Can Hemorrhoids Cause Constipation? Unraveling the Vicious Cycle

It’s a common and uncomfortable question: you’re dealing with the pain and irritation of hemorrhoids, and now you’re also struggling with constipation. You might wonder if the two are related or if one is causing the other. While it's widely known that straining from constipation is a primary cause of hemorrhoids, the reverse is also true. Hemorrhoids can, in fact, cause or significantly worsen constipation, trapping you in a frustrating and painful cycle.

Understanding this bidirectional relationship is the first step toward finding effective relief for both conditions. This article will break down how hemorrhoids contribute to constipation, what you can do to break the cycle, and when it's time to seek medical advice.

The Vicious Cycle: How Hemorrhoids and Constipation are Linked

Hemorrhoids and constipation often exist in a "chicken-or-egg" scenario. Straining to pass hard, dry stools increases pressure on the veins in your lower rectum and anus, causing them to swell and become hemorrhoids. However, once hemorrhoids develop, they can create conditions that actively promote constipation.

This creates a vicious cycle:

1. Constipation leads to straining.
2. Straining causes or irritates hemorrhoids.
3. Hemorrhoids cause pain and potential blockages.
4. Pain and blockages lead to avoidance of bowel movements, which causes or worsens constipation.

Breaking this loop requires addressing both problems simultaneously.

How Hemorrhoids Can Cause Constipation

While it may seem counterintuitive, the presence of swollen and inflamed veins in the rectum can directly interfere with your ability to have a regular, comfortable bowel movement. Here are the primary mechanisms at play.

The Fear of Pain and Stool Retention

This is the most common way hemorrhoids lead to constipation.

• Painful Defecation: Inflamed or thrombosed hemorrhoids (hemorrhoids with a blood clot) can cause sharp pain, burning, and discomfort during a bowel movement.
• Voluntary Avoidance: As Dr. Onikepe Adegbola, founder of Casa de Sante, explained to Medical News Today, "people with hemorrhoids may avoid going to the bathroom due to discomfort or fear of pain."
• Harder Stools: When you consciously or subconsciously delay a bowel movement, the stool remains in your colon longer. Your colon continues to absorb water from the stool, making it harder, drier, and more difficult to pass. This is known as functional constipation.

Physical Obstruction

In more severe cases, hemorrhoids can create a physical barrier.

• Blocked Anal Canal: According to Baptist Health, large internal hemorrhoids, especially those that have prolapsed (slipped down to bulge outside the anus), can partially block the anal canal. This physical blockage makes it difficult for stool to exit the body.
• Incomplete Evacuation: This obstruction can also lead to a sensation that you haven't fully emptied your bowels (tenesmus). This feeling often causes you to strain even more, which further aggravates the existing hemorrhoids.

!Anatomical illustration of internal and external hemorrhoids

*An illustration showing the location of internal and external hemorrhoids, which can cause pain and obstruction. Source: Wikimedia Commons*

Post-Surgical Factors

Sometimes, the treatment for severe hemorrhoids can temporarily lead to constipation. According to Verywell Health, surgery to remove hemorrhoids (hemorrhoidectomy) can sometimes cause a narrowing of the anal canal (anal stenosis). Furthermore, general anesthesia and opioid painkillers used after surgery are known to slow down bowel contractions, contributing to constipation.

Breaking the Cycle: Treatment and Prevention Strategies

To find lasting relief, you need a strategy that softens your stool while also soothing your hemorrhoids. The following lifestyle and dietary adjustments are the foundation of treatment for both conditions.

Key Dietary Adjustments

1. Boost Your Fiber Intake: Fiber adds bulk to your stool and makes it softer and easier to pass. The Mayo Clinic recommends aiming for 25 to 35 grams of fiber per day.

• Excellent Sources: Fruits (apples, pears, berries), vegetables (broccoli, Brussels sprouts), whole grains (oats, barley, quinoa), legumes (beans, lentils), and nuts and seeds.
• Pro Tip: Add fiber to your diet slowly to avoid gas and bloating.

