Why Hemorrhoids Develop: Causes & Risk Factors

Why Hemorrhoids Develop: Constipation, Straining, Diet and Other Risk Factors

If you have ever wondered why hemorrhoids develop, the answer is usually not one single cause. Hemorrhoids are swollen veins and supporting tissues around the anus and lower rectum, and several factors can increase pressure or irritation in this area.

Constipation, straining during bowel movements, low-fiber diets, prolonged toilet sitting, pregnancy, aging, and other factors can contribute to hemorrhoid symptoms. Understanding these risk factors is useful because some can be modified through everyday lifestyle and bowel-habit changes.

Hemorrhoids are common, but experiencing rectal bleeding, pain, or a lump does not automatically mean that hemorrhoids are the cause. Other conditions can produce similar symptoms, so persistent or unexplained symptoms should be evaluated by a healthcare professional. (niddk.nih.gov)

This guide explains why hemorrhoids develop, which factors can increase your risk, how constipation and straining contribute, and what you can do to support healthier bowel habits.

What Are Hemorrhoids?

Hemorrhoids are swollen veins in the lower rectum or around the anus. They are normal structures that help support the anal canal, but they can become enlarged, irritated, or symptomatic. (niddk.nih.gov)

There are two main types.

Internal Hemorrhoids

Internal hemorrhoids develop inside the rectum.

They may cause bright-red rectal bleeding, particularly during or after bowel movements. They can also become prolapsed, meaning the hemorrhoidal tissue extends through the anal opening. (niddk.nih.gov)

External Hemorrhoids

External hemorrhoids develop underneath the skin around the anus.

They may cause:

•  Pain

•  Itching

•  Swelling

•  Irritation

•  A noticeable lump

•  Tenderness

A blood clot can sometimes form inside an external hemorrhoid, creating a thrombosed external hemorrhoid, which can cause sudden and significant pain.

Why Hemorrhoids Develop?

Hemorrhoids can develop when the tissues and veins around the anus and lower rectum experience increased pressure or become weakened over time.

Several factors can contribute.

Not everyone exposed to these factors develops hemorrhoids. However, understanding them can help identify habits or conditions that may be contributing to your symptoms.

Constipation and Hemorrhoids: Why the Connection Matters

Constipation is one of the most important factors associated with hemorrhoid symptoms.

When stool becomes hard, dry, or difficult to pass, you may need to push harder during a bowel movement.

That repeated pressure can contribute to swelling and irritation of hemorrhoidal tissue.

Constipation can also create a cycle:

Low fiber → harder stool → straining → increased pressure → hemorrhoid irritation → painful bowel movements → altered bowel habits.

Breaking this cycle is an important part of hemorrhoid prevention.

What Causes Constipation?

Constipation can have several causes, including:

•  Not eating enough fiber

•  Inadequate fluid intake

•  Physical inactivity

•  Ignoring the urge to have a bowel movement

•  Changes in routine

•  Certain medications

•  Some medical conditions

•  Pregnancy

•  Dietary changes

If constipation is persistent, it is important to identify the underlying cause rather than simply treating each episode individually.

How Straining Contributes to Hemorrhoids?

One of the most common answers to why hemorrhoids develop is repeated straining during bowel movements.

Straining increases pressure inside the abdomen and around the veins of the rectal area.

Occasional straining may not necessarily cause hemorrhoids by itself. The concern is repeated or excessive straining, particularly when it occurs alongside chronic constipation.

If you regularly have to push hard to pass stool, consider it a signal that your bowel habits need attention.

How to Reduce Straining?

You can often reduce the need to strain by:

•  Eating more fiber

•  Drinking adequate fluids

•  Staying physically active

•  Responding to the urge to have a bowel movement

•  Avoiding prolonged toilet sitting

•  Addressing persistent constipation with professional guidance

The goal is not to force a bowel movement. Healthy bowel movements should generally pass without prolonged or excessive pushing.

How Diet Can Affect Hemorrhoid Risk?

Diet does not directly "cause" every hemorrhoid.

However, dietary patterns can influence bowel consistency and constipation, which can affect hemorrhoid risk.

A diet low in fiber may make it more difficult to produce soft, easy-to-pass stools.

Low-Fiber Diets

Fiber helps add bulk to stool and can make bowel movements easier.

If your diet contains mostly refined grains, highly processed foods, and other low-fiber choices, you may not get enough fiber to support regular bowel movements.

High-fiber foods include:

•  Fruits

•  Vegetables

•  Beans

•  Lentils

•  Whole grains

•  Oats

•  Nuts

•  Seeds

NIDDK recommends increasing dietary fiber as part of hemorrhoid management and prevention. (niddk.nih.gov)

How Much Fiber Do You Need?

