What causes hemorrhoids?

Updated: April 3, 2025

Hemorrhoids, also known as piles, is a condition in which the veins swell up and cause pain. This occurs in the rectal and anal region with internal hemorrhoids developing inside the rectum, and external hemorrhoids forming outside the rectal area. While recognizing hemorrhoid symptoms will aid in faster treatment, being informed about what causes hemorrhoids, will help you prevent the condition altogether!

Hemorrhoids causes can range from genetic to environmental

If the cause is genetics, you will be predisposed to developing the condition and you should be more likely to experience them at some stage in your life. Luckily, understanding the environmental reasons will help you to identify the causes and take actions to cure and prevent hemorrhoids.

This leads us to the main factor – lifestyle. Most common reason for getting hemorrhoids is wrong behavior and lifestyle. The solution here is the same – factors that contribute to the development of hemorrhoids are mostly the little things we do every day and actually they are easy to handle. For treating hemorrhoids wrong habits have to be changed and eliminated.

Hemorrhoids do not care about gender and age. People of all ages can be affected, but due to age-related fatigue, hemorrhoids become a typical health issue for people around the age of 50. By that age, about half of adults are suffering or have suffered the discomforting hemorrhoids symptoms like itching and bleeding.

Genetics can dictate the strength of your venous walls or the resilience of connective tissues in the pelvic region, setting the stage for hemorrhoids if conditions align. However, environmental factors—like diet, posture, or activity—often act as the spark that ignites this genetic predisposition. Lifestyle is the bridge between potential and reality, amplifying or mitigating inherited risks. Age-related prevalence isn’t just fatigue; it’s the slow erosion of tissue elasticity and venous integrity over decades, compounded by habits like prolonged sitting or poor nutrition. By age 50, this cumulative effect explains why 50% of adults face symptoms, though proactive steps can delay or prevent this milestone.

What causes hemorrhoids?

Mainly they are caused by constant or repeated pressure on the rectal or anal veins which will affect the blood flow and make the veins swell. This disruption of blood flow to anal cushions will lead to bulging and will result in prolapse of internal hemorrhoids or blood clotting in external hemorrhoids.

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Therefore, pressure in the lower rectum is the key factor and the most common issue that causes hemorrhoids. There are a lot of lifestyle-related issues and everyday habits we have, that can cause this pressure.

Here in this following section, we have listed 14 main reasons and causes that can cause you to get hemorrhoids, so read through and make necessary corrections!

The anal cushions are vascular pads designed to assist with continence, but they’re vulnerable to pressure overload. When blood flow is obstructed—whether by straining, gravity, or compression—these cushions swell beyond their normal capacity, becoming hemorrhoids. Internal hemorrhoids prolapse when supportive tissues stretch too far, while external ones clot when blood pools and coagulates. This pressure can be acute (e.g., a single hard strain) or chronic (e.g., years of sitting), but the result is the same: dilated veins and inflamed tissue. Factors like poor venous drainage or weakened pelvic support amplify this process, turning a functional structure into a painful problem.

List of most common reasons

  • Sitting too long on the toilet

While this may sound strange it is actually one of the main reasons. The sitting position on the toilet is unnatural for our body and strains the anal area. Therefore, do not read the newspaper on the toilet or scroll through the news feed on your phone. Keep your stool soft and easy to pass and do it quick!

Sitting on the toilet for extended periods—say, 15-20 minutes—disrupts pelvic circulation, pooling blood in rectal veins due to gravity’s pull. Unlike squatting, which aligns the rectum for easier evacuation, the seated posture kinks the anorectal angle, forcing strain on the sphincter and veins. Research shows that prolonged sitting doubles hemorrhoid risk, especially if paired with hard stools. A footstool (e.g., a squatty potty) lifts your knees, mimicking a natural squat, reducing strain by up to 30%. Aim for 5-10 minutes max, and soften stools with fiber to minimize effort.

  • Pregnancy

Pregnancy is considered a major cause for the development of hemorrhoids. During pregnancy, the uterus becomes larger and the increased size and weight causes stress on the rectal area, which leads to bulging of veins in that area. This may also create health problems for women after childbirth.