2. Stay Well-Hydrated: Water is essential for fiber to do its job. Drinking plenty of fluids helps keep your stool soft. Aim for 8 or more glasses of water daily.

3. Consider Fiber Supplements: If you struggle to get enough fiber from food, over-the-counter supplements like psyllium (Metamucil) or methylcellulose (Citrucel) can be very effective. Be sure to drink plenty of water with them to prevent them from worsening constipation.

Important Lifestyle and Habit Changes

1. Get Regular Exercise: Physical activity helps stimulate the natural contractions of your intestinal muscles, promoting regular bowel movements. Even a daily 20-30 minute walk can make a significant difference.

2. Improve Your Toilet Habits:

• Don't Delay: Go to the bathroom as soon as you feel the urge. Waiting can make stool harder.
• Limit Toilet Time: Avoid sitting on the toilet for extended periods, as this increases pressure on the anal veins. Experts suggest getting up after 5-10 minutes if you haven't had a bowel movement.
• Quit "Doomscrolling": Recent research highlighted by Healthline suggests that using your phone on the toilet leads to longer sitting times, which is a major risk factor for hemorrhoids.
• Elevate Your Feet: Using a small footstool (like a Squatty Potty) changes your body's posture to more of a squat, which can straighten the rectum and make it easier to pass stool without straining.

At-Home and Over-the-Counter Relief

1. Soothing Sitz Baths: Soaking the anal area in a few inches of plain warm water for 15-20 minutes, two to three times a day (especially after bowel movements), can relieve pain, itching, and inflammation.

2. Topical Treatments: Over-the-counter creams, ointments, or suppositories containing ingredients like witch hazel, hydrocortisone, or lidocaine can provide temporary relief from hemorrhoid symptoms.

3. Stool Softeners: If constipation is severe, a gentle, over-the-counter stool softener can help ease bowel movements and reduce the need for straining. These should generally be used as a short-term solution while you implement dietary and lifestyle changes.

When to See a Doctor

While most cases of hemorrhoids and related constipation can be managed at home, it's important to consult a healthcare professional if you experience any of the following:

• Symptoms do not improve after one week of home care.
• You experience significant or frequent rectal bleeding.
• Your stools change in color or consistency (e.g., they become black, tarry, or pencil-thin).
• You feel severe pain, lightheaded, or dizzy.
• A hemorrhoid becomes prolapsed and cannot be gently pushed back in.

Rectal bleeding can be a symptom of more serious conditions, including colorectal cancer, so it should never be ignored. A doctor can provide an accurate diagnosis and recommend more advanced treatments if necessary, such as rubber band ligation or surgical procedures.

References

1. Adegbola, O. (2023). Expert opinion in "Can hemorrhoids cause constipation? What to know." Medical News Today. https://www.medicalnewstoday.com/articles/can-hemorrhoids-cause-constipation
2. Mayo Clinic Staff. (n.d.). Hemorrhoids - Symptoms and causes. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/hemorrhoids/symptoms-causes/syc-20360268
3. Tresca, A. J. (2025). Can Hemorrhoids Cause Constipation (and Vice Versa)? Verywell Health. https://www.verywellhealth.com/can-hemorrhoids-cause-constipation-8641054
4. Baptist Health. (2025). Can Hemorrhoids Cause Constipation? Baptist Health Blog. https://www.baptisthealth.com/blog/gastroenterology/can-hemorrhoids-cause-constipation
5. USA Hemorrhoid Centers. (2025). Can Hemorrhoids Cause Constipation? USA Hemorrhoid Centers Blog. https://www.usahemorrhoidcenters.com/blog/can-hemorrhoids-cause-constipation/
6. Stokes, V. (2025). Using Your Phone While on the Toilet May Raise Risk of Hemorrhoids. Healthline. https://www.healthline.com/health-news/scrolling-on-phone-toilet-hemorrhoids-risk
7. National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). (n.d.). Hemorrhoids. https://www.niddk.nih.gov/health-information/digestive-diseases/hemorrhoids