Stress and hemorrhoids: How to find your peace of mind

Stress is a well-known phenomenon in modern societies, and while stress is a natural reaction to several foreseen threats,^[1] too much stress can negatively affect all of the body’s delicate systems.^[2]

Added to that, stress can also increase the risk of suffering from hemorrhoidal disease,^[3] together with some of the most common causes of hemorrhoids such as constipation, straining during defecation, and the impairment of defecation habits during pregnancy (due to extra pressure from the expanding uterus, together with a potential lack of fiber in the diet and general dehydration – all of which can lead to constipation and increase the likelihood of hemorrhoids forming. Read more about hemorrhoids during pregnancy here).

So how does stress cause hemorrhoids and what to do to avoid them?

What is the link between stress and hemorrhoids?

Stress can cause hemorrhoids indirectly because it can provoke digestive problems, such as constipation or diarrhea that can lead to more straining and difficulties during bowel movements, and hemorrhoid flare-ups.

How does stress affect your digestion?

Stress is tightly connected to gastrointestinal distress.^[4] The reason for this link is that our nervous system is split into 2 main parts: the sympathetic nervous system, in charge of our “fight-or-flight” response, and the parasympathetic system, which is in charge of calming our bodies after the perceived threat is gone.⁴ Interestingly enough, both the sympathetic and the parasympathetic nervous systems are connected to the enteric nervous system, which has a role in helping to regulate digestion. Added to that, stress has also been proven to aggravate the condition known as irritable bowel syndrome (IBS).^[5]

It has also been shown that stressed people tend to tighten their sphincter muscle which increases the pressure on the rectum which, in turn, raises the likelihood of developing hemorrhoids. This response to stress can be referred to as the pelvic stress reflex response, where the pelvic floor muscles actively contract in response to any perceived physical or mental stress.^[6]

On top of all these factors, since both hemorrhoids and stress can be recurrent, suffering from excessive pressure and stress can create a vicious circle of chronic hemorrhoidal disease.

How depression can increase the risk of hemorrhoids

Another factor, similar to stress, connected to our state of mental health which can also cause hemorrhoids, is depression. This is because depression is linked to a greater risk of developing eating disorders and reducing energy levels which can then lead to a general lack of physical activity.^[7] Depression can also cause interrupted and inadequate sleep patterns and intra-abdominal hypertension, both of which can impact on hemorrhoidal flare-ups.^[8]

There have also been recent studies showing a strong association of microbiome function to mental well-being.^[9]

How to prevent stress-related hemorrhoid

As we have previously seen, some of the causes of stress-related hemorrhoids are due to constipation, depression, and added pressure in the rectal area due to stress. As such, the prevention of stress-related hemorrhoids is mainly focused on these 3 key areas:

• Diet to avoid constipation and thereby decrease straining excessively during bowel movements
• Regular exercise routines to improve stress levels
• Depression management

Keeping these important elements in mind, here are some tips that could help you to prevent stress from ramping up and getting out of control.

1. Being active daily. Whether it’s exercise at the gym, brisk walking, or performing any pleasant activity, such as gardening, dancing, or going for a leisurely bike ride, exercise has been shown to have a positive and powerful effect on stress management and stress relief.^[10]
2. Meditate. Another proven way to relieve stress is through mediation. According to studies, meditation and mindfulness can change our brain and biology in a positive way to have a direct impact on the improvement of both our mental and physical health.^[11] Among these increasingly well-studied benefits, mindfulness-based therapy can be especially effective for reducing stress, anxiety, and depression,^[12] and dramatically boosting the immune system.^[13]
3. Explore yoga. Several medical studies focusing on yoga have proven its effectiveness in the treatment of stress, depression, and some other diseases such as asthma, irritable bowel syndrome, hypertension, drug addiction, and other mental health issues.^[14]
4. Eat a healthy, balanced, and high fiber diet to greatly reduce the chances of excessive straining and constipation, both of which have been strongly linked to the formation and development of hemorrhoids.
5. Treat and prevent hemorrhoids with over-the-counter products. Make sure to ask your doctor about recommended medications and oral flavonoid venoactive treatments which can be used to effectively treat and manage the symptoms, as well as be used as a preventative measure. A meta-analysis suggested that flavonoids significantly decrease the risk of bleeding, persistent pain, itching.^[15]

If you take all of the above-mentioned tips and advice to manage stress levels and the symptoms of your hemorrhoids persist longer than a week, we would strongly recommend that it is time to visit your doctor. Do remember to ask them about the various treatments mentioned above, since those venoactive medications have great results in treating the inflammation and reducing symptoms while also improving the blood flow and overall tone of the veins themselves.^[16]

They can also be used as a preventative measure to reduce the chances of hemorrhoids returning unexpectedly at some future moment in time.