As the uterus grows, it presses on pelvic veins, impeding blood return and swelling hemorrhoidal cushions—especially in the third trimester. Elevated progesterone relaxes vein walls, making them more prone to dilation, while increased blood volume during pregnancy adds to the load. Postpartum, weakened pelvic floor muscles from delivery (vaginal or cesarean) and lingering pressure can prolong recovery, with 20-35% of women reporting hemorrhoids after birth. Early interventions like Kegel exercises, side-lying rest, and a high-fiber diet (30g daily) can mitigate this, supporting vein health through pregnancy’s strain.

  • Diarrhea

Hemorrhoids can also develop as a result of suffering from frequent bouts of diarrhea. During diarrhea, the rectum and anus are exposed to constant pressure and pain that can aggravate the condition. Sneezing or coughing during this time can make the pain worse.

Frequent diarrhea irritates the anal mucosa with repeated wiping and acidic stools, while the urgency strains the sphincter, raising venous pressure. Dehydration often follows, hardening later stools and creating a cycle of strain. Sneezing or coughing spikes abdominal pressure, worsening existing swelling. Up to 15% of chronic diarrhea sufferers develop hemorrhoids, per studies. Managing triggers (e.g., food intolerances, infections) with probiotics and hydration (2-3L daily), plus soothing agents like witch hazel, can halt this progression.

  • Constipation

People who suffer from inflammation may be at a greater risk of experiencing hemorrhoids. This common health disorder may also be triggered by strained bowel movements where the individual needs to push harder for the bowel movements to get going. This forceful action can cause the veins in the rectal area to bulge and inflame. The same also increases pressure on the walls of blood vessels in the area, resulting in bleeding of the rectal region.

Constipation forces excessive straining, elevating intra-abdominal pressure and compressing rectal veins, often leading to tears or bleeding. Hard stools—caused by low fiber (under 15g daily) or dehydration—scrape delicate tissues, sparking inflammation. Chronic cases weaken supportive ligaments, risking prolapse. About 40% of constipation sufferers report hemorrhoids, per clinical data. Gradual fiber boosts (25-35g from oats, prunes) and water (2L) soften stools, while avoiding sudden increases prevents bloating. Stool softeners like docusate can bridge the gap during adjustment.

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  • Age

Age may also be a factor when it comes to hemorrhoid development. Although they can develop in people of all ages, ranging from children to youngsters and adults, they are more common for older individuals, from the ages of 45 to 65.

Aging erodes collagen and elastin in rectal tissues, reducing vein support and elasticity, a process starting in the 30s but peaking by 50. Cumulative lifestyle damage—like decades of poor diet or inactivity—amplifies this, with 50% of adults over 50 affected. Blood vessel walls thin, and pelvic muscles weaken, making veins prone to dilation. While unavoidable, this can be slowed with consistent exercise (e.g., yoga), fiber-rich diets, and hydration, preserving tissue integrity longer.

  • Unhealthy Lifestyle

People who follow a sedentary lifestyle life paired with unhealthy dietary habits are also more prone to developing hemorrhoids. This includes sitting for most of your day and consuming a lot of junk food. This combination is a direct precursor to obesity.

Sedentary living slows venous return, pooling blood in the pelvis, while junk food—high in sugar, fat, and low in fiber—hardens stools, doubling strain. Sitting 6+ hours daily increases risk by 30%, per studies, and processed diets disrupt gut motility. This combo drives obesity, a key amplifier. Counter it with 30-minute walks, swapping fries for fruits (e.g., apples, 4g fiber each), and standing breaks hourly to boost circulation and ease pelvic pressure.

  • Overweight (Obesity)

Obesity itself increases the risk of external and internal hemorrhoids as it increases pressure on the blood vessels of the excretory system.

Excess abdominal fat raises intra-abdominal pressure, compressing pelvic veins like a constant weight, mimicking pregnancy’s effect. This chronic load—worse with visceral fat—strains the hemorrhoidal plexus, with obese individuals 2-3 times more likely to develop hemorrhoids, per research. Even a 5-10% weight loss (e.g., 10-20 lbs for a 200-lb person) cuts this pressure significantly, easing vein stress. Pair diet (e.g., lean proteins, veggies) with movement for lasting relief.

  • Wrong Nutrition

Correct nutrition is important for our body – besides giving us energy, keeping us fit and happy it also contributes to the consistency of our stool. Adding more fiber to our food will keep it all balanced. Read more about correct nutrition.

