Hemorrhoids: Causes, Symptoms & How to Get Rid of Them (2026 Guide)

Hemorrhoids — also called piles — are one of the most common yet least-discussed health conditions affecting adults. Nearly 75% of people will experience hemorrhoids at some point in their lives, yet most suffer in silence rather than seeking effective treatment. Whether you're dealing with occasional discomfort or chronic pain, understanding the root causes and proven treatments is the first step toward lasting relief.

This guide covers everything you need to know: what hemorrhoids actually are, what causes them, how to recognize the symptoms, and the most effective ways to treat and prevent them — including emerging research into peptide-based therapies that may offer new options in the future.

What Are Hemorrhoids, Exactly?

Hemorrhoids are cushions of tissue containing blood vessels, muscle, and elastic fibers located in the lower rectum and around the anus. In their normal state, these vascular cushions play a role in bowel control. They only become a medical problem when the veins within them become swollen, inflamed, or prolapsed — at which point they're referred to clinically as hemorrhoidal disease.

There are two primary types:

• Internal hemorrhoids — Located inside the rectum, above the dentate line. Because this area lacks pain-sensitive nerves, internal hemorrhoids are typically painless. The most common symptom is bright red rectal bleeding during bowel movements.
• External hemorrhoids — Located under the skin around the anus. These are richly supplied with pain-sensitive nerves and can cause significant discomfort, itching, swelling, and pain — especially if a blood clot forms inside (thrombosed external hemorrhoid).

Internal hemorrhoids are further graded on a scale from Grade I (no prolapse) to Grade IV (permanently prolapsed and cannot be manually reduced).

What Causes Hemorrhoids? The Root Factors

Hemorrhoids develop when pressure in the rectal veins increases to the point where the vessel walls stretch and weaken. Several lifestyle and physiological factors contribute to this increased pressure:

1. Straining During Bowel Movements

This is the single biggest mechanical cause. When you strain — whether from constipation or simply sitting too long on the toilet — you dramatically increase intra-abdominal pressure. This forces blood into the hemorrhoidal vessels and can cause them to swell and eventually prolapse.

2. Chronic Constipation or Diarrhea

Both extremes are problematic. Constipation leads to straining, while chronic diarrhea creates repeated irritation and inflammation of the anal tissues. Either condition, left unaddressed, significantly raises hemorrhoid risk.

3. Low-Fiber Diet

Dietary fiber is essential for forming soft, bulky stools that pass easily. The average American consumes only 10–15 grams of fiber per day — well below the recommended 25–38 grams. Low fiber intake is strongly associated with increased constipation, straining, and hemorrhoid development.

4. Prolonged Sitting

Extended periods of sitting — particularly on the toilet — increase pressure on the veins of the lower rectum. This is why hemorrhoids are more common in sedentary populations and in people who spend significant time on the toilet with their phones.

5. Pregnancy

The growing uterus places direct pressure on the rectal veins, and hormonal changes relax vein walls during pregnancy. Combined with the straining of childbirth, hemorrhoids are extremely common during and after pregnancy.

6. Age

The connective tissue that supports hemorrhoidal cushions weakens with age. Hemorrhoids become significantly more common after age 45, affecting the majority of adults over 50 at some point.

7. Heavy Lifting

Athletes and fitness enthusiasts who regularly perform heavy resistance training — particularly high-load squats and deadlifts — experience significant intra-abdominal pressure spikes during maximal efforts. Over time, without proper technique and breath control, this can contribute to hemorrhoid development.

Recognizing Hemorrhoid Symptoms: What to Watch For

Symptoms vary considerably depending on whether hemorrhoids are internal or external, and how advanced they are. Many people have hemorrhoids without knowing it — symptoms often only appear when the condition worsens.

Important: Rectal bleeding should never be self-diagnosed as hemorrhoids without proper medical evaluation. While hemorrhoids are the most common cause of rectal bleeding, other conditions — including colorectal cancer — can present similarly. Always consult a physician for any new or unexplained rectal bleeding.

How to Get Rid of Hemorrhoids: Treatment Options Ranked

The good news is that the vast majority of hemorrhoid cases respond well to conservative management. Only a small percentage require procedural intervention.