General recommendations for adults are commonly around 22 to 34 grams of fiber per day, depending on age and sex. (niddk.nih.gov)

Your individual needs may differ.

If you currently consume little fiber, increase it gradually. A sudden increase can cause gas, bloating, or abdominal discomfort.

Hydration and Hemorrhoids

Adequate fluid intake can support softer stools, particularly when combined with adequate dietary fiber.

When stool is hard and difficult to pass, increasing fiber alone may not be enough.

Drink fluids regularly throughout the day according to your individual health needs.

People with certain medical conditions may have specific fluid restrictions, so follow your healthcare professional's recommendations if applicable.

Can Sitting on the Toilet Cause Hemorrhoids?

Spending too much time on the toilet can increase pressure on the anal area.

This is one reason healthcare professionals commonly recommend avoiding prolonged toilet sitting as part of hemorrhoid prevention. (niddk.nih.gov)

The problem often occurs when people combine prolonged sitting with:

•  Reading

•  Using a smartphone

•  Waiting for a bowel movement

•  Repeatedly straining

A simple habit can help: go when you need to, avoid unnecessary sitting, and leave when you are finished.

Pregnancy and Hemorrhoids

Pregnancy can increase the likelihood of developing hemorrhoids.

As pregnancy progresses, the growing uterus can increase pressure in the pelvic region. Hormonal changes can also affect digestion and contribute to constipation.

Straining during bowel movements can further increase pressure around the rectal area.

Hemorrhoids can also become more noticeable around childbirth.

Fortunately, many pregnancy-related hemorrhoid symptoms improve after delivery. However, persistent or severe symptoms should still be evaluated.

If you are pregnant, consult your obstetrician, midwife, or another qualified healthcare professional before using hemorrhoid medications.

Aging and Hemorrhoid Risk

Age is another factor associated with hemorrhoids.

The tissues that support the veins in the rectum and anus can become weaker over time.

As this supporting tissue becomes less resilient, the hemorrhoidal structures may be more likely to enlarge or prolapse.

This is one reason hemorrhoid symptoms can become more common as people get older.

Aging is not something you can prevent, but healthy bowel habits can help reduce avoidable pressure and straining.

Can Heavy Lifting Cause Hemorrhoids?

Heavy lifting can temporarily increase pressure within the abdomen.

Repeated heavy lifting or lifting while holding your breath and straining may contribute to pressure around the rectal area.

This does not mean that everyone with hemorrhoids needs to stop strength training.

Instead:

•  Use appropriate lifting technique.

•  Avoid unnecessary breath-holding.

•  Avoid lifting beyond your ability.

•  Increase weight gradually.

•  Discuss exercise limitations with a healthcare professional if you have significant hemorrhoid symptoms.

Physical Inactivity and Hemorrhoids

A sedentary lifestyle can contribute indirectly to hemorrhoid risk.

Physical activity supports overall health and can help promote healthy bowel function.

If you spend much of your day sitting, consider adding movement throughout the day.

Simple options include:

•  Walking

•  Stretching

•  Taking movement breaks

•  Walking after meals

•  Using stairs when appropriate

•  Participating in regular moderate exercise

You do not need an extreme workout routine to support healthier bowel habits.

Obesity and Hemorrhoid Risk

Higher body weight may be associated with increased pressure in the abdominal and pelvic regions.

Maintaining a healthy weight through balanced nutrition and regular physical activity can support overall health and may reduce some factors associated with hemorrhoid symptoms.

Weight management should focus on sustainable lifestyle habits rather than restrictive or extreme diets.

If you are concerned about your weight or digestive health, consider discussing an appropriate approach with your healthcare professional.

Chronic Diarrhea Can Also Irritate Hemorrhoids

Hemorrhoids are often discussed in connection with constipation, but frequent diarrhea can also contribute to anal irritation.

Repeated bowel movements can increase friction and irritation around the anus.

Chronic diarrhea can have many possible causes, including infections, food intolerances, medications, inflammatory bowel disease, and other gastrointestinal conditions.

If diarrhea persists, treating the underlying problem is more useful than simply treating the resulting anal irritation.

Does Ignoring the Urge to Go Cause Hemorrhoids?

Repeatedly ignoring the urge to have a bowel movement may contribute to constipation in some people.

When stool remains in the colon for longer periods, more water can be absorbed from it, potentially making the stool harder and more difficult to pass.

That can increase the likelihood of straining.

Whenever practical, respond to your body's natural urge to use the bathroom.

Why Do Hemorrhoids Develop During Pregnancy?

Pregnancy brings together several risk factors.

These can include:

•  Increased pelvic pressure

•  Hormonal changes

•  Constipation

•  Straining

•  Changes in physical activity

•  Increased pressure from the growing uterus

This combination can make hemorrhoids more likely during pregnancy, particularly later in pregnancy.