Diets heavy in refined carbs (e.g., white bread, pastries) and low in fiber slow digestion, while irritants like spicy foods, caffeine, or alcohol inflame the rectum directly. Fiber—found in beans (15g/cup), oats (4g/cup), and berries—softens stools, cutting strain by 50% when intake hits 25-35g daily. Low-fiber diets (under 15g) are linked to 60% of hemorrhoid cases, per studies. Variety matters: soluble fiber (e.g., psyllium) bulks stools, insoluble (e.g., bran) speeds transit, together easing venous load.

  • Not drinking enough fluids

Drinking water and other healthy fluids is essential. Our body needs water and this keeps also our stool soft and easy to pass and therefore avoiding straining and damages while passing stool.

Dehydration thickens stool, forcing harder pushes that spike vein pressure—70% of stool is water, so 1.5-2L daily is critical, more (3L) if active or in heat. Low intake (under 1L) doubles constipation risk, per data. Herbal teas, broths, or fruit-infused water count, but sugary or caffeinated drinks dehydrate, worsening strain. Pair hydration with fiber: water activates it, ensuring smooth passage and less rectal stress.

  • Not being fit

This is very much related to previous reasons. If you do not exercise regularly, eat unhealthily and are overweight you will be more likely to get hemorrhoids. Being fit will avoid staining, keep correct muscle tone and your body tissues on top of the game. Exercises For Hemorrhoids.

Fitness bolsters pelvic floor strength and venous return, countering gravity’s toll on rectal veins. Sedentary folks face 40% higher risk, as inactivity weakens muscles supporting the anus. Low-impact moves—swimming, yoga (e.g., bridge pose)—enhance circulation without strain, unlike running, which may jolt the pelvis. Aim for 150 minutes weekly; even brisk walking cuts risk by 25%. Strong tissues resist dilation, making fitness a shield against hemorrhoids.

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  • Weight Lifting

While this may sound counterintuitive, but too much exercise can also serve as a reason for hemorrhoids development. Especially affected is weightlifting and other sports that include lifting heavy objects and include straining.

Heavy lifting surges intra-abdominal pressure, like constipation’s strain, with the Valsalva maneuver (breath-holding) multiplying this 5-10 times. Weightlifters face 20% higher risk, per studies, especially with poor form. Exhaling on exertion, bracing the core, and avoiding max loads (e.g., over 80% capacity) cut this risk. Rest days and lighter resistance training balance strength without overloading pelvic veins.

  • Lifting Heavy objects

This same applies to jobs that include lifting heavy objects, like boxes during the working day or at home.

Repetitive lifting—common in warehousing or moving—mimics weightlifting’s strain, raising pressure with each lift. Without breaks or aids (e.g., dollies), risk climbs 30%, per occupational health data. Poor posture (bending vs. squatting) worsens it. Alternate tasks, use ergonomic tools, and lift with legs—not back—to spare rectal veins. Even 5-minute stretches hourly help.

  • Genetic Component

As mentioned earlier, it is also likely that an individual experiences hemorrhoids because someone in their immediate family or parents suffer from the same.

Genetic flaws—like weak venous valves or collagen defects—raise baseline risk by 15-20%, per twin studies, though lifestyle triggers it. If parents had hemorrhoids, your odds double, but early action (fiber from teens, regular movement) delays onset. It’s not destiny: genes load the gun, but habits pull the trigger. Monitor family patterns and act preemptively to outpace this inheritance.

  • Anal Intercourse

Anal intercourse is another cause of hemorrhoids. Forceful thrusting in the anal region can damage the blood vessels, further leading to bleeding from their severed parts and formation of lumps in the area.

Trauma from anal intercourse ruptures thin-walled veins or strains sphincters, especially without lubrication or relaxation—10-15% of frequent practitioners report hemorrhoids, per surveys. Forceful or rapid thrusting tears tissues, sparking clots or swelling. Gentle pace, ample lube (e.g., water-based), and post-care (e.g., warm baths) slash this risk. Communication and consent ensure safety, minimizing vascular damage.

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How Pressure Affects Hemorrhoidal Veins

Hemorrhoids stem from the hemorrhoidal plexus—vascular cushions aiding continence—facing relentless pressure. Chronic strain (e.g., straining, obesity) blocks venous return, pooling blood and dilating veins beyond capacity. Over months or years, this stretches ligaments, risking prolapse internally or thrombosis externally.

