"I've had haemorrhoids for years and I'm too embarrassed to talk about it." I hear that a lot. I lived it for over a decade before anyone properly addressed the cause.

Haemorrhoids are swollen blood vessels in the wall of your lower rectum and anus, and the honest answer is nobody knows one single cause. What raises your risk is clearer: constipation, straining, pregnancy, ageing, and too much time sitting on the toilet.

Here's the part most articles on this topic skip entirely: haemorrhoids sit at the 6th of 7 pillars of health, elimination, the one nobody wants to talk about. That's not a footnote, that's the actual reason this problem gets mismanaged for years. If you've been dealing with this and never told anyone, you're not alone, and you're not stuck with it.

My History, in Numbers

3 rounds of injections. 1 radiofrequency procedure. 2 sigmoidoscopies. 1 colonoscopy. A rather interesting session with a biofeedback therapist. Countless inspections and probings by a variety of doctors and specialists. And more banding than a 1980s rock festival, 4 or 5 rounds, I genuinely lost count.

The turning point came when I tried to donate blood plasma. I failed the heart rate test. I failed the iron level test, too, a low iron level can be caused by chronic bleeding. I remember thinking: this has to stop.

Not one conversation in 10 years had properly addressed the cause. So I spent the next 3 years researching gut health and the microbiome properly. That frustration became my book, GUTWISE.

Why This Happens More Than People Admit

Haemorrhoids get treated like a punchline instead of a symptom. Even the cockney rhyming slang, "Farmer Giles," "Chalfont St Giles," a whole list of them, exists partly because nobody wants to just say the word.

The research backs up how common this actually is. A 2022 study in Frontiers in Surgery found haemorrhoids or anal fissures affect up to 40% of pregnant and postpartum women, and 70% of women diagnosed with haemorrhoids had at least one previous pregnancy. Straining, increased pelvic pressure, and constipation all compound each other, which is exactly why you can't properly resolve haemorrhoids without also relieving the underlying constipation.

What Actually Helps

Start with what's causing the pressure, not just the symptom. Softer, bulkier stool from proper fibre intake means less straining, which is the single biggest lever most people never pull. Sitting less, moving more, and not lingering on the toilet all help too, your body isn't designed to sit there scrolling your phone.

Here's your challenge this week: count how many days you strain for more than a few seconds to go. If it's more than half the days, that's your actual signal, not more creams, not more banding, but your fibre and fluid intake need fixing first.

For active symptoms, there's a real treatment ladder: creams and dietary changes first, then options like rubber band ligation, injection sclerotherapy, or infrared coagulation for more persistent cases, and surgical options for anything beyond that. I've had most of them. If you're bleeding regularly, see a doctor rather than guessing, that's not fear-mongering, it's just what I'd tell a friend.

I later discovered something that never came up in 10 years of appointments: your breathing and your diaphragm genuinely influence gut motility. A 2019 review in Physiological Reviews mapped the gut-brain axis in detail, the same vagus-nerve pathway that a properly engaged diaphragm helps activate. It's why I started teaching breathing for gut health alongside everything else in this piece.

The Pillar Nobody Talks About

Elimination is the 6th pillar of health, and it's treated like an afterthought compared to sleep, nutrition, and exercise. That's exactly backwards. A haemorrhoid isn't just an embarrassing inconvenience, it's usually the loudest signal you'll get that this pillar has been ignored for years. Treat the actual cause, not just the symptom sitting on top of it, and everything downstream gets easier.

Ready to Actually Fix the Cause?

Want the full gut health framework, not just the surface-level fixes? GUTWISE - The Secret to Healing That Pain in the Arse covers everything in this article and a lot more. Get the GUTWISE book