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Piles (Haemorrhoids)

Updated 08 August 2018

Causes of haemorrhoids

The most common cause of haemorrhoids is straining during bowel movements.

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Factors that contribute to haemorrhoids include: 

  • Sitting for long periods of time on the toilet
  • Overweight/obesity
  • Pregnancy
  • Chronic constipation or diarrhoea
  • A diet that lacks fibre
  • Ageing
  • Anal intercourse

Why are these contributing factors?

  • Prolonged sitting: Sitting for long periods of time equates to increased pressure on the veins in the anal area.
  • Overweight/obesity: Excess weight stored throughout the body can put extra pressure on the blood vessels in and around the anus.
  • Pregnancy: Haemorrhoids are very common among pregnant women. The pressure of the foetus on the abdomen, as well as hormonal changes, lead to enlargement of the haemorrhoidal vessels. These vessels are also placed under severe pressure during childbirth. For most women, however, haemorrhoids caused by pregnancy and childbirth are a temporary problem.
  • Chronic diarrhoea: Just like long-term constipation, chronic diarrhoea can also lead to haemorrhoids. The diarrhoea causes constant irritation of the anal canal.
    Poor diet: A diet that contains too little fibre and not enough fluid significantly increases your risk for haemorrhoids.
  • Older age: Haemorrhoids are more common in older than in younger people – a result of weakening connective tissue in and around the anus.
  • Anal intercourse: This may cause weakening of the muscles in the anus and rectum.
  • Inflammatory bowel disease (IBD): Conditions such as Crohn’s disease and ulcerative colitis may increase your risk for haemorrhoids.
  • Liver disease: Liver cirrhosis can lead to swollen veins within the anus and rectum.

Reviewed by Dr Britta Dedekind, General Surgeon at Christiaan Barnard Memorial Hospital. MBChB, FCS (SA), MMED (UCT). April 2018.