What diet for haemorrhoids? What you can and cannot eat

A good diet and the awareness of what to eat and what foods to avoid are key in preventing haemorrhoidal discomfort. In this article, we offer you tips on how to adapt your diet to help prevent haemorrhoids.
Haemorrhoids (also referred to as piles) are the most common proctological pathology and one of the most prevalent disorders in the general population1. In Spain, the prevalence of haemorrhoids is 13%, with a peak in the population between the ages of 41 and 60.²
The formation of haemorrhoids is related to a wide variety of causes, although factors such as constipation, diet or pregnancy stand out ².

What to eat if you have haemorrhoids

Constipation is one of the main causes of haemorrhoids. Constipation is frequently related to diet or iatrogenic factors*.
In diets that are poor in fibre or fluids, stool tends to become hard or dry, thus facilitating constipation. Fibre increases the weight and size of stool and leads to softening. Bulky stool is easier to pass, which in turn decreases the likelihood of constipation and may reduce the likelihood of developing haemorrhoids³.
Fibre interacts closely with the intestinal flora, the group of bacteria that live in the intestine. These bacteria are responsible for processing foods that are difficult to digest, absorbing nutrients and forming a complex ecosystem that is self-regulating and kept in balance. Fibre helps to give consistency to the stool , thus promoting intestinal transit⁴.
A diet that is rich in fibre may also provide other health benefits such as helping to maintain a healthy weight, reducing the risk of diabetes, heart disease, and some types of cancer³.
The best thing to do is to introduce fibre into our diet little by little. To achieve this necessary intake, it is recommended to ingest the appropriate daily amount of fibre according to age and sex³.

Table extracted from: https://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/in-depth/fiber/art-20043983

In addition to increasing the fibre content in our diet, it is recommended to drink plenty of water when suffering from haemorrhoids.

Foods rich in fibre

Vegetables are the greatest source of natural fibre. When suffering from haemorrhoids, we recommend the consumption of lettuce, chard, raw carrots, spinach, cooked baby greens, broccoli, artichokes, pumpkins, potatoes, green beans and vegetable juices. Grains and nuts such as sunflower seeds, almonds, pistachios and walnuts are also recommended4. There is also a lot of fibre in pulses, which also contain protein that can aid digestion and bowel movements.
Fruits and vegetables (preferably with skin) are also a great option for incorporating more fibre into your diet. They are also an excellent source of vitamins and minerals. It is recommended to try to eat at least 5 servings a day³.
Be careful! Adding too much fibre too quickly can lead to intestinal gas, bloating and cramping. Increase dietary fibre gradually over a few weeks. This allows the natural bacteria in your digestive system to adapt to the change³.

What foods to avoid when you have haemorrhoids

It is not only important to know what to eat when suffering from haemorrhoids, but also which foods to avoid that may cause constipation or the appearance of haemorrhoids.
The following table lists some of the foods that patients suffering from constipation and/or haemorrhoids should avoid.

Table adapted from: Hemorroides hidratación y protección. Micaela Pérez Alcázar. Farmacia Profesional, Vol 19, No 2, February 2005.

Milk and dairy products: condensed milk, chocolate spread, dairy products enriched with cream.

Fatty meats, charcuterie and offal.

Canned, smoked or salted fish.

Cereals: freshly baked baguette-type bread, undercooked pasta, biscuits filled with or dipped in chocolate.

Legumes cooked with fatty ingredients: chorizo, black pudding, bacon, etc.

Flatulent vegetables: artichokes, cabbage, peppers, radishes, onions, garlic and leek.

Fruit: fruits in syrup and candied fruit, astringent fruits such as quince, bananas, grated apples and lemons.

Drinks: tea (contains tannins and is astringent), lemon juice, grapefruit juice, apple juice.

Fats: lard, cream, bacon and tallow.

Others: chocolate (astringent), cakes and pastries filled with chocolate or dipped in sugary solutions, sweets and candies.

Avoid excessive consumption of sweeteners: sorbitol, saccharin, cyclamate and aspartame.

What else can you do to relieve haemorrhoids?

Although good lifestyle habits and a healthy diet can go a long way in relieving haemorrhoids, you may also try the following recommendations in cases of a flare-up:

Take care of your hygiene

Hygiene of the perianal area after each bowel movement should be frequent and careful. Be sure to use lukewarm water, acid or neutral soap, with abundant rinsing and gentle drying. The use of toilet paper is not recommended. The use of wet wipes is preferable. After cleansing, it is important to dry the area thoroughly to avoid infection and irritation. Sitz baths are recommended (with cold or lukewarm water, never with hot water)^5,6.

Watch your habits and lifestyle

Alternate postures throughout the day and avoid standing for too long.
Never delay the time to defecate.
Applying ice or cold compresses helps to reduce the swollen area.
On the other hand, it is advisable to avoid clothes that press on the abdomen, as they increase internal pressure and hinder venous return.

Be physically active

A sedentary lifestyle can favour the appearance of haemorrhoids. Physical activity is a good ally to combat a sedentary lifestyle and the risk of overweight. Make sure to spend some time every day doing your favourite physical activity and to relax.
Be careful! Sports such as cycling, motorcycling, rowing or horse riding may lead to haemorrhoids.

The health professional is your ally

If you notice that the haemorrhoidal symptoms do not improve despite compliance with all these hygienic-dietary and pharmacological measures, do not hesitate to consult a physician or pharmacist.