Can Hemorrhoids Develop Without Constipation?

Medically reviewed by: Gary H. Hoffman, MD

You’re not alone if you have been diagnosed with hemorrhoids. Hemorrhoids are relatively common and affect many people across the globe. The internet may lead you to believe that constipation is the only cause of hemorrhoids. But is it possible to develop hemorrhoids without constipation?

To answer that question, this article will discuss what hemorrhoids are, why they develop, if they can occur without constipation, and more.

What are hemorrhoids?

Hemorrhoids — also known as piles — are swollen veins around the anal area. When veins of the anus are unable to take blood away from the area, it begins to pool in these vessels. This causes the veins to become engorged and swollen, leading to hemorrhoids.

Hemorrhoids can be divided into internal or external hemorrhoids:

  • Internal hemorroids are inside the anal canal
  • External hemorrhoids are found closer to the anal orifice and skin. The may be seen popping out of the anal canal.

The first symptoms of hemorrhoids are usually pain and bleeding during a bowel movement. Sometimes, you might also experience itching and swelling around the anal area.

What is the main cause of hemorrhoids?

The main cause of hemorrhoids is straining. This may happen when you lift weights, are constipated, or perform other forms of laborious work.

Straining increases the pressure inside the belly. This pressure compresses veins in the anal region, preventing the flow of blood away from the anus. As blood pools in these veins, they become engorged and turn into hemorrhoids.

Can hemorrhoids develop without constipation?

Yes, hemorrhoids can occur without constipation. Although constipation is the most likely cause of hemorrhoids, other factors also contribute to their development. Let’s look at a few examples.

Pregnancy

Hemorrhoids and pregnancy are closely related. During pregnancy, the body releases hormones like progesterone. Some of these hormones cause blood vessels to relax. When veins in the anal region relax, they are unable to carry blood away from the area. And this increases the risk of hemorrhoids.

Another reason why pregnant women often develop hemorrhoids is that tissues in the rectum become weaker during pregnancy. This affects the small muscles that make up the wall of blood vessels in the area. When these muscles become weak, the blood vessels become lax, giving rise to hemorrhoids.

Obesity

Being overweight can also cause hemorrhoids. This occurs because of increased pressure in the body. Just like in constipation, this increased pressure compresses veins in the anus, giving rise to hemorrhoids.

Genetics

If you have a family history of hemorrhoids, you are likely to develop them. Genetics play an important role in various illnesses, and hemorrhoids are no exception.

Diet

A diet low in fiber does not cause hemorrhoids on its own. However, it can give rise to constipation, which then leads to hemorrhoids as discussed earlier.

Therefore, consuming a fiber-rich diet is a good way to prevent constipation and hemorrhoids.

Spicy foods and alcohol have also been associated with hemorrhoids, so it might be a good idea to avoid them.

Diarrhea

Chronic diarrhea (diarrhea that lasts more than four weeks) can damage the lining of the anus over time. This happens because continuous passage of stool irritates the lining, making it inflamed. Because blood vessels lie close to this lining, inflammation in the area can damage them. And this might lead to hemorrhoids.

Age

Our organs become weaker as we age. This is also true for blood vessels in the anus. Therefore, older people are more likely to develop hemorrhoids.

It is also important to know that if you have had episodes of hemorrhoids in the past, you are more likely to get them when you are older.

When should I worry about hemorrhoids?

Small hemorrhoids usually don’t cause any trouble and go away on their own. But larger hemorrhoids — and sometimes even smaller ones — can undergo a few changes that warrant a doctor’s visit. You should visit a doctor if:

  • Your hemorrhoids are bleeding: If the bleeding is profuse, you must seek urgent medical attention. Even though smaller bleeds are not too dangerous, it’s always a good idea to consult a doctor for bleeding hemorrhoids.
  • Your hemorrhoids are causing pain: Pain can be a sign of a clot in the hemorrhoid. This can lead to bleeding and ulceration, causing even more pain.
  • Your hemorrhoids have not resolved despite treatment: Small hemorrhoids usually resolve on their own. If your hemorrhoids persist after home remedies, it is time to visit a doctor to get an evaluation. A variety of office procedures as well as more permanent solution such as surgery may be offered depending on the symptoms and size of the hemorrhoids.

Do hemorrhoids go away on their own?

Yes, hemorrhoids can go away on their own. Small hemorrhoids can disappear in a few days. If you are pregnant, your hemorrhoids might go away once you deliver.

But sometimes, hemorrhoids can persist, even after trying homemade remedies.

How to treat hemorrhoids?

When hemorrhoids won’t go away on their own — or when they cause extreme discomfort — your doctor may offer you one of these common office treatment options:

Band ligation

Rubber band ligation is one of the most common treatments for hemorrhoids. Your doctor will take a ligator (a medical-grade rubber band) and tie it tightly around the hemorrhoid.

The tightly bound rubber band cuts off the blood supply to the hemorrhoid, causing it to die. Three to ten days after the procedure, the ligated hemorrhoid will simply fall off.

This method is usually not painful but you may feel a dull sensation for a day or two. However, you can resume your daily activities right after the procedure.

Photocoagulation

Photocoagulation is used for internal hemorrhoids. This technique makes use of infrared light, which is why it’s also called infrared photocoagulation.

The intense beam of light creates heat and forms a scar on the hemorrhoid, cutting off its blood supply and causing it to die. The scar also holds other vessels firmly against the anal wall, which prevents them from bulging out in the future.

The downside to this treatment is that it treats only a single hemorrhoid per visit. So if you have more than one hemorrhoid, you will have to wait approximately two weeks before your next appointment.

It’s also important not to strain or lift weight after the procedure until your doctor tells you to.

Sclerotherapy

This technique uses a chemical that is injected into or around the hemorrhoid. The chemical causes damage to the hemorrhoid and its blood supply, shrinking its size. This method takes just a few minutes and is associated with minimal discomfort during the procedure.

Keep in mind that you also have more invasive surgical procedures for hemorrhoids, and you might need one if your condition doesn’t respond to one of these treatments.

Now you know hemorrhoids can develop without constipation

Remember, constipation and straining are not the only causes of hemorrhoids. Pregnancy, diet, genetics, obesity, chronic diarrhea, and age are all important factors that can increase your risk of developing hemorrhoids.

Although most small hemorrhoids go away on their own, you might need a procedure for larger hemorrhoids. Treatments like sclerotherapy, band ligation, and photocoagulation are all good options with very few side effects, and it’s a good idea to discuss these with your doctor.