What are haemorrhoids?
Haemorrhoids, or “piles”, are swellings located inside or around the anus/rectum. They contain enlarged blood vessels and may bleed. If you think you have piles it is important to consult your doctor so that any appropriate treatment can be administered and they can check that there is nothing more sinister at play.
Symptoms may include:
- An itchy bottom
- Bleeding after going to the toilet
- A lump hanging down after passing a stool
- Mucus discharge after passing a stool
- Soreness, redness or swelling around your anus.
Often piles will be painless, but an interruption of the blood supply may trigger some pain.
Interestingly haemorrhoids themselves are actually part of our anatomy. However, we tend to only hear about them when they have become inflamed and problematic, hence the name has become synonymous with the problem.
Taking time on the toilet
While the exact cause of haemorrhoids has not yet been identified, taking more than 15 minutes on the toilet may well contribute to the development or worsening of piles. This is why taking reading material etc with you can be a problem as you may lose your sense of time. The pressure of trying to ‘go’ for this length of time affects the tissues and blood vessels in the rectum, as does the posture we tend to adopt.
Of course, there is more to spending too long on the toilet than reading. If you need to spend so long passing a stool it is likely to be a sign of constipation. If nothing is happening within 15 minutes (ideally it will happen in less time than that!), you may well be better off giving up and trying again later.
You may also find it helpful to raise your knees while sitting on the toilet to put you in more of a squatting position (for example, by borrowing your child’s toilet step if you have one). It is thought that this helps the alignment of the colon making it easier to pass stools.
There are people who unfortunately suffer with diarrhoea, which results in more trips to the toilet than normal. This increased frequency may also contribute to haemorrhoids.
Other possible contributors
Besides, prolonged sitting, constipation and diarrhoea, other possible causes of piles include:
- Excess weight
- Hypertension (high/raised blood pressure)
- Picking up and carrying a heavy load
- Pregnancy
- Low collagen (an association has been identified between Ehlers-Danlos syndrome and haemorrhoids).
It may be that a combination of factors contributes to the problem, rather than one specific factor.
Soften your stools through diet
If you suffer with haemorrhoids, it is helpful to keep your stools soft. This can be helped by ensuring you are hydrated and consuming plenty of soluble fibre. This fibre helps to draw water into the stool to keep it soft. You get this simply by eating fruit, green leafy vegetables, beans, oats and seeds.
Soluble fibre also acts as a prebiotic and feeds your ‘good’ bacteria, as well as being associated with lower risks of type 2 diabetes, heart disease and obesity.
You may find that increasing your fruit consumption helps to ease constipation as a result of the sugar sorbitol helping to draw water into the gut. Prunes, apple juice and pear juice are particularly good sources.
Magnesium is also a useful nutrient for helping to keep stools soft – green vegetables are a great source of this, as well as the soluble fibre. Magnesium can also be found in good quality dark chocolate, avocadoes and nuts (almonds, cashews and Brazil nuts in particular). You may also want to try relaxing in a bath containing Epsom salts believed to be a good source of transdermal magnesium. The relaxation itself may even help you to pass stools more easily. This link includes instruction on using Epsom salts for haemorrhoids without bathing: https://www.healthline.com/health/epsom-salt-for-hemorrhoids
Keep it moving
While soluble fibre helps to keep stools soft, insoluble fibre can also help to keep your digestion moving. You will find it in vegetables and grains. We should aim for around 30g of total fibre per day, but many of us will only get half this amount. If you do need to increase your fibre intake it is best to do this slowly to reduce your risk of unwanted gas and flatulence.
However, think about your fibre intake if you are experiencing constipation and don’t simply add more – too much may compound the problem!
Keeping yourself active may help constipation – if you have a sedentary lifestyle try to go for a couple of short walks each day, if a longer walk is not an option.
Slow it down
If you have the opposite problem in the form of diarrhoea, there are dietary interventions that may help you until the cause has been resolved.
- Ensure you keep yourself hydrated with up to 2 litres of fluid per day – you could include soup or broth in your fluid intake.
- Depending on your appetite, aim to eat smaller, more frequent meals each day rather than a few large meals. Try to include sources of fibre to help firm up your stools, although you may find some fibrous foods could worsen it!
- Try to avoid sugary foods, including smoothies, and fried or fatty foods as these are thought to make diarrhoea worse.
This article by the GI Society includes helpful tables setting out foods which you may be able to tolerate, and foods that commonly make symptoms worse: https://badgut.org/information-centre/health-nutrition/diarrhea-and-diet/
References/Further Reading
Review of Hemorrhoid Disease: Presentation and Management – Sun and Migaly. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4755769/
