemorrhoids might sound like a complicated medical issue, but at their core, they’re simply swollen veins located in and around the rectum or anus. To picture them, imagine the veins in your legs when they become varicose—twisted, stretched, and swollen. Now imagine that same situation happening internally or externally near the anus. That’s essentially what hemorrhoids are. But because this area of the body is sensitive, even small changes can create a lot of discomfort.

There are two main types: internal and external hemorrhoids. Internal hemorrhoids form inside the rectum, which means you usually don’t feel them unless they become large, irritated, or prolapsed. They often cause painless bleeding during bowel movements—something that surprises many people. External hemorrhoids, on the other hand, form under the skin around the anus, and this is where most of the pain, itching, burning, and swelling come from. Because they’re on the outside, they tend to get irritated more quickly, especially when sitting, walking, or wiping.

Hemorrhoids form when the veins in this region experience too much pressure or strain. Over time, the vein walls start to weaken and swell, similar to a balloon slowly stretching out. When this balloon-like swelling occurs, it becomes inflamed—and that’s when symptoms show up. Some people feel only mild discomfort, while others deal with intense pain that makes sitting or moving difficult. In severe cases, clots can form inside external hemorrhoids, known as thrombosed hemorrhoids, which are hard, painful lumps that require careful attention.

What many people don’t realize is that hemorrhoids are actually a normal part of human anatomy. The tissues in the anal canal contain blood vessels that help with continence, meaning they assist in controlling bowel movements. These vascular cushions only become a “problem” when they swell beyond their natural state. So, hemorrhoids aren’t foreign—they’re just irritated structures you’ve always had.

Understanding what hemorrhoids truly are helps remove the stigma. They’re not caused by poor hygiene or anything “dirty.” They’re simply a physical response to pressure, strain, or irritation—something everyone experiences at some point. And knowing this makes it easier to recognize the signs early and take steps to prevent them from getting worse.

Internal vs. External Hemorrhoids

Internal and external hemorrhoids are often grouped together as one condition, but they behave very differently. Understanding the contrast between the two helps you identify symptoms more accurately and choose the right steps for relief. Even though they share the same basic cause—swollen veins in the rectal area—their location and the type of discomfort they cause make a big difference.

Internal hemorrhoids develop inside the rectum, in a spot where there are few pain-sensing nerves. That’s why many people don’t even realize they have them until they notice bright red blood on the toilet paper or in the toilet bowl. Bleeding is the hallmark symptom. Sometimes internal hemorrhoids become irritated by hard stools or straining, which can trigger itching or a feeling of fullness in the rectal area. In more advanced cases, they can prolapse, meaning they slip out of the anus during a bowel movement. At first, they may go back inside on their own, but as they get worse, they might need to be gently pushed back in—or remain protruded, causing discomfort and irritation.

External hemorrhoids, on the other hand, form under the skin around the anus. Because this area is rich in pain receptors, these hemorrhoids tend to be more painful. People often describe the sensation as a sharp, burning, or stinging discomfort, especially when sitting. Swelling, itching, and irritation are also common. In some cases, blood can pool inside an external hemorrhoid and cause a clot, leading to a thrombosed hemorrhoid. This causes a hard, extremely tender lump that may feel like a pebble beneath the skin. It’s not dangerous, but it can be intensely painful without treatment.

The two types can also occur simultaneously, which is when symptoms become especially confusing. You might feel pain from an external hemorrhoid while also noticing bleeding from an internal one. This combination is more common than people think, especially in individuals with chronic constipation or prolonged sitting habits.

Recognizing the difference helps you determine whether you need over-the-counter remedies, lifestyle adjustments, or, in some cases, medical intervention. Each type behaves differently—but both are manageable when you understand what’s going on beneath the surface.

Why Hemorrhoids Become Painful

Hemorrhoids don’t always hurt. In fact, many people walk around with mild internal hemorrhoids for years without even realizing it. So why do some hemorrhoids suddenly become painful while others remain silent? The answer lies in pressure, inflammation, nerve sensitivity, and the location of the swollen veins. Pain happens when these factors collide, creating a perfect storm inside one of the most delicate areas of the body.

First, the location of the hemorrhoid plays a huge role. Internal hemorrhoids sit higher inside the rectum, where there are very few pain-sensitive nerves. That’s why they can bleed without causing pain. But when they swell significantly or become prolapsed, they slip down into the anal canal—a region full of highly sensitive nerve endings. This is when pain begins. The stretched tissue gets exposed, irritated, and inflamed, making even small movements feel uncomfortable. Imagine taking a soft, cushioned balloon and squeezing it through a narrow opening. The stress and friction alone are enough to trigger discomfort.

External hemorrhoids are naturally more painful because they form under the thin, delicate skin surrounding the anus. This area is loaded with nerve endings designed to detect pressure, irritation, and injury. When an external hemorrhoid swells, the skin stretches tightly around it, creating that tender, throbbing sensation people describe. Even minor friction from walking, sitting, or wiping can feel magnified. That’s why people with external hemorrhoids often struggle to get comfortable—the pain is constant because the area is always in motion.

Another major cause of pain is inflammation. When veins swell, the surrounding tissue reacts by becoming red, irritated, and warm. This inflammation intensifies pressure, making the hemorrhoid feel larger than it actually is. In severe cases, a blood clot can form inside an external hemorrhoid, resulting in a thrombosed hemorrhoid. This is one of the most painful experiences associated with the condition. The clot turns the hemorrhoid into a hard lump that feels like a marble trapped under the skin. Every movement—sitting, standing, bending—adds pressure and amplifies the pain.