Pregnancy-related hemorrhoids are often managed conservatively, but significant bleeding or severe pain should be discussed with a healthcare professional.

Are Hemorrhoids Genetic?

There may be a hereditary component to the tendency to develop hemorrhoids, particularly because some people may inherit differences in connective tissue or venous structure.

However, having a family member with hemorrhoids does not mean that you will definitely develop them.

Lifestyle and bowel habits can still influence your individual risk.

Other Possible Hemorrhoid Risk Factors

Beyond constipation and straining, several other circumstances may contribute to hemorrhoid development or symptoms.

▸  Previous Hemorrhoids

Once you have experienced hemorrhoids, symptoms can return.

This makes long-term bowel and lifestyle habits particularly important.

▸  Prolonged Sitting

People who spend many hours sitting for work or other activities may experience increased pressure around the pelvic and anal region.

Breaking up long periods of sitting with movement can support overall health.

▸  Pregnancy

As discussed earlier, pregnancy can increase pelvic pressure and constipation risk.

▸  Chronic Constipation

Long-term constipation can repeatedly expose hemorrhoidal tissue to hard stools and straining.

▸  Frequent Diarrhea

Repeated bowel movements can cause irritation around the anus.

▸  Heavy Lifting

Repeated heavy lifting with significant straining may increase abdominal pressure.

Hemorrhoids vs. Other Causes of Anal Symptoms

One of the most important things to understand is that not every anal symptom is caused by hemorrhoids.

Anal fissures, abscesses, fistulas, inflammatory bowel disease, infections, and other conditions can produce pain, bleeding, swelling, or changes in bowel habits.

For example, an anal fissure can cause sharp pain during bowel movements and bright-red bleeding.

A healthcare professional can help determine the actual cause.

This is particularly important if symptoms:

•  Are new

•  Are severe

•  Keep returning

•  Are worsening

•  Do not improve with home care

•  Include significant bleeding

•  Are accompanied by fever or abdominal symptoms

Can Hemorrhoids Be Prevented?

There is no way to guarantee that hemorrhoids will never develop.

However, you can reduce several modifiable risk factors.

Focus on Healthy Bowel Habits

Try to:

•  Eat enough fiber

•  Drink adequate fluids

•  Avoid straining

•  Avoid prolonged toilet sitting

•  Respond to the urge to have a bowel movement

•  Stay physically active

•  Address constipation early

•  Manage persistent diarrhea

These habits can support regular, easier bowel movements and reduce unnecessary pressure on the anal area.

A Daily Routine for Reducing Hemorrhoid Risk

A simple daily routine can help turn prevention into a habit.

Morning

Start with a fiber-rich breakfast and adequate fluids.

For example:

Oatmeal + fruit + seeds + water

During the Day

Include vegetables, fruits, whole grains, and legumes in your meals.

Take regular movement breaks if you work at a desk.

Bathroom Habits

When you feel the urge to go:

Go → avoid straining → avoid prolonged sitting → finish and leave.

Evening

Review your meals and bowel habits.

If you are consistently constipated, don't simply accept it as normal. Discuss persistent constipation with a healthcare professional.

A Simple Comparison: Risk Factor vs. Prevention Strategy

When Should You See a Doctor About Hemorrhoids?

Mild hemorrhoid symptoms can sometimes improve with lifestyle and bowel-habit changes.

However, professional evaluation is appropriate when symptoms persist or become significant.

See a healthcare professional if you experience:

•  Recurrent rectal bleeding

•  Significant anal pain

•  A painful or swollen lump

•  Hemorrhoids that repeatedly prolapse

•  Symptoms that do not improve with home treatment

•  Persistent changes in bowel habits

•  Unexplained weight loss

•  Fever

•  Severe or worsening symptoms

NIDDK recommends seeking medical care for rectal bleeding and for hemorrhoid symptoms that do not improve after home treatment. (niddk.nih.gov)

When Is Rectal Bleeding an Emergency?

Rectal bleeding should not automatically be attributed to hemorrhoids.

Seek prompt medical attention for heavy or severe rectal bleeding, particularly when it occurs with severe anal pain, abdominal pain, diarrhea, or fever. (niddk.nih.gov)

If you are unsure about the source of bleeding, it is safer to have it evaluated rather than repeatedly treating yourself for presumed hemorrhoids.

Can Lifestyle Changes Get Rid of Hemorrhoids?

Lifestyle changes can help reduce symptoms and prevent some contributing factors, particularly when constipation and straining are involved.

However, lifestyle changes may not eliminate larger or advanced hemorrhoids.

