Can Crohn’s Disease Cause Hemorrhoids?

Medically reviewed by: Liza M. Capiendo, MD
Last modified on January 26th, 2023

Crohn’s disease (CD) is a relatively rare condition. However, it comes with a long list of complications, such as weight loss, anemia, and digestive issues. But are hemorrhoids included in that list? That is — can Crohn’s disease cause hemorrhoids?

Well, the answer is both yes and no. Read ahead to learn more about what we mean by this, as well as more helpful information related to CD and hemorrhoids.

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What is Crohn’s disease?

Crohn’s disease is a chronic inflammatory bowel disease (IBD) that can affect any part of the gastrointestinal tract, from the mouth to the anus (unlike ulcerative colitis). 

It’s characterized by inflammation of the gastrointestinal tract lining, which can lead to a wide range of symptoms, including abdominal pain, diarrhea, weight loss, and fatigue.

Can Crohn’s disease cause hemorrhoids?

No, Crohn’s disease doesn’t directly cause hemorrhoids. However, the inflammation and irritation associated with Crohn’s disease can lead to anal fistulas and abscesses. 

These, in turn, can make bowel movements extremely painful and uncomfortable. As people become more hesitant to pass stool, they may become constipated. And constipation is a well-known risk factor for hemorrhoids.

Why does constipation lead to hemorrhoids?

Constipation leads to hemorrhoids because it puts extra pressure on the veins in your anus and rectum. This pressure can cause the veins to swell and eventually bulge, leading to hemorrhoids.

In fact, any condition that leads to chronic constipation or diarrhea can lead to hemorrhoids. This is because these conditions put extra pressure on rectal veins, leading to their inflammation and swelling.

What digestive issues cause hemorrhoids?

There are many digestive issues that can cause hemorrhoids, including Crohn’s disease, constipation, diarrhea, and irritable bowel syndrome (IBS). These conditions all put extra pressure on the veins in your anus and rectum, displacing them downwards and out of the anal canal.

Unfortunately, hemorrhoids can develop as a result of non-digestive issues as well. Examples include:

  • Chronic cough
  • Heavy lifting
  • Long periods of sitting
  • Pregnancy
  • Connective tissue problems such as scleroderma and Ehler-Danlos syndrome (which are very rare)
  • Benign prostatic hyperplasia, where the prostate gland in males gets bigger than normal

All of these conditions lead to increased pressure inside the abdomen one way or the other. This pressure is transmitted to anal veins, leading to their swelling and popping out of the anal canal.

What can you do to reduce your risk of hemorrhoids if you have Crohn’s disease?

The best way to reduce your risk of hemorrhoids is to take measures to reduce the inflammation in your gastrointestinal tract. This is especially true if your CD is affecting the area around your anus (peri-anal area), making bowel movements painful.

So how would you know if CD is affecting your peri-anal area? Well, if you develop an anal abscess as a result of your CD, you’ll experience things like:

  • Dull discomfort around the anal area
  • Excessive itching around the anal area
  • A red mass under the skin of the peri-anal area
  • Fever with chills

In case you develop an anal fistula as a result of your CD, you’ll experience:

  • A foul-smelling, pus-containing liquid draining from the skin around your anal area
  • Pain while passing stool

If you experience any of these symptoms, it’s important to seek medical attention as soon as possible. That’s because unlike regular CD, which may be treated with medication, peri-anal CD usually requires surgery.

Even if you don’t have peri-anal CD, though, it’s still important to take measures to reduce the inflammation in your gastrointestinal tract. This can be done through a combination of medication and lifestyle changes (such as eating a healthy diet).

Also, keep in mind that you don’t necessarily have to have a CD in order to develop an anal abscess or peri-anal fistula. Both of these conditions can affect anyone, regardless of whether they have a CD or not.

Can you check hemorrhoids without a colonoscopy?

Yes, hemorrhoids can be checked without a colonoscopy. This is in contrast to CD, which often requires a colonoscopy for diagnosis.

This means that if your healthcare provider suspects that your hemorrhoids are due to underlying CD, they might perform a colonoscopy. This is especially true if you have red flag symptoms that are not common in simple hemorrhoids, such as:

  • Weight loss
  • Long-term fever
  • Fatigue
  • Abdominal pain
  • Sticky (or greasy) diarrhea, which indicates that your body is unable to absorb fats from your diet

All of these symptoms may prompt your healthcare provider to perform a colonoscopy, just to rule out CD (or other more sinister bowel conditions).

How are hemorrhoids treated if you have Crohn’s disease?

Hemorrhoids are treated the same way whether you have Crohn’s disease or not. That is, the goal of treatment is to reduce the inflammation and swelling of the veins in your anus and rectum.

Treatment for hemorrhoids usually depends on the grade of your condition. For instance, if you have grade I hemorrhoids, your healthcare provider might suggest:

  • Applying over-the-counter topical creams or ointments
  • Taking sitz baths several times a day

On the other hand, if you have grade 4 hemorrhoids, you’ll probably need to undergo a surgical procedure called hemorrhoidectomy.

For your reference, hemorrhoids are graded as follows:

  • Grade I: hemorrhoids that bleed but do not prolapse (protrude from the anus)
  • Grade II: hemorrhoids that prolapse but spontaneously reduce (go back inside the anus on their own)
  • Grade III: hemorrhoids that prolapse but must be manually reduced
  • Grade IV: hemorrhoids that are permanently prolapsed and cannot be reduced

So, Crohn’s disease doesn’t usually cause hemorrhoids

Although people with CD are more likely to develop hemorrhoids, hemorrhoids are not a common complication of CD and not every patient with CD will get hemorrhoids.

Those CD patients who do get hemorrhoids do so as a result of long-term diarrhea or long-standing constipation due to a perianal abscess or fistula. 

We hope this article helps you understand the relationship between CD and hemorrhoids better. If you suffer from either condition and have more questions, please feel free to reach out to us. We will be happy to answer any questions you may have!

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