Lifestyle Advice for Haemorrhoids

Prevention & Symptom Management

It is advisable to avoid prolonged straining when passing stools. Ensuring adequate dietary fibre intake by eating a balanced diet containing whole grains, fruits, and vegetables provides the dietary fibre that helps to soften stools, thereby making them easier to pass. Maintaining an adequate fibre content in your diet helps to avoid risk of constipation and straining, which can lead to haemorrhoids.

Maintaining an adequate fluid intake (at least 6 glasses of water per day recommended) is particularly important with an increased fibre diet as this helps maintain soft, formed and well-lubricated stools.

Regular exercise, such as a brisk walk (20-30 minutes per day) helps to stimulate bowel function, which in turn helps to maintain a healthy weight and prevent constipation.

It is advisable to open your bowels when the need arises. Holding stools in can cause them to back up and become dry and hard, leading to increased pressure and straining, increasing the risk of haemorrhoids and their severity. Scheduling a time each day, such as after breakfast, to sit on the toilet for a short time can help you to establish a healthy bowel habit, but don’t strain, let things happen naturally!

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Maintaining good anal hygiene is important: by keeping the area clean and dry reduces the risk of irritation that leads to scratching and soreness. This helps to avoid aggravating such symptoms when they are present, by reducing itching.

A Sitz bath (for symptom relief).
Sitting in warm water for up to 20 minutes post defecation and 2-3 times per day in addition, can help to relieve haemorrhoid symptoms such as itching, irritation, soreness, burning, inflammation and spasms of the anal sphincter muscle.

Sitz baths can be purchased from pharmacies and/or online. They are strong plastic bowls used to create a warm shallow bath for washing intimate areas. A shallow bath or use of a bidet is equally effective.

Following having your bowels open or bathing, it is important to pat the anal area clean/dry, rather than rubbing or wiping hard, as this can exacerbate symptoms.

Simple analgesics if needed, such as paracetamol, are recommended for pain relief due to the risk of constipation from using opioid analgesics (such as Codeine) or risk of increased rectal bleeding from nonsteroidal anti-inflammatory drugs (NSAIDs).

Over the counter topical creams containing local anaesthetics and other soothing ingredients, can help to temporarily relieve haemorrhoidal symptoms (ask your local pharmacist for more information on these). In addition to such topicals, a cool pack placed on the anal region can aid in relieving pain and inflammation.

Sitting on a soft cushion as opposed to a hard surface helps to reduce existing swelling of haemorrhoids and helps to prevent new ones from forming.

When to contact your GP

You need to see your GP if:

There is no improvement following 7 days of treatment at home.
You keep getting recurrent haemorrhoid (piles) symptoms such as itching or soreness or prolapsing (a lump coming out from your bottom, usually when having your bowels open).
You experience bleeding from the anus either on the toilet paper or dripping into the bowl.

You need to see your GP urgently if:

You have piles and your temperature is very high, with symptoms of a fever.
You have pus leaking from your piles.
You experience a large amount of bleeding from your bottom.

References:
https://patient.info/doctor/haemorrhoids-piles-pro
https://nhs.uk/conditions/piles-haemorrhoids
https://nice.org.uk/haemorrhoids
https://ncbi.nlm.nih.gov/pubmed/19852813

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