For persistent or severe hemorrhoids, treatment options may include:

•  Conservative management

•  Medication

•  Rubber band ligation

•  Sclerotherapy

•  Infrared coagulation

•  Other office-based procedures

•  Surgical treatment for selected cases

The appropriate option depends on the type, severity, symptoms, and individual circumstances. (niddk.nih.gov)

Frequently Asked Questions (FAQ's):

Q. Why do hemorrhoids develop?

Hemorrhoids can develop when veins and supporting tissues around the anus and lower rectum become swollen or enlarged. Constipation, straining, pregnancy, aging, prolonged toilet sitting, and other factors can contribute.

Q. Does constipation cause hemorrhoids?

Constipation can contribute to hemorrhoids because hard stools may require repeated straining. Addressing constipation is an important part of hemorrhoid prevention.

Q. Can straining cause hemorrhoids?

Repeated or excessive straining increases pressure around the rectal and anal veins and can contribute to hemorrhoid symptoms.

Q. Can a low-fiber diet cause hemorrhoids?

A low-fiber diet can contribute to harder stools and constipation, which may increase the need to strain. A fiber-rich diet can support softer, easier-to-pass stools.

Q. How much fiber should I eat to prevent hemorrhoids?

General adult recommendations are approximately 22–34 grams of fiber per day, depending on age and sex. Individual needs may differ. (niddk.nih.gov)

Q. Does drinking water prevent hemorrhoids?

Adequate hydration supports healthy bowel function and can help fiber work effectively. However, hydration alone cannot guarantee hemorrhoid prevention.

Q. Can sitting on the toilet too long cause hemorrhoids?

Prolonged toilet sitting can increase pressure around the anal area and may contribute to hemorrhoid symptoms. Limiting toilet time is recommended as part of prevention. (niddk.nih.gov)

Q. Can pregnancy cause hemorrhoids?

Yes. Pregnancy can increase pelvic pressure and may contribute to constipation and hemorrhoid development, particularly later in pregnancy.

Q. Can heavy lifting cause hemorrhoids?

Heavy lifting involving significant straining can increase abdominal pressure. Using proper technique and avoiding excessive strain may help reduce this contributing factor.

Q. Can diarrhea cause hemorrhoids?

Frequent diarrhea can irritate the anal area and may worsen hemorrhoid symptoms. Persistent diarrhea should be evaluated to determine its underlying cause.

Q. Why do my hemorrhoids keep coming back?

Recurring hemorrhoids can be associated with ongoing constipation, straining, prolonged toilet sitting, pregnancy, diarrhea, or other individual factors. Persistent recurrence may require professional evaluation.

Q. Can hemorrhoids develop because of aging?

Yes. The supporting tissues around the anal and rectal veins can weaken with age, potentially increasing the likelihood of hemorrhoids.

Q. Are hemorrhoids caused only by diet?

No. Diet is only one potential factor. Constipation, straining, pregnancy, aging, prolonged sitting, physical activity patterns, and other factors can also contribute.

Q. When should I see a hemorrhoid specialist?

Consider specialist evaluation if hemorrhoids are persistent, recurrent, painful, bleeding frequently, prolapsing, or interfering with daily activities. A specialist can determine whether hemorrhoids are responsible and discuss appropriate treatment.

Final Thoughts: Understanding Why Hemorrhoids Develop

Understanding why hemorrhoids develop is the first step toward reducing the factors that may contribute to them.

Constipation and straining are two of the most important modifiable factors to address. A diet rich in fiber, adequate fluid intake, regular physical activity, shorter toilet sessions, and healthier bowel habits can all support easier bowel movements and reduce unnecessary pressure around the anal area.

But hemorrhoids are not always caused by something you did wrong. Pregnancy, aging, anatomy, medical conditions, and other factors can also play a role.

If symptoms keep returning despite lifestyle changes, don't simply continue treating each flare-up at home. Persistent bleeding, severe pain, recurrent prolapse, or other concerning symptoms deserve professional evaluation.

Get Professional Hemorrhoid Care in Arizona

If you are dealing with recurring hemorrhoids or are unsure what is causing your symptoms, professional evaluation can help you understand the problem and your available treatment options.

The Hemorrhoid Center of Arizona provides hemorrhoid-focused care for patients throughout Scottsdale, Peoria, Phoenix, Glendale, Mesa, Tempe, Gilbert, and the Greater Phoenix area.

Whether your symptoms are occasional or recurring, getting the right diagnosis can help you move beyond temporary symptom relief and toward a treatment approach suited to your condition.

Don't keep guessing why your hemorrhoids keep coming back. Contact the Hemorrhoid Center of Arizona to discuss your symptoms and explore appropriate care options.

Medical disclaimer: This article is intended for general educational purposes and does not replace professional medical diagnosis, treatment, or individualized advice. Rectal bleeding, severe pain, or persistent bowel changes should be evaluated by a qualified healthcare professional.