Finally, hemorrhoids become painful due to friction and strain. Daily activities like bowel movements, exercise, and even wiping can worsen swelling. If you’re constipated or straining, the pain becomes even more intense because you’re adding pressure directly onto the swollen veins.

In short, hemorrhoid pain isn’t random—it’s a direct response to swelling, inflammation, and pressure in a nerve-rich area. Understanding why they hurt helps you take the right steps to soothe irritation and prevent flare-ups in the future.

How Hemorrhoids Form: The Science Behind It

To understand what actually causes hemorrhoids, it helps to visualize what’s happening inside your body when they form. Hemorrhoids develop because the veins in the lower rectum and anus become stretched, swollen, or irritated. But this doesn’t happen overnight—it’s a gradual process influenced by pressure, blood flow, and the natural structure of the anal canal. Think of hemorrhoids like elastic bands that get pulled too tightly over time. Eventually, they lose their shape, become inflamed, and start causing symptoms.

Inside the anal canal, you have what are called vascular cushions—spongy clusters of tissue filled with blood vessels. Their job is to help with bowel control. These cushions expand and contract naturally, creating a tight seal that prevents leakage. They’re essential for normal bodily function. The problem starts when these cushions are repeatedly exposed to pressure. When pressure builds, blood starts pooling in the veins. Instead of flowing smoothly, it becomes “trapped” in the swollen tissue, causing the veins to stretch like balloons.

Once the veins stretch beyond their normal capacity, they weaken. The walls become thin and irritated, and the tissue around them becomes inflamed. This is the beginning of a hemorrhoid. Over time, repeated strain causes the swollen vein to grow larger and more irritated. As this continues, the hemorrhoid can even protrude outward (in the case of internal hemorrhoids) or form a painful lump under the skin (in the case of external hemorrhoids).

Another part of the science behind hemorrhoids involves gravity and posture. The human body wasn’t exactly designed with modern habits—like long hours of sitting—in mind. When you sit, especially on a hard surface, more pressure is placed directly on the veins near the anus. Standing helps blood circulate freely, but sitting slows that circulation, causing blood to gather and swell the veins. This is the same reason people who sit at desks all day tend to experience hemorrhoids more often than those who move around frequently.

Additionally, hemorrhoids form more easily when bowel movements become difficult. Hard stools push against the rectal walls, forcing the veins to stretch beyond what they’re meant to handle. Straining makes this worse by increasing pressure inside the abdomen. The more you strain, the more the veins swell. Over time, that pressure takes a toll, leading to irritation, inflammation, and eventually, the formation of hemorrhoids.

Finally, there’s the role of weakening tissue. As people age, the connective tissues that support the veins naturally lose elasticity. This makes the veins more likely to swell and less likely to return to their normal size after pressure is applied. This is why hemorrhoids become more common as you get older.

In short, hemorrhoids form because pressure, poor circulation, and inflammation create the perfect conditions for swollen veins. Understanding this makes it easier to pinpoint what habits or health factors might be contributing to their development.

Primary Causes of Hemorrhoids

Hemorrhoids don’t appear randomly—they develop because certain habits, conditions, or physical pressures gradually weaken the veins in the rectal area. While many people think hemorrhoids are only caused by constipation or straining, the truth is that several everyday factors can trigger them. Understanding these primary causes helps you identify what might be contributing to your symptoms and what changes you can make to prevent flare-ups.

One of the biggest causes is chronic constipation. When you’re constipated, stools become hard, dry, and difficult to pass. Your body has to push harder to get them out, which dramatically increases pressure on the rectal veins. This pressure stretches the veins beyond their natural limits, causing swelling and irritation. Over time, repeated strain weakens the vein walls, making hemorrhoids more likely to develop—and once they form, constipation keeps aggravating them. This creates a cycle that many people struggle with without even realizing constipation is the underlying issue.

On the opposite end of the spectrum, chronic diarrhea is another major cause. Loose stools require frequent trips to the bathroom, and each bowel movement irritates the sensitive tissues around the anus. The constant wiping, combined with inflammation from diarrhea itself, causes the veins to swell. Many people assume diarrhea would prevent hemorrhoids since stools are soft, but the frequent irritation is what leads to swelling and tenderness. This is especially common in people with IBS or digestive disorders.

The next major cause is straining during bowel movements. Straining often happens when you feel pressure to “force” a bowel movement—even when your body isn’t ready. This forceful pushing increases abdominal pressure, which squeezes the veins near the anus. Think of it like tying a tight knot around a balloon; the more pressure you apply, the more the vein swells. This is why doctors emphasize letting bowel movements happen naturally rather than trying to rush the process.

Another often-overlooked cause is sitting on the toilet for too long. Many people bring their phones to the bathroom and end up spending 15–30 minutes on the toilet without realizing it. The sitting position causes the rectal veins to drop downward, increasing pressure. Even without straining, this extra pressure can lead to swelling and irritation over time. It’s a simple habit with a bigger impact than most people expect.

Finally, poor bowel habits—like ignoring the urge to go—can also trigger hemorrhoids. Holding in stool causes it to become harder and more compact, making it more difficult to pass later. This increases the likelihood of straining, which puts more pressure on the veins and raises the risk of hemorrhoids forming.