Step 1: Dietary Changes (The Foundation)

Increasing dietary fiber is the single most evidence-backed intervention for hemorrhoid management. Aim for 25–38 grams of fiber per day through whole foods such as:

• Legumes (lentils, black beans, chickpeas)
• Vegetables (broccoli, Brussels sprouts, sweet potato)
• Fruits (pears, apples, berries with skin)
• Whole grains (oats, quinoa, whole wheat)

If diet alone isn't sufficient, psyllium husk fiber supplements are well-tolerated and effective. Hydration is equally critical — aim for at least 8–10 cups of water daily to keep stools soft.

Step 2: Sitz Baths

Soaking the affected area in warm water for 15–20 minutes, two to three times per day, is one of the most effective and immediate-relief strategies for external hemorrhoids. Sitz baths reduce inflammation, relieve muscle spasm, and promote healing. Add Epsom salts for additional anti-inflammatory benefit.

Step 3: Topical Treatments

Over-the-counter creams, ointments, and suppositories containing hydrocortisone, witch hazel, or lidocaine can temporarily relieve itching, pain, and swelling. These provide symptomatic relief but do not address the underlying vascular issue. Do not use hydrocortisone products for more than 7 days consecutively without medical guidance.

Step 4: Behavioral Changes

• Never strain — if a bowel movement doesn't come easily after 2 minutes, get up and try later
• Limit toilet time — avoid reading or scrolling on the toilet; get up as soon as you're done
• Use a squatting stool — positioning the knees above hip level (as with a Squatty Potty) reduces strain and improves anorectal angle
• Move regularly — physical activity stimulates bowel motility and reduces constipation risk

Step 5: Minimally Invasive Procedures

For Grade II–III internal hemorrhoids that don't respond to conservative care, several office-based procedures are available:

• Rubber band ligation — A small rubber band is placed around the hemorrhoid base, cutting off blood flow. The hemorrhoid shrivels and falls off within 1–2 weeks. This is the most widely used and effective office procedure.
• Sclerotherapy — A chemical solution is injected to shrink the hemorrhoid. Less effective than banding but useful for certain cases.
• Infrared coagulation — Heat is applied to cut off blood supply to the hemorrhoid.

Step 6: Surgery (Hemorrhoidectomy)

Reserved for Grade III–IV hemorrhoids or cases that have failed all other treatments. Hemorrhoidectomy involves surgical removal of the hemorrhoid tissue. It is the most effective long-term solution but comes with a more significant recovery period. Stapled hemorrhoidopexy is a less painful alternative that repositions rather than removes hemorrhoidal tissue.

Emerging Peptide Research and Hemorrhoid Treatment

An area of growing interest in gastrointestinal and anorectal health is the application of research peptides for tissue repair, inflammation modulation, and vascular health. While clinical research specific to hemorrhoidal disease is still limited, several peptides have demonstrated properties that may be relevant:

BPC-157 (Body Protection Compound 157) is a synthetic peptide derived from a protein found in gastric juice. In preclinical research, BPC-157 has demonstrated accelerated wound healing, anti-inflammatory effects, and angiogenic properties — all of which are theoretically relevant to the damaged vascular tissue seen in hemorrhoidal disease. Researchers have noted BPC-157's ability to promote collagen synthesis and support gut tissue integrity.

GHK-Cu (copper peptide) has shown strong tissue-regenerative and anti-inflammatory properties in research settings, with particular relevance to skin and connective tissue repair — the type of repair needed in chronic external hemorrhoid cases.

It's important to note that no peptide is currently FDA-approved for the treatment of hemorrhoids, and these compounds remain research-stage only. This area represents a promising but early frontier in anorectal medicine. Anyone interested in peptide-based approaches should consult a qualified healthcare provider.

How to Prevent Hemorrhoids From Coming Back

Once you've successfully treated hemorrhoids, preventing recurrence is the next priority. The lifestyle factors that cause hemorrhoids in the first place are the same ones you need to manage long-term:

Frequently Asked Questions About Hemorrhoids