A hemorrhoid gets bigger when blood pools inside the cushion of tissue and can’t drain properly. This happens because of increased pressure in or around the veins of the anal canal, whether from straining on the toilet, sitting too long, lifting heavy objects, or hormonal changes during pregnancy. The swelling can be gradual over weeks and months, or it can happen suddenly overnight if a blood clot forms inside the vein.
Understanding what’s driving the growth helps you figure out whether this is something you can manage at home or something that needs medical attention.
How Hemorrhoids Swell in the First Place
Hemorrhoids aren’t abnormal. Everyone has them. They’re cushions of blood vessels inside the anal canal that contribute about 15 to 20 percent of the seal that keeps your anus closed. During rest, the internal sphincter muscle naturally impedes blood from draining out of these cushions, which is what keeps them plump and functional. When you have a bowel movement, the sphincter relaxes, blood drains from the cushions, and they shrink down temporarily.
Problems start when that drainage cycle breaks down. Repeated straining, chronic constipation, or prolonged sitting keeps pressure elevated in the area, and blood stays trapped in the cushion longer than it should. Over time, the tissue stretches, the supporting connective fibers weaken, and the cushion swells beyond its normal size. Once the tissue has stretched, it doesn’t snap back easily, which is why hemorrhoids tend to get progressively worse rather than resolving on their own.
Common Reasons for Sudden Growth
If your hemorrhoid got noticeably bigger in a short period, one of a few things likely happened.
Straining during a bowel movement is the most common trigger. Hard stools or pushing forcefully spikes pressure in the anal veins. Even a single difficult bowel movement can push an internal hemorrhoid further out or cause an external one to swell significantly.
Heavy lifting creates a similar effect. Any activity that forces you to hold your breath and bear down raises pressure in your abdomen, and that pressure transmits directly to the pelvic floor veins. Research shows that intra-abdominal pressure increases with higher loads, faster movements, and greater impact forces. This applies to gym workouts, moving furniture, or even picking up a toddler repeatedly.
Prolonged sitting compresses the veins around the anus and slows blood flow. Long stretches on the toilet are particularly problematic because the position opens the anal canal and lets gravity pull the cushions downward while venous drainage is already restricted.
A blood clot (thrombosis) can form inside an external hemorrhoid, causing it to balloon into a tense, painful, bluish lump at the anal margin almost overnight. These thrombosed hemorrhoids are hard to miss. They feel firm, throb constantly, and have a distinct blue or purple color under the skin. Left alone, they typically resolve over 7 to 10 days, though the first 48 hours tend to be the worst. If you catch it early (within 24 to 48 hours), a doctor can drain the clot under local anesthesia for faster relief.
Pregnancy and Hemorrhoid Growth
Pregnancy is one of the most reliable triggers for hemorrhoid enlargement because it hits you from multiple angles at once. Progesterone relaxes the walls of your blood vessels, making them more prone to swelling. Your total blood volume increases substantially, putting more fluid through veins that are now weaker and more distensible. And the growing uterus presses on the pelvic veins, making it harder for blood to travel back up toward the heart.
Hemorrhoids during pregnancy are especially common in the third trimester, when all three of these forces are at their peak. They often improve after delivery once the pressure on the pelvis is relieved, though they may not disappear entirely.
The Four Stages of Internal Hemorrhoids
Internal hemorrhoids progress through a well-defined grading system, and knowing where yours falls helps explain why it seems to be getting bigger.
- Grade 1: The hemorrhoid bulges into the anal canal during a bowel movement but stays inside. You likely wouldn’t feel it or see it.
- Grade 2: It pushes out past the opening during straining but slides back in on its own once you stop.
- Grade 3: It protrudes during bowel movements and doesn’t go back in unless you push it in with your finger.
- Grade 4: It stays outside permanently and can’t be pushed back in.
What many people experience as a “growing” hemorrhoid is actually progression from one grade to the next. A hemorrhoid that used to retract on its own now hangs out longer, or one that you could push back in now refuses to stay put. A prolapsed internal hemorrhoid looks like a soft, pinkish-red or skin-colored lump protruding from the anus. It’s typically soft to the touch, which distinguishes it from the firm, tense feel of a thrombosed external hemorrhoid.
How to Tell It’s Not Something Else
Not every growing lump near the anus is a hemorrhoid. A perianal abscess can look similar at first glance but behaves differently. Abscesses are infections. They tend to be extremely painful, red, and warm to the touch, and they often produce pus-like discharge. Fever and chills can accompany a significant abscess. Hemorrhoids, by contrast, are not infections. They may bleed bright red blood and cause discomfort, but they don’t produce pus or cause systemic symptoms like fever.
If the lump is red, hot, progressively more painful over days, and accompanied by fever or discharge, that points toward an abscess rather than a hemorrhoid, and it needs medical evaluation promptly.
What Slows the Growth
The most effective way to stop a hemorrhoid from getting bigger is to reduce the pressure that’s driving the swelling. Practically, that means softening your stools so you don’t strain (more water, more fiber, or a fiber supplement), keeping bowel movements brief (no phone on the toilet), and avoiding prolonged sitting when possible.
Warm sitz baths, where you sit in a few inches of warm water for 10 to 15 minutes, help promote blood drainage from the swollen tissue and reduce discomfort. Over-the-counter topical treatments can ease itching and pain but don’t shrink the hemorrhoid itself.
If you lift weights, exhaling during the exertion phase rather than holding your breath can reduce the spike in abdominal pressure that aggravates hemorrhoids.
When Size Signals a Need for Treatment
Grade 1 and 2 hemorrhoids that don’t respond to lifestyle changes can be treated with office-based procedures like rubber band ligation, where a small band is placed around the base of the hemorrhoid to cut off its blood supply. This is a quick procedure that doesn’t require general anesthesia.
Grade 3 and 4 hemorrhoids, especially those with a significant external component, are more likely to need surgical removal. This is also the case for hemorrhoids that keep coming back despite treatment, or those causing persistent bleeding. Surgical hemorrhoidectomy remains the most effective treatment for advanced hemorrhoidal disease, though it comes with a more involved recovery.
Strangulation is the most urgent scenario. This happens when a prolapsed internal hemorrhoid gets trapped outside the anus by the sphincter muscle, cutting off its blood supply. The result is severe, constant pain, significant swelling, and the tissue can progress to tissue death if left untreated. If you have a prolapsed hemorrhoid with escalating pain that isn’t improving, that warrants same-day medical evaluation.