In short, hemorrhoids develop because of pressure, irritation, and poor bowel habits. By identifying which of these primary causes may apply to your lifestyle, you can take important steps to reduce your risk and ease your symptoms.

Chronic Constipation

Chronic constipation is one of the most common and powerful triggers behind hemorrhoids. When you think about it, it makes perfect sense—if your body struggles to pass stool, the process becomes more forceful, more strained, and more prolonged than it should be. That extra effort places enormous pressure on the veins in your rectum and anus, causing them to stretch and swell over time. Constipation isn’t just uncomfortable; it’s one of the most damaging bowel habits when it comes to hemorrhoid development.

Constipation usually means your stool is hard, dry, and compact. This happens when your digestive system absorbs too much water from the food waste as it moves through the colon. When the stool becomes too dry, it doesn’t slide through smoothly. Instead, the rectal muscles have to work harder to push it out. This leads to straining, and straining is one of the top reasons hemorrhoids form. Imagine trying to force something through a tight space with a lot of pressure. Eventually, the surrounding structures—in this case, your veins—start to stretch and weaken.

But constipation does more than cause strain. It also prolongs the time spent on the toilet. When you’re struggling to pass stool, you tend to sit longer, and that position increases pressure on the rectal veins. Even if you’re not actively pushing, the simple act of sitting—especially leaning forward—causes the veins to bulge downward. Over time, this constant downward pressure makes them more likely to swell, become irritated, and develop into hemorrhoids.

Constipation can also create a cycle. Once hemorrhoids start forming, bowel movements become even more uncomfortable. Pain and swelling can make you subconsciously avoid going to the bathroom, worsening the constipation. The longer you hold in stool, the harder and drier it becomes. This eventually leads to even more straining, and the hemorrhoids continue to grow or flare up. It’s a frustrating loop that many people struggle to break.

Several factors contribute to chronic constipation: low fiber intake, dehydration, lack of exercise, certain medications, stress, and even ignoring the urge to go. All of these lead to slower bowel movements and harder stools, which in turn increase pressure on the veins. The good news is that constipation is often manageable with simple changes like increasing fiber, drinking more water, and practicing healthy toilet habits.

Understanding how constipation affects your rectal veins is the first step toward preventing the painful cycle of hemorrhoids. When your digestive system functions smoothly, everything else follows—including the health of your veins.

Chronic Diarrhea

While constipation gets most of the attention, chronic diarrhea is an equally powerful and often overlooked cause of hemorrhoids. Many people assume that soft or watery stools would make bowel movements easier and therefore reduce hemorrhoid risk. Surprisingly, the opposite is true. Diarrhea exposes the anal area to constant irritation, inflammation, and friction—conditions that create the perfect environment for hemorrhoids to develop or worsen.

When you experience diarrhea frequently, you’re often rushing to the bathroom several times a day. Each bowel movement, even if effortless, places sudden pressure on the rectal veins. Unlike regular stools, diarrhea is acidic, loose, and filled with digestive enzymes that irritate the lining of the anus. This repeated irritation inflames the delicate tissues surrounding the veins, making them more sensitive and more likely to swell. Over time, the veins become weakened and start to bulge, eventually forming hemorrhoids.

Another reason chronic diarrhea contributes to hemorrhoids is the increased frequency of wiping. The skin around the anus is extremely thin and sensitive. Constant wiping—especially with dry or rough toilet paper—creates friction that irritates the area. This irritation causes inflammation, and inflammation leads to swelling of the veins. Even gentle wiping can feel abrasive when you’re making multiple bathroom visits in a short period of time. Some people even resort to excessive cleaning out of discomfort, which only worsens the irritation.

Chronic diarrhea also alters the natural balance of moisture in the anal region. Instead of being occasionally exposed to stool, the area becomes constantly damp. Moisture weakens the skin barrier and makes the tissue more prone to breakdown. Once the tissue is weakened, the veins underneath lose structural support, making them more vulnerable to swelling. This is why those with IBS-D (Irritable Bowel Syndrome – Diarrhea-predominant), inflammatory bowel disease, food intolerances, or gastrointestinal infections often experience hemorrhoids more frequently.

Additionally, diarrhea often comes with abdominal cramping that causes involuntary tensing and straining. Even though the stool is soft, the body sometimes pushes forcefully during spasms, increasing pressure around the anus. It’s not the consistency of stool that matters as much as the frequency and irritation it brings.

Many people underestimate how damaging diarrhea can be to the rectal area, but its effects add up quickly. The combination of frequent bowel movements, acidic stool, wiping, and constant inflammation makes hemorrhoids almost unavoidable if diarrhea isn’t managed properly. Using soothing wipes, staying hydrated, addressing underlying digestive triggers, and giving the area time to recover can help reduce flare-ups.

Straining During Bowel Movements

Straining during bowel movements is one of the most direct and damaging causes of hemorrhoids. When you push too hard, you increase pressure inside the abdomen and force the veins around the anus to expand beyond their natural limits. This pressure doesn’t just stretch the veins—it weakens the surrounding tissues that normally hold them in place. Over time, these veins become swollen, irritated, and inflamed, leading to the development of both internal and external hemorrhoids.

