You have a hemorrhoid because something increased the pressure inside the veins around your anus, causing them to stretch, swell, and bulge. These veins sit in cushions of tissue that line your anal canal, and when pressure builds up in your lower rectum or pelvis, blood pools in those cushions instead of flowing freely. The result is the swollen, sometimes painful lump you’re dealing with now.
The specific reason yours showed up depends on your habits, your body, and sometimes just your age. Here’s what’s most likely going on.
Straining and Constipation
The most common trigger is straining during a bowel movement. When you bear down hard to pass stool, you spike the pressure inside your abdomen, and that force gets transmitted directly to the veins around your anus. If this happens occasionally, your body recovers. If it happens repeatedly, those veins gradually stretch out and stay swollen.
Constipation is the usual culprit behind straining. Hard, dry stool is difficult to pass, so you push harder and longer. Chronic diarrhea can do the same thing, though for a different reason: frequent, urgent bowel movements irritate and inflame the anal tissue. Either extreme, too hard or too loose, puts your hemorrhoidal veins under stress they aren’t built to handle long-term.
A related cause that often gets overlooked is pelvic floor dysfunction, where the muscles that coordinate bowel movements don’t relax properly. This forces you to strain even when your stool consistency is normal.
Sitting Too Long on the Toilet
Spending extra time on the toilet is a surprisingly significant risk factor. When you sit on a toilet seat, your pelvic floor has no support underneath it. The longer you stay in that position, the more pressure builds passively in the hemorrhoidal cushions, even if you aren’t actively straining.
A 2024 study published in PLOS One found that using a smartphone on the toilet was associated with a 46% increased risk of hemorrhoids, after adjusting for age, sex, BMI, exercise, straining, and fiber intake. The connection wasn’t really about the phone itself. It was about time: 37.3% of smartphone users spent more than five minutes per toilet visit, compared to just 7.1% of people who didn’t bring their phone. The researchers noted that time spent sitting on the toilet may actually be a more accurate predictor of hemorrhoids than straining itself. So scrolling through your phone, reading, or just sitting and waiting is doing more damage than you’d think.
Diet and Fiber
A low-fiber diet has long been considered a primary driver of hemorrhoids, and the logic makes sense: less fiber means harder stool, harder stool means more straining. That said, the direct link between fiber intake and hemorrhoid risk is less clear-cut than most people assume. Research reviews have found the connection is historically assumed but not conclusively proven, and studies on fiber supplements as a hemorrhoid treatment have produced inconsistent results.
Still, fiber clearly helps with stool consistency. Softer stool that passes easily means less time on the toilet and less straining, both of which reduce the pressure that causes hemorrhoids. Whether fiber prevents them directly or just removes the conditions that lead to them, the practical effect is the same.
Pregnancy
If you’re pregnant, you have multiple forces working against you at once. The growing weight of your uterus presses on the veins in your pelvis, making it harder for blood to flow back from the rectal area. Your blood volume increases significantly during pregnancy, which means your veins are handling more blood than usual and are more prone to swelling.
On top of that, hormonal shifts slow your digestion, making constipation more likely. The combination of extra weight pressing on your pelvic veins, increased blood volume, and constipation-related straining makes pregnancy one of the most common times for hemorrhoids to appear. They often develop in the third trimester or during labor itself, when pushing creates enormous downward pressure.
Heavy Lifting
Regularly lifting heavy objects, whether at the gym or for work, can cause hemorrhoids through the same basic mechanism as straining on the toilet. When you lift something heavy, especially if you hold your breath or tense your core, intra-abdominal pressure spikes. That pressure pushes down on the veins in your anal canal. Do this often enough, particularly with poor breathing technique, and those veins can swell into hemorrhoids. This is why hemorrhoids are common among weightlifters and people with physically demanding jobs.
Age
If none of the above factors seem to apply, age alone may be the explanation. The connective tissue that supports the veins in your rectum and anus weakens and stretches over time, the same way skin loses elasticity elsewhere on your body. As that support structure deteriorates, the hemorrhoidal cushions are more likely to slide downward and swell, even under normal pressure. This is why hemorrhoids become increasingly common as people get older.
Internal vs. External Hemorrhoids
The causes are the same for both types, but they feel different because of where they form. Internal hemorrhoids develop inside the anal canal, in tissue lined with mucosa that doesn’t sense pain, touch, or temperature. That’s why internal hemorrhoids typically don’t hurt. The most common sign is painless bright red blood on the toilet paper or in the bowl. As they get larger, they can prolapse, meaning they push out through the anus during a bowel movement. This can cause a feeling of fullness, itching, mucus discharge, or a sense that stool is stuck.
External hemorrhoids form under the skin just outside the anus, in tissue loaded with pain-sensing nerves. They often appear as a swollen lump you can feel or see. If a blood clot forms inside one (called a thrombosed hemorrhoid), the pressure in that tight space builds rapidly, producing severe, constant pain. The lump typically looks bluish and feels firm. The pain from a thrombosed external hemorrhoid is usually worst in the first 48 to 72 hours and then gradually improves as the clot is reabsorbed.
What You Can Change
Most hemorrhoids develop from habits and conditions you can modify. The highest-impact changes target the pressure cycle that caused the problem in the first place:
- Limit toilet time. Get in, do what you need to do, and leave. If nothing is happening after a couple of minutes, get up and come back later. Leave your phone outside the bathroom.
- Eat more fiber. Fruits, vegetables, whole grains, and legumes soften your stool and make it easier to pass. If you increase fiber quickly, expect some bloating at first. Build up gradually.
- Stay hydrated. Fiber works by absorbing water. Without enough fluid, high-fiber food can actually make constipation worse.
- Don’t strain. If stool isn’t coming easily, that’s a signal to address your diet or hydration, not to push harder.
- Breathe during lifting. Exhale during the effort phase of a lift rather than holding your breath and bearing down.
For immediate relief, warm baths (sitting in a few inches of warm water for 10 to 15 minutes) can reduce swelling and ease discomfort. Over-the-counter creams and suppositories can help with itching and pain. Most hemorrhoids resolve within a few weeks once you remove the pressure that caused them. If yours persists, bleeds heavily, or causes significant pain, that’s worth bringing up with a doctor to rule out other conditions and discuss more targeted options.