Constipation and haemorrhoids: how to get your bowels moving gently

2026-10-13

• Hard stools and straining raise the pressure in the haemorrhoidal cushions, which is how constipation keeps haemorrhoids going.
• The foundations are fibre, water and movement; increase dietary fibre gradually.
• Don't linger on the toilet with your phone, don't strain hard and don't ignore the urge to go.
• Laxatives and enemas are not for long-term use and only on a doctor's advice.
• Heavy bleeding, black stools or unexplained weight loss mean seeing a doctor urgently.

It is morning, everyone is in a hurry, there is one bathroom for the whole family, and nothing is happening. You sit longer than you would like, strain, reach for your phone, and the same thing happens day after day. Then comes itching, discomfort or a drop of blood on the paper, and it starts to feel genuinely worrying.

Constipation and haemorrhoids really do often go together. The good news is that in most cases your bowels can be eased with gentle, safe steps, without harsh laxatives or risky experiments. Here is where to start.

How is constipation linked to haemorrhoids?

Haemorrhoids are normal cushions of blood vessels in the anal canal, and everyone has them. Problems begin when these cushions become enlarged, inflamed, bleed or slip down and out.

Hard stools and forceful straining raise the pressure in these vessels, slow the outflow of blood and damage the delicate lining. Sitting on the toilet for a long time adds to the load: the cushions fill with blood and gradually slide downwards. That is why international guidelines on haemorrhoids put softening and regulating the stools first. You can read about other risk factors in our article on the causes of haemorrhoids.

What counts as constipation?

Everyone has their own rhythm: for some people once a day is normal, for others every day or two. There is no need to compare yourself with anyone else: what matters is how easy and comfortable it is for you. Doctors usually talk about constipation when:

• you open your bowels fewer than three times a week;
• stools are hard, lumpy or pellet-like;
• you have to strain a lot;
• you feel you haven't fully emptied your bowels.

Short-term constipation is common when travelling, when your routine changes, in the summer heat when the body loses a lot of fluid, during pregnancy and after giving birth, and with desk jobs. But if your bowel habits have changed recently for no clear reason, especially in middle or later life, be sure to discuss it with a doctor.

Fibre: your main ally for soft stools

Dietary fibre holds water in the bowel and makes stools bulkier and softer. Research shows that getting enough fibre reduces haemorrhoid symptoms and bleeding, which makes it one of the best-studied ways to help.

• Vegetables at every meal: pumpkin, beetroot, carrots, cabbage, courgettes and fresh herbs.
• Pulses: mung beans, chickpeas, beans and lentils, in mastava, mashkhurda, soups and salads.
• Wholegrain porridges such as oats, buckwheat and pearl barley, and bran bread instead of white non at least some of the time.
• Fruit with the skin on, such as apples, pears, quince, apricots and persimmons, plus dried fruit: prunes, dried apricots and figs.

If it is hard to get enough fibre from food, your doctor may suggest a fibre supplement, for example one based on psyllium. These should also be introduced gradually and always taken with water.

Water and movement: fibre won't work without them

Fibre needs fluid; without it, stools only become firmer. Drink water steadily throughout the day, and more in summer, on journeys and when working in the heat. Tea at the dastarkhan is lovely, but it doesn't replace plain water. If you have heart or kidney disease, check with your doctor how much fluid you should drink.

Movement helps your bowels work. A daily walk, the stairs instead of the lift, and a short stretch every hour if you sit at work all make your bowel habits more regular. This is especially important if you spend many hours behind the wheel, at a desk or behind a shop counter. Even a 20–30 minute walk around the mahalla or the office during your lunch break is a good start.

What are good toilet habits?

What you do on the toilet affects haemorrhoids just as much as what you eat:

1. Don't put off the urge to go. If you hold on, the stool gets harder and you will have to strain more later.
2. Use your natural rhythm: many people find it easiest to open their bowels soon after breakfast, when the gut becomes more active after eating.
3. Put a low footstool under your feet so that your knees are higher than your hips; many people find this makes things easier.
4. Don't sit for long, and leave your phone outside. If nothing happens within a few minutes, get up and try again later.
5. Don't strain with all your might or hold your breath: breathe calmly and relax your tummy.
6. Afterwards, wash with warm water and pat the skin dry with a soft towel rather than rubbing with rough paper. Wet wipes with fragrance or alcohol can irritate the skin.

Washing with water is a normal part of life for many families in Uzbekistan, and it is a good tradition: it is much gentler on the skin than paper.

Is it OK to take laxatives?

Sometimes a doctor does recommend a laxative, for example for stubborn constipation or during a flare-up of haemorrhoids, to keep the stools soft. But the product, dose and length of use should be chosen by a specialist: some laxatives, if used all the time, cause loss of fluid and salts, tummy pain and a sluggish bowel.

• Don't take laxatives just in case, or in long courses without a prescription.
• Regular enemas and bowel cleanses are unnecessary and can do harm.
• Don't try detox teas or herbal blends with strong laxative herbs without a doctor's advice either.

During pregnancy and breastfeeding, and for children and older people, any remedies for constipation should be used only on a doctor's recommendation.

When are constipation and haemorrhoids a reason to see a doctor urgently?

If constipation lasts for several weeks despite changes to your diet, or haemorrhoids keep coming back, book an appointment with a proctologist or GP. The doctor will examine you, arrange bowel tests if needed and choose a treatment. Remember, too, that hard stools can cause an anal fissure, a small tear that causes sharp pain during and after a bowel movement, and this is also treated by a proctologist. We have described the first warning signs in our article on the signs of haemorrhoids.

The main points

Constipation and haemorrhoids feed each other, but the cycle can be broken. Fibre and water, a daily walk and a calm, short visit to the toilet without your phone are simple steps that, over time, make stools soft and life noticeably more comfortable. Start with one change today, perhaps a bowl of mastava for lunch and a walk after dinner.

Sources: 1. van Tol RR, Kleijnen J, Watson AJM, et al. European Society of ColoProctology: guideline for haemorrhoidal disease. Colorectal Dis. 2020;22(6):650–662. 2. Davis BR, Lee-Kong SA, Migaly J, Feingold DL, Steele SR. The American Society of Colon and Rectal Surgeons Clinical Practice Guidelines for the Management of Hemorrhoids. Dis Colon Rectum. 2018;61(3):284–292. 3. Alonso-Coello P, Mills E, Heels-Ansdell D, et al. Fiber for the treatment of hemorrhoids complications: a systematic review and meta-analysis. Am J Gastroenterol. 2006;101(1):181–188.

• Why haemorrhoids develop: the main risk factors
• Early signs of haemorrhoids you should not ignore
• Internal and external haemorrhoids