Straining usually happens when bowel movements feel difficult or incomplete. This can occur for several reasons—constipation, hard stools, dehydration, or simply the habit of rushing. Many people treat bowel movements like a task to “get done,” but the body isn’t designed to work under pressure. Forcing stool out is similar to trying to squeeze toothpaste from a nearly empty tube. You may eventually get something out, but the pressure builds internally, causing stress on the area.

When you strain, the abdominal muscles tighten, and the pelvic floor muscles contract. This squeezes the rectal veins, making them bulge outward. The more often this happens, the more the veins stretch. Eventually, they lose elasticity and become permanently swollen, forming hemorrhoids. Internal hemorrhoids may start to protrude (prolapse), while external ones may become painful lumps under the skin. Even a few seconds of intense pushing can irritate the veins, so imagine the damage caused by repeated straining over months or years.

Another problem with straining is that it reduces blood flow. When you push hard, you temporarily cut off circulation to the rectal area. Veins already under pressure become congested with blood, increasing the chances of swelling. Once circulation returns, the veins remain inflamed, making bowel movements even more uncomfortable. This is why hemorrhoids often worsen after just one difficult bathroom experience.

Straining can also happen when someone sits on the toilet too long. Even without pushing, the posture itself creates downward pressure that encourages straining. This is especially common with people who scroll on their phones, read, or relax on the toilet. The longer you sit, the more likely you are to push unnecessarily.

Breaking the habit of straining is possible. Drinking more water, increasing fiber, responding to the urge to go immediately, and giving yourself enough time for natural bowel movements can reduce the pressure dramatically. The key is to let the body work at its own pace. Hemorrhoids often develop because we force a process that’s meant to be natural and gentle.

Lifestyle Factors That Trigger Hemorrhoids

Hemorrhoids aren’t caused solely by digestive issues—they’re also strongly influenced by lifestyle habits. The way you live, move, and even sit during the day can create the kind of pressure that makes veins around the rectum prone to swelling. By understanding which habits increase your risk, you can take proactive steps to protect your health and reduce flare-ups.

Sitting for Long Periods

One of the biggest lifestyle triggers is prolonged sitting. Modern life keeps many of us glued to chairs at work, school, or even at home watching TV. When you sit for long stretches, especially on hard surfaces, the weight of your body presses directly onto the veins near your anus. This constant pressure slows blood flow, causing it to pool in the veins and gradually stretch them. Think of it like standing water in a garden hose: the longer it sits under pressure, the more likely it is to bulge or leak. Over time, this pooling leads to vein swelling and eventually hemorrhoids. People who work desk jobs or drive long distances regularly are particularly vulnerable.

Lack of Physical Activity

A sedentary lifestyle also contributes to hemorrhoid formation. Regular movement helps blood circulate and prevents veins from becoming congested. Exercise strengthens muscles in the abdomen and pelvic floor, reducing pressure on the rectal veins. Without physical activity, blood tends to pool in lower areas of the body, including the rectum, which increases the risk of swelling. Even simple daily walks or stretches can improve circulation and reduce hemorrhoid risk significantly.

Poor Toilet Habits

Lifestyle factors extend to how you manage bathroom habits. Spending excessive time on the toilet, reading, or using a phone prolongs pressure on the anal area. Ignoring the urge to have a bowel movement is another major problem. Holding in stool allows it to become harder and more compact, increasing strain when you eventually defecate. Both behaviors combine to elevate the pressure on the veins, creating an ideal environment for hemorrhoids to form.

Stress and Its Role

Stress might not seem directly connected to hemorrhoids, but it can indirectly worsen the condition. High stress levels affect digestion, leading to constipation or irregular bowel movements. Stress can also make you less active and more likely to sit for extended periods. Together, these factors create a perfect storm for hemorrhoid development.

Lifestyle habits are surprisingly powerful contributors to hemorrhoids. While dietary choices often get most of the blame, simple daily behaviors—how you sit, move, and respond to bathroom urges—play an equally significant role. Adjusting these habits can drastically reduce both the risk of developing hemorrhoids and the severity of existing ones.

Diet-Related Causes

What you eat has a massive influence on hemorrhoid development. Many people don’t realize that diet is more than just a source of nutrition—it directly affects stool consistency, bowel movements, and vein health. Poor dietary habits can lead to constipation, dehydration, and even chronic diarrhea, all of which are major triggers for hemorrhoids.

Low-Fiber Diets

Fiber is the unsung hero when it comes to digestive health. It adds bulk to the stool and helps it pass smoothly through the intestines. A low-fiber diet, which is common in people who eat a lot of processed foods, fast food, or refined grains, makes stools hard and difficult to pass. When your stool is hard, the body has to strain to push it out, which puts immense pressure on the rectal veins. Over time, this repeated pressure stretches and weakens the veins, leading to hemorrhoids.

Fiber also retains water in the stool, preventing it from becoming dry. Without enough fiber, even adequate water intake can’t compensate for hard, compact stools. Incorporating high-fiber foods—like fruits, vegetables, whole grains, beans, and nuts—creates softer, bulkier stools that move easily, reducing strain on the rectal veins. Experts recommend aiming for at least 25–30 grams of fiber daily, but many adults fall far below this benchmark.

Dehydration and Insufficient Water Intake

Water works hand in hand with fiber to maintain healthy bowel movements. When you don’t drink enough water, your body extracts more fluid from the stool, making it harder and more difficult to pass. This dehydration-driven hardening of the stool forces you to strain, increasing the risk of hemorrhoids. Even mild dehydration can have a noticeable effect on bowel consistency.

