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What makes external hemorrhoids worse?

13 common mistakes that can aggravate your piles or hemorrhoids

Being overweight can worsen your condition. If you have a desk job and spend most of your free time watching TV or surfing the internet, it will only lead to chronic constipation and more straining on the toilet. Being physically inactive can put more pressure on the veins of the blood vessels around your anal area, so avoid sitting at one place for too long. Make an effort to walk more and take up cardio exercises for your own well-being. Go for a brisk walk or a jog for at least 30 minutes every day to get some form of relief.

2. Lifting very heavy objects on a daily basis

If you have started working out in the gym, it is definitely a positive step. However, don’t overdo it with the weight lifting and completely avoid heavy weight lifting. You will only end up putting more pressure on your clot(s) or external haemorrhoids. Moderate exercising is the way to go until your symptoms start to subside.

3. Ignoring symptoms of constipation or diarrhea

It’s a known fact that suffering from constipation will result in the formation of more external haemorrhoids or what is more commonly called skin tags. The other extreme, which is diarrhea, can also aggravate your piles and worsen the symptoms. If you have been suffering from loose motions or difficulty in passing bowel movements, make a food diary. Evaluate your diet carefully and try to figure out what is causing the constipation or diarrhea and consciously eliminate those food items from your diet. If the diarrhea still persists, consult your physician. These are the medicines that can cause chronic constipation.

4. Maintaining poor hygiene

In India, the heat and high humidity levels can be a piles patient’s worst enemy. If you don’t take a shower every day and keep your anal area clean and dry, the irritation and itching will go from bad to worse. Remember to keep toilet paper handy with you when you go to the toilet. Thoroughly wash your genital area with warm water and after that, gently pat the area dry. Don’t rub toilet paper or any cloth against your anal area to avoid any burning sensation. During your menstrual cycle, switch to sanitary napkins specifically made for sensitive skin to avoid any rashes.

5. High stress and anxiety levels

If you have a demanding job or if you’re going through a stressful phase, take some time out to de-stress if you have to. Leading a stressful life will lead to anxiety and depression which will in turn make your haemorrhoids flare up. Find an activity that calms you down and if need be, take two to three days off from work until you stress levels go down. This really helped me while I was suffering from chronic anal fissures and piles.

6. Overusing laxatives

Your gastroenterologist is going to prescribe stool softeners and laxatives to get some relief from the symptoms of piles. Usually, these tablets or syrups are meant to be taken for not more than one week. Don’t abuse these laxatives and make a habit of popping these tablets regularly. If you’re still feeling constipated, go natural and switch to Isapgol for immediate relief. You could also try these home remedies for constipation.

7. Reading or using your smartphone while sitting on the toilet

Remember not to spend more than 10-15 minutes maximum on the toilet. Straining on the pot will lead to more anal skin tags and bleeding. When you’re reading your morning newspaper or scrolling through various social media apps, you lose track of time and end up putting a lot of pressure on the blood vessels. Set a timer for 10 minutes on your phone and once that time is up, get off your commode! If possible, use Indian toilets to facilitate your bowel movements.

8. Using scented wet wipes

Be careful while buying wet wipes. As far as possible, avoid them because most wet wipes are scented and contain irritants like alcohol which will cause excruciating pain on the affected areas. If you want to keep your anal area clean and devoid of any faecal matter, opt for asitz bath.

9. Using your nails or scratching

Anal itching is a persistent problem for those suffering from piles or haemorrhoids. As far as possible, avoid scratching your anal area because it will only result in more pain. The last thing you want is a burning sensation down there throughout the day. Ask your doctor to prescribe topical ointments or gels to get rid of the itching.

10. Drinking too much coffee

Just like alcohol, coffee can also cause dehydration and irritate your stomach lining. Caffeine is also known to be the leading cause of constipation, so cut down drastically on your caffeine consumption. Here’s how to deal with caffeine withdrawal symptoms.

11. Sitting on hard or rough surfaces for too long

As far as possible, you need to avoid putting any form of pressure on your anal area. Avoid sitting on the floor for prolonged periods of time and if your chair at work isn’t comfortable enough, keep a small pillow handy to sit on.

12. Not answering nature’s call on time

When your body is signalling that you have to go no.2, drop whatever it is that you are doing and evacuate your bowels. Controlling the urge to defecate will only put more pressure on the veins around your anal area. Schedule your timings to go to the toilet according to your bowel movements and stick to that routine.

13. Avoiding surgical treatment

In some cases, despite undergoing the traditional medical treatment for hemorrhoids or even anal fissures, the symptoms can still persist. If you have made adequate lifestyle and diet changes but you still notice blood in your stools along with symptoms such as excessive pain, swelling and itching down there, it is time to consult a general surgeon. Here’s what you need to know about hemorrhoid surgery. Don’t be embarrassed by your condition and seek the treatment required instead of suffering in silence.

Piles (haemorrhoids)

A close-up of the anus of someone with piles. There is a small, pink, pea-sized lump visible around the outside of the anus. A close-up of the anus of someone with piles. There is a pink or purple bulge near the opening of the anus. A close-up of severe piles. There are several large pink and purple, grape-sized lumps surrounding the anus.

Many pharmacies have private areas if you do not want to be overheard.

Non-urgent advice: See a GP if:

  • you have symptoms of piles and they’re getting worse or there’s no improvement after 7 days of treatment at home
  • you keep getting piles
  • you notice a change around your anus that is not normal for you

The GP may prescribe stronger medicines for piles or constipation. They may also check your symptoms are not being caused by something else.

