How To Prevent Hemorrhoids
What Are Hemorrhoids?
First off, we all have ‘em—hemorrhoids that is. Their mechanism and function is to cushion the anal region due to the increased pressures occurring with both defecation and anal play, all in the hopes of preventing injury. However, when hemorrhoids become symptomatic from repetitive increased pressure in the veins of the anus, it causes them to bulge and expand, which leads to significant pain, swelling, and/or bleeding. That’s what we don’t want to happen. Two different types of hemorrhoids can occur: external or internal. More than 90% heal without surgery and instead by adjusting to an appropriate bowel regimen, epsom salt baths, and topical creams to provide relief as they heal. However, hemorrhoids that become chronic, impacting quality of life with normal bowel functions and/or limiting anal intercourse, may require surgical treatment.
What Causes Hemorrhoids?
The most common causes of hemorrhoids are:
- Constipation and straining during bowel movements
- Sitting for prolonged periods of time
- Heavy lifting
- Squat work
- Anal intercourse
How Can Hemorrhoids be Prevented?
The key is to understand all of the above and to work on how one can prevent hemorrhoidal occurrence with this knowledge in mind.
A high fiber diet is key and in the western world, this is quite limited. If you see a dog take a shit on the street, most are perfect, easy, with minimal to no wiping needed. Their diet is strictly fiber and the goal should be similar for us humans. Supplementation is a convenient way to get enough fiber. We at Bespoke Surgical love Take Two or Pure for Men, both geared towards our community and with the goal of full, complete, and easy evacuation. Please remember our overall water intake is usually lacking as well. Tons of water is needed daily and especially in tandem with fiber supplementation, it is a must. I like taking the fiber at night with two large glasses of water (all this liquid will be absorbed in the stool to improve transit as we sleep). When standing up in the morning, this creates a change in the pelvic angle, which is a signal to your body to start the defecation process. With the addition of fiber supplements, your bowls are primed and ready.
2.) Less Time, Less Force, Less Pressure
It’s important to understand that the more localized and prolonged the pressure in the anal canal is, the more redirected the blood flow is to that region. It makes sense that in both sitting and/or exercising, which engages that musculature, this can indeed be a problem. For instance, with bowel movements, the days of reading the newspaper or now checking all your social media accounts should be limited. Less time, less force, and less pressure will minimize the blood flow to your anus and/or will allow the proper mechanism to function. Actually, the act of wiping in a standing position, re-directs the blood flow out of hemorrhoids, which will decrease the distention. Just a reminder that the more blood flow there is, the more stretching of the skin or hemorrhoids, which means the more sequelae can occur, like bleeding, clotting, and pain—all leading to difficulty during both defecation and anal intercourse.
3.) Managing Blood Flow
Cushioned seating or frequent standing and walking. Standing desks or the ability to do both (sitting and standing) are revolutionary in assisting with appropriate blood redistribution. Understanding the formal medical concepts allow for life alterations that assist with prevention or at least worsening. We spoke of limiting toilet bowel defecation times, as well as standing during wiping. The squatty potty is a hot thing right now because it changes the pelvic angle in a way that optimizes defecation, which limits pressure in the anal area and thus should limit anal pathologies, too.
4.) Proper Exercise
Squats may be good for your tight booty or glutes, but problems exist with most people not being able to truly isolate those muscles from their anal sphincter. With this, over time, one gets hypertrophied anal muscle and contracture, which leads to a ‘tight ass’. Where we get in trouble is that sometimes too much muscle may lead to limited relaxation or improper function, which causes hemorrhoids and fissures. It is quite common in weight lifters and can totally be avoided. The key is isolation of the glutes only and proper breathing mechanics to lower one’s pressure and therefore help to prevent hemorrhoids from developing. No one said it was easy, but being able to understand the mechanism is critical.
5.) Anal Play
Tight sphincters actually can be the culprit of hemorrhoids. It’s purely physics when you think about it in terms of the smaller the exit, the more pressure is needed to defecate. It’s like blowing out of a small straw—it’s hard work! Because of that increased pressure, one can have hemorrhoids or other anal pathologies develop. So gaining control of the anal opening through anal play can actually allow for more relaxation in the area when needed. The greater the opening, the less pressure or force needed. See the correlation? Have you ever topped anyone and they can open their anus as wide as they want with precision? With this control happening during intercourse, it can indeed happen similarly with defecation, which decreases trauma in the region and helps to prevent hemorrhoids. Dilating with plugs is imperative, specifically for anal engagement, but again for individuals with tighter muscles in the anal region, which can be the real culprit for developing hemorrhoids. So play, play, play! It helps everything in life.
Final Thoughts on Hemorrhoid Prevention
The key to betterment and preventing hemorrhoids is understanding the complete science behind the normal mechanics of proper defecation and anal intercourse, the pathological development of symptomatic hemorrhoids, and, of course, the preventative measures one can implement. Again, all in the name of bottoming.
Bespoke Surgical offers anal reconstruction procedures that can help you tighten a loose anus.
Dr. Evan Goldstein is the Founder and CEO of Bespoke Surgical. Dr. Goldstein has extensive experience educating and shedding light on health care issues relating to the gay community, and has been published in several national publications including The Advocate, OUT Magazine, Vice, Refinery 29, NY Mag and more.