It’s not just the water you drink that counts—fluids from fruits, vegetables, soups, and herbal teas also contribute to hydration. However, caffeinated beverages or alcohol can have a dehydrating effect, potentially worsening constipation if not balanced with adequate water intake.

Dietary Triggers Beyond Fiber

Certain foods can exacerbate hemorrhoid symptoms rather than directly cause them. Spicy foods, overly salty foods, and heavily processed snacks can irritate the digestive tract and worsen inflammation. While they might not directly cause hemorrhoids, they can make existing swelling more uncomfortable.

In summary, a diet low in fiber, paired with insufficient hydration and irritating foods, is one of the most significant contributors to hemorrhoid formation. Adjusting your diet is one of the simplest, most effective ways to reduce pressure on the veins and promote smoother, more comfortable bowel movements.

Pregnancy and Hemorrhoid Development

Pregnancy is a time of incredible change in a woman’s body, and unfortunately, it’s also a period when hemorrhoids are more likely to develop. The combination of hormonal shifts, increased blood volume, and physical pressure on the pelvic region creates the perfect storm for swollen veins around the rectum and anus.

Pressure From the Growing Uterus

As the uterus grows, it exerts increasing pressure on the veins in the pelvis and rectal area. This pressure slows down blood flow in the lower body, causing blood to pool in the rectal veins. Over time, this pooling stretches the veins and weakens their walls, making them more prone to swelling and hemorrhoid formation. Many women first notice hemorrhoid symptoms during the third trimester, when the fetus is largest, and the pressure on the pelvic region is greatest.

Hormonal Changes

Pregnancy hormones, especially progesterone, also play a key role. Progesterone relaxes smooth muscles throughout the body, including the walls of blood vessels. While this relaxation is important for accommodating increased blood flow during pregnancy, it can make veins more likely to swell. Hormonal changes also slow digestion, which can contribute to constipation—a major risk factor for hemorrhoids.

Constipation During Pregnancy

Constipation is extremely common during pregnancy, partly due to hormonal shifts, partly due to iron supplements, and partly because physical pressure on the intestines makes bowel movements more difficult. Hard stools and straining amplify the pressure on already stressed rectal veins, increasing the likelihood of hemorrhoids.

Other Contributing Factors

Weight gain, decreased physical activity, and increased pelvic pressure from carrying the baby all contribute to hemorrhoid formation. Even small lifestyle adjustments, like staying active, drinking plenty of water, and eating a fiber-rich diet, can reduce the severity of hemorrhoids during pregnancy.

Many pregnant women are surprised to learn that hemorrhoids are not uncommon and are a normal side effect of the changes their bodies undergo. Understanding why they occur helps in managing symptoms and preventing complications, especially since most hemorrhoids resolve naturally after childbirth.

Obesity and Hemorrhoids

Obesity is another significant risk factor for developing hemorrhoids. Carrying excess weight places additional pressure on the veins in the pelvis and rectal area. Over time, this pressure can weaken the walls of the veins, causing them to swell and form hemorrhoids. Essentially, the veins are forced to bear more weight than they were designed for, which can lead to persistent vein dilation and irritation.

People with obesity often experience increased abdominal pressure even while standing or walking. This constant pressure affects blood flow in the lower body, causing blood to pool in the rectal veins. The result is swollen, inflamed veins that can manifest as both internal and external hemorrhoids. Even small amounts of pressure over time can create a cumulative effect, gradually worsening the condition if lifestyle or dietary adjustments aren’t made.

Obesity also tends to coincide with other contributing factors such as sedentary behavior, poor diet, and constipation—all of which further increase the risk of hemorrhoids. Sitting for long periods, consuming low-fiber foods, and straining during bowel movements amplify the pressure on already stressed veins. In essence, multiple risk factors stack together, compounding the likelihood of hemorrhoid development.

Weight loss, regular physical activity, and a diet rich in fiber and water can dramatically reduce the strain on rectal veins. Even modest reductions in abdominal pressure help improve circulation and prevent the formation of new hemorrhoids. For those already suffering from hemorrhoids, managing body weight can also reduce flare-ups and ease symptoms, making daily life much more comfortable.

Understanding the connection between obesity and hemorrhoids highlights the importance of a holistic approach to prevention—one that combines weight management, healthy lifestyle habits, and proper digestive care.

Aging as a Major Risk Factor

Aging is a natural process that affects almost every part of the body, and the veins in the rectal and anal area are no exception. As we get older, the connective tissues that support these veins begin to weaken and lose elasticity. This reduced structural support makes it easier for veins to swell under pressure, which is why hemorrhoids are more common in older adults.

Over time, the vascular cushions in the anal canal—responsible for maintaining continence—start to lose their firmness. When these cushions weaken, they can slip or bulge during bowel movements, forming internal hemorrhoids. External hemorrhoids may also develop more easily because the surrounding skin and connective tissue are less resilient. Essentially, aging turns a minor strain into a more serious problem because the body is less capable of recovering from pressure and irritation.

Aging also brings lifestyle changes that increase hemorrhoid risk. Many older adults have slower digestion, chronic constipation, or mobility issues that reduce physical activity. All of these factors increase pressure on the rectal veins and make hemorrhoids more likely. Medications commonly prescribed to older adults, such as painkillers or iron supplements, can also contribute to constipation, which indirectly increases hemorrhoid risk.

