How do you get haemorrhoids? And how to prevent them

Last updated:
Reviewed by:
Dr Bryony Henderson, Lead GP at Livi
Painful bottom
This pain in the bottom is very common. Here’s why haemorrhoids (piles) happen and how to prevent them

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Haemorrhoids (or piles) happen when the blood vessels in or around the opening of your bottom become inflamed and swollen. This is why you might feel pain, itchiness or lumps around your bottom.

Piles are more common than you’d think. Anywhere between 5-37% of us will experience symptoms at some point in our lives. The number of people is so wide-ranging as experts have found it difficult to get the exact data. This is probably because the symptoms can range so much and because some of us might not seek help due to embarrassment.

How do you get haemorrhoids in the first place?

You might be surprised to learn that we all have haemorrhoids. They are lines of tissue and blood vessels close to the opening of your anus. They’re useful because they help us sense what’s in your rectum (the last few inches of your large intestine before it reaches the anus).

They help you feel whether the pressure you’re feeling in your bottom is gas, a normal poo or potentially diarrhoea. Haemorrhoids also help to form a seal within your anus that keeps it closed. In other words, they help to keep your poo in until you’re ready to go.

The problem happens when your haemorrhoids become inflamed or enlarged, usually when we strain or put pressure on them. This causes those uncomfortable symptoms – including burning, itching, swelling and bleeding.

Your chances of getting piles increases, if:

  • You regularly strain your bottom while pooing
  • You have long-term diarrhoea or constipation
  • You sit down for long periods of time
  • You do lots of heavy lifting

What’s the difference between internal and external haemorrhoids?

Haemorrhoids can be either internal (when they're located further inside the anus) and external (when they're very close to the anal opening).

External haemorrhoids are rare and tend to occur suddenly. They might hang down or come out of your anus, and they can be very painful.

Piles are also graded according to whether they come out and how far they come out of your anus. First-degree piles may be inside and you might see some bleeding, while fourth-degree piles hang down from your anus and can become swollen and painful if the blood clots inside them.

Most importantly, don’t worry. There are treatments available for all types of haemorrhoids.

What should I do if I have symptoms of haemorrhoids?

If you have symptoms of piles, speak to a pharmacist who can provide over-the-counter medication. If you’re in pain and your symptoms have lasted over a week, speak to a doctor who will be able to help.

It’s always worth finding out whether your symptoms are haemorrhoids or something more serious. You can also discover more about medication and treatments.

How to prevent haemorrhoids

The best way to swerve the pain and discomfort of haemorrhoids is to prevent them happening in the first place.

The good news is that there are simple lifestyle habits that can help. Here are 6 ways to lower your risk:

1. Don’t sit too long

Sitting down for long periods on a regular basis, whether for work or when relaxing, can put pressure on your bottom and worsen haemorrhoid symptoms.

Experts now warn against sitting on the toilet for too long. This can put strain on the blood vessels around your anus. If you feel like you’ve got more to go but it’s not coming, rather than sitting and straining, try getting up and coming back later.

If you tend to sit on the toilet for longer, try leaving your phone in a different room so you’re not tempted to sit and scroll.

2. Eat plenty of fibre

Piles are more likely to happen if you don’t poo regularly. How often you should poo differs for everyone, but around one poo a day is a good guide. Not sure what a healthy poo looks like? Check out our guide.

An easy way to become more regular is by eating more fibre – experts recommend around 30g a day. But you don’t need to count, try adding a little more fibre to every meal:

  • Breakfast – try high-fibre cereal, oats and fruit
  • Lunch – try whole grain bread and vegetables like carrots, broccoli, peppers and spinach
  • Dinner - try pulses like lentils, whole grain rice or pasta and leafy vegetables

3. Drink more water

Staying hydrated is key for having healthy poos. Drinking enough water can make our stools sofer, help to prevent constipation and therefore decrease straining and the risk of getting piles. Aim for 6-8 glasses of water each day, and it will benefit your whole body too.

4. Try a poo stool

New research is showing that how you sit on the toilet matters. Using a footstool (scientifically known as a ‘defecation postural modification device’) under your feet while sitting on the toilet changes the angle of your sitting. Sitting in more of a squatting position – where your knees are raised above your hips – is proven to reduce strain and help you poo more easily.

5. Try to go when you feel the urge

The longer a poo sits in your colon, the more dehydrated it becomes and the more difficult it is to pass. As soon as you feel the urge to poo, try to head to the toilet as soon as possible.

6. Keep it moving

Getting active helps to keep your bowel movements regular and means you’ll generally spend less time sitting down, which can put pressure on the blood vessels in your bottom. Walking, jogging, yoga or swimming are all great exercises to introduce into your routine.

However, certain exercises can make the problem worse. If you’re prone to piles or worried about symptoms, try to avoid activities that increase pressure on sensitive areas or cause straining like heavy weight lifting, cycling or horse riding.

When should I speak to a doctor about haemorrhoids?

If you have any symptoms of piles like burning, bleeding, pain or itching around your anus, speak to a pharmacist or doctor.

Always speak to a doctor if:

  • You’re in severe pain – it’s painful to sit down or go to the toilet
  • There’s blood in your poo, from bright red through to black
  • You’ve have persistent abdominal pain
  • You have unexplained weight loss
  • There's any change in your normal bowel habit

This article has been medically approved by Dr Bryony Henderson, Livi Lead GP.

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