Why Haemorrhoids Happen (and No, It’s Not Because You Sat on a Cold Floor)

If you grew up being warned that sitting on a cold step would “give you piles”, you can relax. Haemorrhoids are not a punishment for chilly pavements, they are a very common side effect of how we sit, strain, eat and live. Slightly less catchy, but far closer to the truth.

In this guide we will walk through what haemorrhoids are, why they actually turn up, and what you can do about them that does not involve blaming the nearest tiled floor.

First things first, what are haemorrhoids

Around your back passage you have soft, cushion like pads made of blood vessels and tissue. They help keep everything sealed and comfortable. When these pads swell or become inflamed, you get haemorrhoids. They can be:

• Internal, higher up inside the back passage
• External, sitting under the skin around the opening

Symptoms often include itching, swelling, a feeling of fullness, pain when you go to the loo, or bright red blood on the paper or in the bowl. None of this is pleasant. All of it is very common.

Why haemorrhoids really happen

Haemorrhoids usually appear when there is extra pressure on the blood vessels around the back passage. That pressure makes the veins swell, a bit like a traffic jam in a very small cul de sac.

1. Straining on the toilet

Straining is one of the biggest triggers. If poo is hard and you need to push for a long time, pressure builds up in the veins around the bottom. Over time those veins stretch, swell and can start to slip down, which is when you notice lumps, pain or bleeding.

Common reasons for straining include:

• Constipation and hard stools
• Low fibre diet
• Not drinking enough fluids
• Waiting too long to go when you feel the urge

2. Long, relaxed bathroom sessions

Reading, scrolling or playing games on the toilet means you are sitting with your body weight bearing down on the same area for longer than it needs. That extra time on the seat puts more pressure on those delicate blood vessels and can encourage swelling.

Shorter, more purposeful trips to the loo are kinder on your body and on your screen time.

3. Pregnancy and giving birth

During pregnancy, there is more blood in the body, hormones relax the blood vessel walls, and the growing uterus increases pressure in the pelvic area. Put those together and haemorrhoids are a frequent visitor in late pregnancy and after birth.

Labour and pushing can also add sudden pressure, which is why many new parents discover haemorrhoids at the same time as discovering that sleep is now a rumour.

4. Ongoing coughs, heavy lifting and strain

Repeated heavy lifting, chronic coughing or anything that makes you hold your breath and brace your body can push pressure down into the pelvic veins. Over time that extra strain adds up, especially if it combines with constipation or long sitting.

5. Ageing and family history

As you get older, the supporting tissues around the back passage naturally weaken. That makes it easier for the vascular cushions to swell and slip. If close relatives have struggled with haemorrhoids, you may be more likely to get them too.

6. Diarrhoea and frequent trips to the loo

Haemorrhoids are not only linked to constipation. Frequent loose stools and repeated wiping can also irritate the area, increase blood flow and inflame the tissue. So both ends of the bathroom spectrum can cause trouble.

Myths that deserve retirement

“Cold floors cause haemorrhoids”

Temperature at seat level is not the problem. Pressure, straining and circulation are the real players. If sitting on a cold wall was all it took, half the population would have flare ups every winter walk.

“Only older people get haemorrhoids”

Age increases the chance, but younger adults, pregnant people and anyone with constipation or gut issues can also develop them. Haemorrhoids are an equal opportunity nuisance.

“They always mean something serious”

Haemorrhoids are usually harmless, although uncomfortable and annoying. Bright red blood on the paper is often from haemorrhoids or small tears. That said, any bleeding from your back passage should be checked with a GP, especially if it is persistent or you are over 40.

Everyday habits that make haemorrhoids more likely

You cannot always control pregnancy, age or family history, but you can tweak daily habits so your back passage has a calmer life.

Boost fibre and fluids

A diet rich in fibre helps to soften poo and keep everything moving. Think wholegrains, beans, lentils, fruit and vegetables. Pair that with enough water through the day so stools stay soft rather than stubborn.

Rethink bathroom timing

Go when you feel the urge rather than holding it in for hours. Try not to sit on the toilet for long periods. If nothing is happening after a few minutes, get up and try again later.

Be gentle when you wipe

Rough toilet paper and vigorous wiping add friction and irritation right where you have sensitive, swollen tissue. A softer, moist clean is kinder and can help reduce itching, soreness and that angry, burning feeling after a bowel movement.

Move more, sit smart

Long periods of sitting slow circulation in the pelvic area. Short movement breaks, even gentle walks round the room, can help. If you have a desk job, try to stand up regularly and keep your weight balanced rather than slumped.

Caring for haemorrhoids when they flare

When haemorrhoids do make an appearance, a few simple comforts can ease the sting.

• Cool compresses or short, cool sitz baths to calm swelling
• High fibre meals and plenty of fluids to keep stools soft
• Short, gentle walks to support blood flow
• Loose, breathable underwear and clothing to reduce friction
• Gentle cleansing with soft, soothing wipes rather than dry paper

Over the counter creams or suppositories can help some people, although they are usually for short term use. Always read the leaflet and speak with a pharmacist or GP if you are unsure.

When to speak to a GP

Get medical advice if you notice:

• Bleeding from your back passage that keeps coming back
• A change in your usual bowel habit that lasts for more than a few weeks
• Severe pain or a hard, very tender lump near the opening
• Unintentional weight loss, tiredness or other new symptoms along with bleeding

Haemorrhoids are common and treatable, but blood from the back passage should always be checked so that more serious causes can be ruled out.