It’s not just about physical changes; age-related habits like sitting for extended periods, less exercise, and less attention to hydration and fiber intake can further exacerbate the problem. Combined with weakened connective tissues, these habits make hemorrhoids more common and often more severe in older adults.

Understanding the role of aging in hemorrhoid formation emphasizes the need for proactive measures. Regular exercise, a fiber-rich diet, adequate hydration, and mindful bathroom habits become even more important as we age. While aging cannot be prevented, its impact on hemorrhoid development can be managed effectively with lifestyle adjustments and proper care.

Heavy Lifting and Hemorrhoids

Heavy lifting, whether at work or in the gym, can significantly increase the risk of developing hemorrhoids. When you lift a heavy object, you instinctively hold your breath and strain—a maneuver known as the Valsalva maneuver. This sudden increase in abdominal pressure directly impacts the veins in the rectal and anal area, causing them to swell. Repeatedly exposing your veins to this kind of pressure can lead to chronic swelling, irritation, and eventually hemorrhoid formation.

Even short bouts of intense lifting can trigger hemorrhoids if the veins are already vulnerable due to other factors like constipation, aging, or obesity. For example, someone lifting heavy boxes at a job may not notice immediate symptoms, but repeated strain over months or years weakens the vein walls. The veins lose elasticity and may bulge or prolapse, leading to both internal and external hemorrhoids.

Athletes and gym-goers are particularly at risk if they frequently lift heavy weights without proper technique. Holding the breath and straining excessively during exercises like squats, deadlifts, or overhead presses increases intra-abdominal pressure, which can aggravate existing hemorrhoids or cause new ones to form. Proper breathing techniques and pacing weightlifting sessions can mitigate this risk.

It’s not only lifting that matters—any activity that increases intra-abdominal pressure, like coughing, sneezing, or straining during bowel movements, can exacerbate hemorrhoids. However, heavy lifting is unique because it is deliberate and repeated, often compounding the risk over time.

The solution isn’t necessarily to avoid lifting altogether but to practice safer techniques. Exhaling during the lift, using supportive belts, pacing repetitions, and avoiding overexertion can help reduce the pressure on rectal veins. Understanding how lifting impacts hemorrhoid formation allows you to stay active while protecting your vascular health.

Genetics and Family History

Genetics plays a surprisingly significant role in hemorrhoid development. If your parents or close relatives have a history of hemorrhoids, you may be more susceptible to developing them yourself. While lifestyle and diet are important, inherited traits can influence the strength and elasticity of your veins and connective tissues, which are key factors in how easily hemorrhoids form.

Some people are naturally born with weaker vein walls or less supportive connective tissue in the rectal area. This makes it easier for veins to swell under pressure from constipation, straining, or prolonged sitting. Essentially, your body may be predisposed to developing hemorrhoids even if your lifestyle is relatively healthy. In these cases, small triggers—like mild constipation or occasional straining—can result in a problem more quickly than in someone with stronger veins.

Family history also plays a role in circulation patterns. Poor venous return or naturally higher pressure in the rectal veins can make hemorrhoids more likely. Genetics can even influence bowel habits indirectly; for instance, a tendency toward chronic constipation or slower digestion can increase the risk of straining, which then contributes to hemorrhoid formation.

It’s important to note that having a family history doesn’t guarantee you’ll get hemorrhoids, but it does mean you should be more vigilant. Early preventive measures, such as maintaining a high-fiber diet, staying hydrated, exercising regularly, and avoiding prolonged sitting or straining, can significantly reduce your risk.

Recognizing the role of genetics helps people understand that hemorrhoids are not a result of poor hygiene or laziness. Inherited traits combined with lifestyle factors determine susceptibility, making awareness and prevention strategies crucial—especially if you know hemorrhoids run in your family.

Anal Intercourse and Hemorrhoids

Anal intercourse can increase the risk of developing hemorrhoids due to the direct physical stress it places on the rectal veins and surrounding tissues. The anal canal is delicate, and any activity that causes repeated stretching or friction can irritate the veins, leading to swelling, inflammation, and eventually hemorrhoids.

During anal intercourse, the anal sphincter is stretched, which can weaken the support around the veins over time. Even when lubrication is used, the pressure from penetration can cause minor tears in the tissue or aggravate existing hemorrhoids. This creates inflammation, which increases the likelihood of swelling and pain. Repeated trauma, even if mild, can make the rectal veins more susceptible to forming hemorrhoids.

Another factor is straining. Some people unconsciously strain during anal intercourse, increasing intra-abdominal pressure. This mirrors the effect of straining during bowel movements, which is a primary cause of hemorrhoids. Combined with friction and irritation, the pressure further weakens the veins, making them more prone to bulging.

It’s important to note that while anal intercourse can contribute to hemorrhoid formation, it doesn’t automatically mean someone will develop them. Risks are higher if other contributing factors—such as chronic constipation, obesity, or existing vascular weakness—are present. Proper precautions, like using adequate lubrication, going slowly, and avoiding prolonged pressure, can minimize risk.

Understanding this cause helps individuals make informed decisions about sexual activity and prioritize rectal health. Open communication, gentle practices, and attention to hygiene can prevent hemorrhoid flare-ups while maintaining a healthy sexual lifestyle.