Urgent advice: Ask for an urgent GP appointment or get help from NHS 111 if:

  • you have piles and your temperature is very high or you feel hot and shivery and generally unwell
  • you have pus leaking from your piles

Hospital treatment for piles

If there’s no improvement to your piles after home treatments, you may need hospital treatment.

Talk to your doctor about the best treatment for you. Treatment does not always prevent piles coming back.

Treatment without surgery

Common hospital treatments include:

  • rubber band ligation: a band is placed around your piles to make them drop off
  • sclerotherapy: a liquid is injected into your piles to make them shrink
  • electrotherapy: a gentle electric current is applied to your piles to make them shrink
  • infrared coagulation: an infrared light is used to cut the blood supply to your piles to make them shrink

You’ll be awake for this type of treatment, but the area will be numbed.

You should be able to go home on the same day.

If these treatments do not work, you may need surgery to remove your piles.


Surgical treatments include:

  • haemorrhoidectomy: your piles are cut out
  • stapled haemorrhoidopexy: your piles are stapled back inside your anus
  • haemorrhoidal artery ligation: stitches are used to cut the blood supply to your piles to make them shrink

You’ll usually need to be asleep for this type of treatment and may need to stay in hospital for more than 1 day.

Immediate action required: Go to A&E or call 999 if you have piles and:

  • you’re bleeding non-stop
  • there’s a lot of blood – for example, the toilet water turns red or you see large blood clots
  • you’re in severe pain
  • always there and so bad it’s hard to think or talk
  • you cannot sleep
  • it’s very hard to move, get out of bed, go to the bathroom, wash or dress
  • always there
  • makes it hard to concentrate or sleep
  • you can manage to get up, wash or dress
  • comes and goes
  • is annoying but does not stop you doing daily activities

What causes piles?

Piles are swollen blood vessels. It’s not clear what causes them.

Things that make piles more likely:

  • constipation
  • pushing too hard when pooing
  • heavy lifting
  • pregnancy

Page last reviewed: 28 March 2022
Next review due: 28 March 2025

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What makes external hemorrhoids worse?

Paonessa Colon & Rectal Surgery, P.C.

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The Link Between Prolonged Sitting and Hemorrhoids

Hemorrhoids affect 75% of adults during their lifetime, making them one of the most common gastrointestinal problems. Unfortunately, many patients don’t visit Dr. Nina Paonessa at Paonessa Colon and Rectal Surgery until they already have hemorrhoids, but she would rather help you avoid the problem.

Here’s what you need to know about the connection between sitting and hemorrhoids and how you can lower your risk or outright prevent them.

Hemorrhoids explained

The areas around your anus and inside the rectum contain a network of blood vessels. When one or more veins become inflamed and swollen, you have hemorrhoids.

What causes hemorrhoids? In a word, pressure. Hemorrhoids develop when excessive pressure in the lower rectum makes the veins stretch, setting them up to become engorged with blood.

Sometimes the pressure comes from activities like lifting heavy objects. Women also commonly develop hemorrhoids during pregnancy, as the weight of the baby places pressure on the rectum.

But the pressure responsible for hemorrhoids primarily comes from prolonged sitting and straining due to constipation.

How sitting causes hemorrhoids

When you sit, the pressure on your buttocks makes the gluteal muscles spread out. In the process, the small veins around the anus and rectum are stretched and lose elasticity. Then the fragile veins become engorged with blood, and you have hemorrhoids.

The intense pressure from prolonged sitting leads to new hemorrhoids and aggravates existing ones. But not all sitting has the same effect. Sitting on a hard chair causes more pressure than a soft chair. And the worst is sitting too long on the toilet.

Spending too much time on the toilet places extreme pressure on your rectum and anus. On a toilet seat, your rectum is lower than the rest of your buttocks. As a result, gravity pushes down on the veins and blood pools in the veins. If you strain due to constipation, you further increase the pressure.

Lack of exercise magnifies prolonged sitting

Your job may require you to sit for an extended time. However, sitting a lot also occurs if you lead a sedentary lifestyle. This type of sitting and the resulting lack of activity only increases your risk of developing hemorrhoids.

Exercise helps you prevent hemorrhoids and lowers your risk of flare ups. When you exercise, you stimulate bowel function, tone the rectal area, and increase blood flow.

Improving bowel function helps you avoid constipation, while boosting blood flow promotes healing of existing hemorrhoids. Toning the tissues that support your anus and rectum helps offset the effect of pressure on the rectal area.

Tips for preventing hemorrhoids

Here are four tips we give our patients to prevent hemorrhoids:

Take breaks

Even if you need to sit for your job, you can lower your risk of hemorrhoids by taking regular breaks to get up and walk around.

Get off the toilet

You should only sit on the toilet long enough to have a bowel movement, which typically takes a few minutes. You shouldn’t spend more than five minutes on the toilet.

One of the best ways to avoid sitting on the toilet too long is to stop reading at the same time. When you stay engaged with something interesting while on the toilet, it’s easy to lose track of time.

Don’t strain

Never strain or push down to force stool out of your rectum. Give yourself about five minutes to have a bowel movement then get off the toilet and try again later. The best way to avoid straining is to prevent constipation.

Get enough fiber, water, and exercise

To prevent constipation, you need to exercise, drink plenty of water during the day, and eat a high-fiber diet. Some great sources of fiber include beans, vegetables, fruits, and whole grains like oats and bran.

If you live in or around Brielle or Manahawkin, New Jersey, and need expert care for hemorrhoids, call Paonessa Colon and Rectal Surgery or schedule an appointment online today.

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