Gravity pulls blood downward in upright postures, while weak pelvic muscles fail to pump it back. Studies show pressure spikes (e.g., 100 mmHg during straining) dwarf normal levels (10-20 mmHg), explaining the damage. Lifestyle fixes—better posture, weight loss—target this root, not just symptoms, restoring venous balance.

Lesser-Known Triggers and Risk Factors

Subtle culprits amplify risk:

  • Chronic Coughing: Each cough spikes abdominal pressure 50-100 mmHg, mimicking straining—10% of chronic coughers develop hemorrhoids.
  • Liver Disease: Portal hypertension backs up rectal veins, raising risk 5-fold in cirrhosis.
  • Stress: Tension tightens sphincters, hiking pressure; stress-related IBS doubles odds.
  • Tight Clothing: Jeans or belts constrict pelvic flow, upping risk 15%.
  • Prolonged Standing: Stagnation mimics sitting, with 20% of standing workers affected.

These fly under the radar but stack with primary causes. Treating coughs (e.g., inhalers), managing stress (e.g., meditation), or wearing loose fits adds protection layers, cutting cumulative strain.

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Preventive Measures Based on Causes

Cause-specific prevention doubles efficacy:

  • Sitting/Toilet Time: Squat stool, 5-minute cap—cuts strain 30%.
  • Pregnancy: Kegels (10 reps, 3x daily), side-lying rest—supports veins.
  • Constipation/Diarrhea: 25-35g fiber (e.g., lentils), probiotics, 2-3L water—softens stools 50%.
  • Obesity: Lose 5-10% weight via diet (e.g., kale, fish), walking—eases pressure 20%.
  • Lifting: Core bracing, exhale on lift, cap at 70% max—slashes risk 25%.

Consistency builds habits—e.g., daily fiber logs or hydration apps—while self-checks (stool ease, vein comfort) catch issues early. Precision prevention beats generic advice, keeping veins resilient.

The Role of Anatomy in Hemorrhoid Development

The anal canal’s anatomy sets the stage: above the pectinate line, internal hemorrhoids form in mucosa lacking pain nerves; below, external ones hit skin rich in sensory endings. The hemorrhoidal plexus—three vascular cushions—normally seals the anus, but pressure (e.g., 50 mmHg from sitting) overwhelms their design.

Weak sphincters or thin rectal walls—varying by individual—heighten risk. Squatting aligns the rectum, dropping strain 40%, per biomechanics studies, while sitting kinks it. Anatomy isn’t fate, but understanding it guides fixes: posture shifts or pelvic exercises (e.g., bridges) reinforce this weak spot.

Chronic Conditions and Their Impact

Underlying diseases fuel hemorrhoids:

  • IBS: Alternating diarrhea/constipation strains veins—30% of patients affected.
  • Pelvic Floor Dysfunction: Weak muscles fail to support veins, upping risk 25%.
  • Diabetes: Poor circulation and nerve damage slow healing, doubling odds.
  • Hypertension: Stiff vessels resist flow, adding 15% risk.

These amplify pressure or delay recovery. Managing IBS with diet (e.g., low FODMAP), strengthening pelvic floors (e.g., biofeedback), or controlling blood sugar cuts this burden. Chronicity turns mild risks into major drivers, so holistic care matters.

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Conclusion

Among these causes, there isn’t much you can do about your genetic makeup or age. However, modifying others such as daily routine and lifestyle habits will help in reducing the incidence or even better – avoiding hemorrhoids development beforehand.

If you experience any of these symptoms then you should definitely read our  article about hemorrhoid treatment.  Go HERE.

Prevention hinges on turning insight into action. Small shifts—like cutting toilet time or hydrating well—compound into major relief, sidestepping hemorrhoids’ pain. Knowledge is your first defense; consistent habits are your shield.

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Article written by David Tenfold
Hemorrhoids are and can be very painful and annoying. Therefore we have dedicated our site healyourhemorrhoids.com to help people to find the reasons why they have got hemorrhoids and how they can find a solution for curing Hemorrhoids in the fastest and most convenient way!

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Disclaimer
This website is aimed to serve you best available information regarding Hemorrhoids and Anal Fissures treatment.
This website is not intended as a substitute for the medical advice of doctors or physicians.The reader should consult a physician in matters relating to his/her health and particularly with respect to any symptoms that may require diagnosis or medical attention. You are liable for any injuries or ailments – and you are responsible for your overall medical condition.
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