Medical Conditions That Raise Hemorrhoid Risk

Certain medical conditions can significantly increase the likelihood of developing hemorrhoids. These conditions usually affect blood flow, abdominal pressure, or bowel habits—three of the biggest factors that lead to swollen and irritated rectal veins. Understanding how these health issues contribute to hemorrhoids can help you manage symptoms more effectively and take preventive measures.

Liver Disease

Liver disease, especially cirrhosis, can cause a condition known as portal hypertension, which is increased pressure in the veins that supply the digestive organs. When the liver isn’t functioning properly, blood doesn’t flow through it efficiently. This causes pressure to build in nearby veins, including those in the rectal area. Over time, this elevated pressure can lead to swollen, engorged veins—essentially hemorrhoids.
People with liver disease often experience hemorrhoids without having typical risk factors like constipation or straining, simply because the venous pressure is abnormally high. In advanced cases, hemorrhoids may become more severe or difficult to treat because the underlying circulatory issue persists.

Chronic Coughing

Conditions that cause chronic coughing—such as asthma, COPD, bronchitis, or smoking-related lung disease—can also contribute to hemorrhoids. Every time you cough forcefully, the sudden contraction of abdominal muscles increases intra-abdominal pressure. This constant pressure repeatedly pushes against the veins in the rectum, weakening them over time.
Much like heavy lifting, chronic coughing acts like a repetitive strain on the vascular tissue. Even mild coughing, when prolonged over months or years, can stress the veins enough to cause swelling and irritation.

Digestive Disorders

Conditions like Crohn’s disease, ulcerative colitis, and IBS can also make hemorrhoids more likely. These disorders often cause chronic diarrhea, constipation, or frequent bowel movements—all triggers for rectal irritation and swelling. People with digestive disorders may also experience inflammation throughout the digestive tract, and this inflammation can amplify the irritation around the anal area.

Pelvic Tumors or Growths

Any abnormal growth in the pelvic area can compress the veins surrounding the rectum. Fibroids, ovarian cysts, or tumors can increase venous pressure and cause hemorrhoids to develop. This is similar to the pressure experienced during pregnancy, where something inside the pelvis pushes on the rectal veins.

Mobility Limitations

Medical conditions that reduce mobility—such as arthritis, stroke recovery, or spinal injuries—can indirectly contribute to hemorrhoids. Reduced movement slows digestion and increases the likelihood of constipation. Spending long periods sitting or lying down also places more pressure on the rectal area.

Understanding how these medical conditions affect hemorrhoid risk is essential for proper prevention and treatment. Addressing the underlying condition, improving diet, and adopting healthy bowel habits can help reduce the strain and prevent symptoms from worsening.

Habits That Make Hemorrhoids Worse

Certain daily habits can quietly worsen hemorrhoids, even if you’re already taking steps to manage or prevent them. These habits often seem harmless, but they create consistent pressure, irritation, or inflammation in the rectal area—making existing hemorrhoids more painful and increasing the likelihood of new ones forming. Becoming aware of these habits is a powerful step toward protecting your digestive and vein health.

Holding in Bowel Movements

Ignoring the urge to have a bowel movement is one of the most common and most damaging habits. When you delay going to the bathroom, the stool remains in your colon longer, and your body continues to absorb water from it. This makes the stool harder, drier, and more difficult to pass later. Hard stool increases the likelihood of straining, which puts intense pressure on the rectal veins.
Holding in bowel movements repeatedly can create a cycle where constipation becomes persistent, and hemorrhoids develop or worsen. Over time, the rectal muscles can become less responsive, making it even harder to have regular bowel movements. Listening to your body’s signals is essential for preventing unnecessary pressure on the veins.

Spending Too Much Time on the Toilet

It might seem relaxing or convenient to scroll on your phone, read, or take long breaks on the toilet, but this habit can worsen hemorrhoids significantly. Sitting on the toilet places the rectal area in a downward position, which causes blood to pool in the veins. The longer you sit, the more pressure builds. Even without straining, this prolonged pressure can cause the veins to swell.
Studies show that modern bathroom habits—especially using smartphones—have increased the amount of time people sit on the toilet. What used to be a quick bathroom visit has turned into a 10–20 minute session, which is more than enough time to exacerbate hemorrhoids.

Wiping Too Aggressively

When hemorrhoids are irritated or itchy, some people tend to wipe harder or more frequently, hoping to feel clean. Unfortunately, aggressive wiping can damage the thin skin around the anus and worsen inflammation. Dry or rough toilet paper compounds the irritation, making hemorrhoids more painful.
Gentle cleaning with unscented wipes or rinsing with water is much safer and reduces the risk of tearing or inflaming the tissue.

Lack of Hydration

Many people underestimate how much proper hydration affects bowel movements. Drinking too little water leads to harder stool, which increases straining. Even mild dehydration can make bowel movements more difficult, contributing to hemorrhoid flare-ups.

Poor Posture and Prolonged Sitting

Slouching or sitting for extended periods compresses the rectal veins, reducing blood flow and causing swelling. Whether you’re at a desk, driving, or lounging at home, sitting too long adds unnecessary pressure to sensitive veins.

These habits may seem small, but their cumulative effects can be significant. Making simple adjustments—responding promptly to bathroom urges, reducing toilet time, cleaning gently, staying hydrated, and taking breaks from sitting—can dramatically improve hemorrhoid symptoms and prevent future flare-ups.

