Maybe we don't talk about them a lot, but they're not all that uncommon.
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Hemorrhoids — swollen veins around the anus — affect one in 20 adults in the U.S., according to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). And they're something else, leaving you with uncomfortable or painful lumps around your anus or intrusive itchiness (and it's not exactly polite to scratch in public).
These bulges can either form under the skin around the anus (called external hemorrhoids) or in the lining of the anus and lower rectum (called internal hemorrhoids), says the NIDDK.
"Hemorrhoids are a dilation of the veins in the anus. It may be caused by increased pressure against those veins, that causes them to engorge or get bigger," Jacqueline Wolf, MD, a gastroenterologist at Beth Israel Deaconess Medical Center in Boston, tells LIVESTTRONG.com.
There are big life events that make you more prone to hemorrhoids, like pregnancy and childbirth, according to a May 2014 study in BJOG. But smaller, daily habits can also increase the risk of these bulges. In short: If you're straining, you could develop hemorrhoids as a result, Dr. Wolf says. Here's what might be going on:
1. You’re Doing a Lot of Heavy Lifting
Whether it's part of your job or your workout goals, lifting heavy weights can contribute to the straining that may lead to hemorrhoids, Dr. Wolf says. If you're adding weight to your exercise routine, you'll want to make sure that as you're increasing the weights you're using, you're also focused on proper form so that your target muscles are bearing the load — and you're not straining unintentionally. If you're doing heavy lifting at work, be sure to follow the safety regulations outlined by your employer.
2. You’re Taking Long Plane Rides
While there's not a study that evaluates the risk of developing hemorrhoids following long plane travel, Dr. Wolf says she often sees patients who've experienced just this. The increased pressure from prolonged sitting may contribute to the condition, she says.
3. You're Not Treating Your Constipation
When you're constipated, you might be spending a long time on the toilet in an attempt to push through a bowel movement. All that "trying to go" might actually mean bearing down hard and — you guessed it — straining.
People who consume fewer than 12 grams of fiber per day and less than two liters of water per day (about 68 ounces) are more likely to have internal hemorrhoids because these dietary habits contribute to constipation, per a small April 2019 study in La Tunis Médicale.
People who are constipated are advised to consume more high fiber foods (or a fiber supplement) and drink more water for an easier go, Dr. Wolf says. If it's a common problem for you, she also recommends using a toilet stool, which raises your feet and knees up to a more comfortable squat position.
4. You're Not Treating Your Diarrhea
This may be surprising, but diarrhea is also associated with straining, Dr. Wolf says. While going to the bathroom, you're likely making more of an effort to propel all the liquid or loose stools out.
If diarrhea is a chronic problem for you, you should talk to your doctor who may want to do an exam to rule out causes of diarrhea like irritable bowel syndrome (IBS) or inflammatory bowel syndrome (IBD), Dr. Wolf says.
5. You're Sitting On the Toilet for Too Long
If you're hanging in the bathroom for a long time because pushing to go takes a lot of effort, then that straining may lead to hemorrhoids. Spending even 10 minutes struggling to go could be too long, Dr. Wolf says. If you can't go right then, then get up and try again later.
That said, if you're hanging out on the toilet as an escape or for fun — a curiously common habit — you might be in the clear. Dr. Wolf points to a older March 2009 study in Neurogastroenterology & Motility that found while about half of adults admitted to "toilet reading," it was not significantly linked to a greater increase in hemorrhoids. What matters most is if you're actually straining while spending time locked away in the loo.
6. You're Holding In Your Poop
When you gotta go … you gotta go. Or, at least, that's the best option. If the urge comes and goes — whether you're not in a comfortable place to have a BM or there's nowhere available — you delay using the bathroom. But, despite your best efforts, now you can't go and you're sitting there straining. Again, it's the increased pressure associated with straining here that makes deferring a BM a possible risk for hemorrhoids, Dr. Wolf says. While it's not always possible, it's in your best interest to use the bathroom as soon as you feel the urge to do so.
Is This an Emergency?
- National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK): “Symptoms and Causes of Hemorrhoids”
- BJOG: “Haemorrhoids and anal fissures during pregnancy and after childbirth: a prospective cohort study”
- La Tunisie médicale: “Dietary habits associated with internal hemorrhoidal disease: a case-control study”
- Neurogastroenterology & Motility: “Toilet reading habits in Israeli adults”