Fun fact: Everyone has hemorrhoids — they’re actually a normal part of your anatomy. It’s when they become inflamed or irritated that you start to have the symptoms people usually associate with hemorrhoids.
There are two types of hemorrhoids: internal and external. With internal hemorrhoids, the most common problem is irritation that causes bleeding, and prolapse, which means they “drop” out of the rectum.
External hemorrhoids are under the skin around the anus, and they tend to be the biggest source of complaint because they can become painful and swollen.
“Hemorrhoids are simply veins that serve a function, which is providing blood flow to that area,” says Mitchell Bernstein, M.D., director in the division of colon and rectal surgery at New York University’s Langone Health. “Unfortunately, because of where they’re located, problems can occur due to factors like pressure and digestive health.”
Fortunately, he notes, many of those factors can be controlled through some minor lifestyle changes. Here are five simple strategies that can help prevent hemorrhoids from becoming a problem:
1. Go when you have to go.
While there are certainly times when it’s not convenient to relieve yourself, waiting too long to poop can make your stools harder to pass, and that might lead to the top reason for hemorrhoid concerns: straining and pushing.
Part of the colon’s function is to remove water from fecal matter, according to Heather Bartlett, M.D., a family practice physician in Columbus, Ohio. If you’re adhering to your body’s signals and evacuating when it’s go time, then your ratio of water-to-fecal-matter is usually just right. But the longer you wait, the more water gets removed, and that firms up stools over time.
Dr. Bartlett says that the resulting, more compact stool is more likely to cause fissures or tears that could expose both internal and external hemorrhoids, and straining could then prompt inflammation.
2. Avoid the snooze button.
Sleep and digestion work together, according to W. Chris Winter, M.D., author of “The Sleep Solution: Why Your Sleep is Broken and How to Fix It.” They both rely on circadian rhythms to stay on track, and when one gets derailed, the other is often affected.
When you wake up, your body starts peristalsis, a series of wave-like muscle contractions that help food to progress through the digestive tract. That’s why many people tend to poop in the morning, Dr. Winter says, particularly after having coffee — a beverage that can have a stimulating effect on the colon and promote peristalsis.
If you’re snoozing through that first block of wake-up time, though, it might begin to change your body’s signals, Dr. Winter says. When that happens, you’re more likely to feel constipated and resort to straining, potentially creating painful hemorrhoids.
3. Get in, do your business, and get out.
Before smartphones, Dr. Bernstein used to tell patients: “Don’t make your bathroom into a library.” Now, he’s had to modernize his advice to: “Leave your devices outside in the hallway.”
That’s because sitting on the toilet for longer than necessary creates downward pressure that makes hemorrhoids more likely, he says. The shape of the toilet bowl, coupled with slightly spread buttock cheeks, causes a mild form of suction.
That’s not a problem if you’re only there for a few seconds, but if you’re trying to catch up on emails or your Facebook feed, that suction builds up and causes blood to pool in the veins, notes Dr. Bernstein. The pressure then adds inflammation into the mix.
4. Drink more water.
Eating more fiber in the form of vegetables, fruits, and whole grains is always a good idea, says Dr. Bartlett, but also be sure you’re getting the hydration you need to go along with that increased fiber intake.
“Hydration helps every part of your digestive system,” she says. “It keeps your intestines lubricated, it makes that fiber easier to pass, and it shortens the transit time from colon to toilet bowl.”
Anything that makes your poop more pliable is a good thing, she adds, because then it will pass out of your system more efficiently, and without much effort.
5. Increase exercise gradually.
In his practice, Dr. Bernstein often sees “weekend warriors” who’ve decided to get a week’s worth of gym time into one afternoon — doing multiple sessions of squats, lifting heavy weights, or getting gung-ho with the leg presses.
The sudden pressure of pushing, especially if you’re holding your breath or exhaling with your mouth closed, can increase intra-abdominal pressure and cause those hemorrhoid veins to become inflamed. You can prevent the situation by warming up with lighter weight sets first, focusing on proper breathing (exhale with mouth open during exertion), and taking breaks when needed, Dr. Bernstein advises.
Of course, you may do all this and get hemorrhoids anyway, he adds. If that happens, there are several treatments your doctor can recommend for relief, and they often work quickly. Be sure to make an appointment especially if you have rectal bleeding or ongoing pain.
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Elizabeth Millard is a freelance journalist specializing in health, wellness, fitness, and nutrition. Her articles have appeared in SELF, Men’s Health, CNN, MyFitnessPal, and WebMD, and she has worked on patient education materials for Mayo Clinic and UnitedHealth Group. Find her on Instagram at @bossykind and on Twitter at @EMillard_Writer. Her online portfolio is at elizabethmillard.pressfolios.com. When not writing, she’s also a yoga teacher and organic farmer.