Hemorrhoids form as a result of stretching, bulging, or swelling in the veins around the anus, due to increased pressure in the anus or lower part of the rectum. This venous pressure may be the result of activities such as straining during bowel movements or sitting for long periods of time on the toilet. Additional risk factors include obesity, pregnancy, smoking, lack of exercise, anal intercourse, chronic diarrhea or constipation, colon cancer, liver disease, spinal cord injury, inflammatory bowel disease, overusing laxatives, getting older, and consuming a diet that is low in fiber. These factors all promote the development of hemorrhoids in some way or another.
Getting older puts people at a greater risk for hemorrhoids since the tissues supporting the veins in the rectum and anus begin to weaken and stretch. Pregnant women often develop hemorrhoids since the uterus presses down on the colon as the fetus grows larger, and the baby’s weight puts additional pressure on the anal region. Hemorrhoids in pregnancy are especially common in the third trimester and can also develop during childbirth, but they usually resolve immediately postpartum. Cigarette smoking can increase the risk for hemorrhoids due to the effect that smoking has on the blood vessels, including those in the rectum and anus. As for the overweight population, reasons for more frequent hemorrhoids include inadequate fiber intake as well as decreased levels of physical activity and prolonged sitting.
The discussion of fiber and fluid in relation to hemorrhoids is particularly interesting, not only for individuals who are obese. Fiber is important in preventing constipation and avoiding hard stools, the latter of which can cause rectal bleeding or an anal fissure, a tear in the anus. Insoluble fiber is especially helpful for healthy, regular stools and is found in lots of fruits and vegetables. Since fiber acts like a sponge to hold onto water and keep stools moving through the large intestine, it is important to consume enough fluids so that the fiber can do its job properly. When the body does not receive enough fiber or fluid, hemorrhoids are more likely to occur.
Fiber and fluid are also important components when talking about constipation and diarrhea. Difficulties emptying the bowels or frequently discharging feces in liquid form can wreak havoc on the body, and the additional straining during bowel movements can put extra pressure on the hemorrhoid. In terms of internal hemorrhoids becoming prolapsed or external hemorrhoids becoming thrombosed, it appears that continuing to do any of the activities that caused the hemorrhoid in the first place may make the condition progress to more severe varieties.
While hemorrhoids are one of the most common causes of rectal bleeding, blood in the stool can also be caused by anal fissures, Crohn’s disease, ulcerative colitis, or cancer in the gastrointestinal tract. Additionally, the color can vary from bright red and maroon to black and tarry to occult, meaning that the blood is not visible to the naked eye. Similarly, anal itching is a commonly cited complaint for hemorrhoids, but other potential causes include skin infections such as yeast infections and parasites such as pinworms. Due to these more serious potential causes, it is important to contact a health care professional in the event of rectal bleeding or anal itching.