How to Reduce Your Risk of Hemorrhoids

Preventing hemorrhoids doesn’t require dramatic lifestyle changes—just consistent, mindful habits that support healthy digestion and reduce pressure on the rectal veins. By adjusting your diet, improving your daily routine, and adopting healthier bathroom habits, you can significantly lower your risk of developing hemorrhoids or experiencing painful flare-ups. Prevention is always easier (and far more comfortable) than treatment.

Diet Changes

Diet is one of the most powerful tools for preventing hemorrhoids. The two biggest dietary factors are fiber and hydration.

Increase Fiber Intake:
Fiber helps soften and bulk up stools, allowing them to pass smoothly without straining. When stool moves easily, there’s less pressure on the veins in your rectum. Aim for 25–30 grams of fiber daily from foods like:

• Whole grains

• Fruits (berries, apples, pears)

• Vegetables (broccoli, carrots, leafy greens)

• Legumes (lentils, beans, chickpeas)

• Nuts and seeds

If you struggle to get enough fiber through food, fiber supplements like psyllium husk can be extremely effective.

Drink Plenty of Water:
Water works together with fiber to keep your digestive system moving. Without enough water, fiber can actually cause constipation, making hemorrhoids worse. Aim to drink at least 6–8 glasses of water a day, or more if you’re active.

Avoid Trigger Foods:
Some foods can irritate the digestive system or worsen hemorrhoids, such as:

• Spicy foods

• Excessive caffeine

• Alcohol

• Highly processed snacks

• Low-fiber fast foods

While these foods don’t directly cause hemorrhoids, they can worsen inflammation or lead to constipation and diarrhea—two major triggers.

Lifestyle Adjustments

Small, consistent changes in your daily routine can make a huge difference.

Stay Active:
Regular movement improves digestion and reduces pressure on the veins. Even simple activities like walking, stretching, or yoga help stimulate bowel function and prevent constipation.

Take Sitting Breaks:
If you sit for long periods at work or home, make it a habit to stand up and move every 30–60 minutes. Reducing pressure on the pelvic veins helps prevent swelling.

Use Proper Lifting Techniques:
When lifting heavy objects, exhale as you lift instead of holding your breath. This prevents excessive abdominal pressure that can trigger hemorrhoids.

Healthy Bathroom Habits

The bathroom is where most hemorrhoid problems begin—and where many can be avoided.

Go When You Feel the Urge:
Holding in stool allows it to become harder and more difficult to pass later. Listen to your body and avoid delaying bathroom trips.

Don’t Strain:
Straining dramatically increases pressure on rectal veins. Allow bowel movements to happen naturally. If you struggle, consider a footstool (like a Squatty Potty) to help align your colon for easier passage.

Limit Toilet Time:
Avoid using your phone, reading, or sitting on the toilet for long periods. This reduces unnecessary pressure and prevents swelling.

Be Gentle When Cleaning:
Use soft, unscented toilet paper or gentle wipes. Even better, rinse with water instead of wiping vigorously.

By implementing these prevention strategies, you can dramatically reduce your hemorrhoid risk, support smoother digestion, and maintain healthier rectal veins over the long term. These changes also help manage existing hemorrhoids and prevent painful flare-ups from returning.

Conclusion

Hemorrhoids are incredibly common, yet they remain one of the most misunderstood health issues. While many people assume they happen randomly or are caused by one specific factor, the reality is that hemorrhoids usually develop from a combination of lifestyle habits, diet choices, physical pressures, and sometimes even genetics. Understanding the root causes—such as constipation, diarrhea, straining, prolonged sitting, pregnancy, obesity, aging, and medical conditions—gives you the power to prevent them and manage symptoms more effectively.

The good news is that hemorrhoids are highly preventable. Small, consistent habits like drinking enough water, eating a fiber-rich diet, staying physically active, and listening to your body’s natural bathroom signals can make a world of difference. Equally important is avoiding behaviors that worsen the condition, like sitting too long on the toilet, straining, or wiping aggressively. These minor adjustments can drastically reduce your discomfort and keep your digestive system functioning smoothly.

Whether you’re currently dealing with hemorrhoids or simply trying to prevent them, the key is awareness and proactive care. When you understand what causes hemorrhoids and how your everyday choices impact your health, you can protect your body from unnecessary pain and irritation. With mindful habits and a supportive lifestyle, you can keep your rectal veins healthy and avoid the discomfort that hemorrhoids bring.

FAQs

1. Can hemorrhoids go away on their own?

Yes, mild hemorrhoids often go away on their own with proper self-care, including hydration, increased fiber intake, and avoiding straining. More severe cases may require medical treatment.

2. Does sitting on cold surfaces cause hemorrhoids?

No, this is a myth. Cold surfaces don’t cause hemorrhoids—pressure, straining, and poor circulation do. However, sitting too long on any surface can contribute to hemorrhoids.

3. Are hemorrhoids dangerous?

Hemorrhoids themselves aren’t dangerous, but they can cause discomfort, bleeding, and irritation. In rare cases, severe or untreated hemorrhoids may lead to complications that require medical attention.

4. Can exercise make hemorrhoids worse?

Some activities, like heavy lifting, can worsen hemorrhoids, but most forms of exercise—walking, swimming, yoga—actually help prevent them by improving circulation and digestion.

5. What is the best sleeping position for hemorrhoids?

Sleeping on your side can reduce pressure on the rectal veins. Avoid sleeping on your back if hemorrhoids are painful or swollen.