As many as one in four Britons suffer from haemorrhoids – but simple lifestyle changes could prevent the painful condition from occurring.
Haemorrhoids, also known as piles, are caused by swollen and inflamed veins in the lower part of the rectum or anus.
They can cause itching, pain and bleeding, especially during bowel movements. The problem can often be brought on by constipation and straining on the toilet, but chronic coughing and heavy manual labour can also cause them.
Dr Mohammad Bakhtiar, Clinical Lead at Medical Express Clinic, tells the Daily Mail that they’re almost impossible to avoid.
‘They’re common because the modern way of living is almost designed to cause them: low fibre diets, too much sitting and straining on the loo.
‘About half of people will have had them by the age of 50. They’re one of the conditions patients are most embarrassed to mention, which is a shame because they’re usually straightforward to treat.
‘Being overweight and pregnancy can also increase the risk.’
‘Anatomically, we all have small cushions of blood vessels lining the back passage. They help with continence, and most of the time you’d never know they were there.
Straining on the toilet is a major cause of piles
‘Haemorrhoids are simply those cushions becoming swollen and engorged, usually from repeated pressure,’ says Dr Bakhtiar.
‘Anything that raises pressure in those veins can lead to piles – including heavy lifting with your breath held, that’s why weightlifters often get them.
‘Straining on the toilet is the big one and that is often the result of constipation.
‘Prolonged sitting matters too, and the modern culprit is the phone. People sit on the loo scrolling for ten or fifteen minutes, and that sustained pressure is exactly what we’re trying to avoid.’
Some people inherit weaker tissue in and around the back passage, which leaves them more prone to piles regardless of how careful they are.
But regardless of if you’re genetically inclined to piles or not, there are steps that everyone can take to keep their back passage bulge-free.
The most obvious is to make sure you’re eating a diet with plenty of fibre and staying hydrated.
‘This is where most of the prevention happens,’ says Dr Bakhtiar. ‘Fibre softens and bulks the stool so it passes without effort, and that removes the straining that causes piles in the first place.
‘The evidence here is genuinely good: raising fibre intake cuts the risk of persistent symptoms and of bleeding by roughly half.’
The NHS recommends that adults eat around 30g of fibre a day – but the average Briton only eats around half of that benchmark.
Piles are caused by swollen blood vessels in the rectum
‘Build up gradually with wholegrains, fruit, vegetables and pulses,’ says Dr Bakhtiar. ‘Drink enough water as well, because fibre without fluid can make constipation worse, not better. The two work as a pair.’
Another ‘underrated’ recommendation is to exercise, and it can be as simple as a daily walk. This helps to keep bowel movements regular, and also stops people from being dangerously sedentary.
One caveat is very heavy weightlifting.
‘Holding your breath and bearing down raises abdominal pressure in much the same way straining does,’ says Dr Bakhtiar. ‘If you’re prone to piles, breathe through your lifts rather than holding your breath.’
But, even with the best will in the world (and perfect weightlifting form) piles can still happen.
If you think you have haemorrhoids, the biggest mistake you can make is waiting for them to go away on their own.
Dr Bakhtiar often deals with patients who have suffered in silence for months, too embarrassed to speak up.
‘Another mistake is reaching for creams and ignoring the cause,’ he adds. ‘Over the counter creams can settle symptoms, but if you don’t address the constipation and straining, the piles keep coming back.
‘Some steroid containing creams can also thin the skin if used for weeks on end, so they are not intended for long term use.’
However the biggest mistake of all is assuming any bleeding is ‘just piles’.
‘Most piles are harmless, but some symptoms should never be brushed off because other conditions, including bowel cancer, can mimic them,’ says Dr Bakhtiar.
More than 2,400 people in the UK under the age of 50 are diagnosed with bowel cancer each year, with the number of cases among younger adults rising by 25 per cent over the past decade.
Cancer researchers have long suspected that changes to modern diets and lifestyles are helping to drive the worrying surge.
When it comes to colorectal cancer, early detection is crucial as it allows for more treatment options – and often, the first symptom is noticing blood when going to the toilet.
‘See a doctor if you notice a change in your normal bowel habit lasting more than a few weeks, blood mixed in with the stool rather than just on the paper, dark or tarry stools, unexplained weight loss, or tiredness that could signal anaemia from ongoing blood loss,’ says Dr Bakhtiar.
‘New symptoms over the age of 40, or a family history of bowel cancer, also warrant a proper assessment.
‘The principle I give every patient is simple: rectal bleeding deserves an examination, and you shouldn’t make assumptions. It is usually something minor, but it is not something to self diagnose.’
