These structures, which are a natural part of human anatomy, normally help seal the anal canal and control winds. However, chronic increase in intra-abdominal pressure can lead to their dysfunction, manifested by bleeding, pain, and prolapse of the hemorrhoidal nodules. One of the key factors generating excessive straining is an abnormal defecation, directly resulting from impaired intestinal transit.
Diet modification is the foundation of conservative treatment and prevention of recurrence. The main goal of diet therapy is to optimize stool consistency so that defecation does not require intense straining of the abdominal muscles. Hard stools, resulting from a low-residue diet, irritate the mucosa of the anal canal, exacerbating inflammation and leading to mechanical damage of the venous plexuses.
Fibre intake as the foundation of conservative treatment
Effective reduction of haemorrhoid symptoms requires adequate intake of the fibre, which directly affects bowel movement mechanics. Fibre, a fraction of carbohydrates not digested in the human gastrointestinal tract, performs two key functions depending on its structure.
Insoluble fibre, found mainly in whole grains, bran, and vegetable skins, stimulates mechanical receptors in the intestines, accelerating peristalsis and shortening intestinal transit time. Soluble fibre, present in fruit pulp and legumes, forms a gel-like substance when combined with water, softening stool and facilitating its movement through the colon.
Regular consumption of high-fibre foods allows for the formation of stools with greater volume and lower density. This eliminates the need for excessive straining, thereby reducing pressure on the anal venous plexuses and preventing further stretching and prolapse.
Valuable sources of fibre in a proctology patient’s diet include coarse groats (e.g., buckwheat, barley), wholemeal bread, brown rice, and legumes such as lentils and chickpeas. Flaxseeds and psyllium husk are also recommended due to their strong coating and stool-softening properties.
The introduction of a high-fibre diet should be gradual. A sudden increase in fibre intake in individuals previously consuming mostly processed foods may lead to excessive gas production and bloating (flatulence). Adaptation of the gut microbiota to increased fibre intake usually takes several days to a couple of weeks. A key condition for effectiveness is ensuring adequate fluid intake, without which fibre may have the opposite effect and worsen constipation.
Adequate fluid intake improves defecation
Increasing fibre intake must go hand in hand with proper hydration. From a medical perspective, fibre acts like a sponge in the intestines - it binds water, increasing the elasticity and volume of stool. If a patient increases whole-grain intake without maintaining a positive fluid balance, this process is disrupted. In such cases, fibre may become overly compacted, leading to hard, dense stools and worsening functional constipation. This is particularly dangerous in hemorrhoidal disease, as hard stools require stronger straining, directly damaging the mucosa and venous plexuses.
Optimal stool hydration requires consuming at least 2–2.5 litres of fluids per day, with higher needs depending on physical activity and body weight. The primary source of hydration should be still, moderately mineralized water. Mild herbal infusions, such as lemon balm or chamomile, may also be beneficial due to their relaxing effect on intestinal smooth muscles. Proper hydration ensures smooth passage of intestinal contents without
excessive stretching of the rectal walls.
It is also important to be aware of beverages that may hinder treatment. Dehydrating drinks such as strong black tea, excessive coffee, and alcohol can lead to secondary stool hardening. Alcohol additionally has a vasodilatory effect, which may increase swelling and congestion of haemorrhoids. Proper hydration is therefore not only a complement to a high-fibre diet but also an independent therapeutic factor that significantly reduces pressure within the anal canal during defecation.
Contraindicated products – what worsens haemorrhoid symptoms?
In treating piles, eliminating harmful products is just as important as introducing beneficial ones. Highly irritating foods include spicy spices containing capsaicin, such as chili, pepper, and hot paprika. These substances are not fully digested and can irritate the sensitive mucosa of the anal canal during excretion, causing increased blood flow, burning, itching, and worsening pain after defecation.
Highly processed foods and low-residue diets also negatively affect patients. Products made from refined white flour, such as white bread, pastries, and wheat pasta, lack natural fibre and significantly slow intestinal transit. This leads to functional constipation, where stool becomes hard and difficult to pass. Additionally, foods with strong constipating effects, such as chocolate, cocoa, blueberries, and strong black tea, should be limited, as they have astringent properties and slow peristalsis.
Alcohol consumption affects piles through multiple mechanisms. Ethanol causes vasodilation, promoting blood pooling in the pelvic venous plexuses and increasing the risk of bleeding. It also contributes to dehydration, which further hardens stool. Patients should also avoid foods that cause excessive gas production, such as cabbage or some legumes (if not introduced gradually), as bloating and gas increase intra-abdominal pressure and hinder tissue healing in the anal region.
Meal timing and bowel habits – how daily routine supports treatment
Stabilising digestive function requires not only proper diet composition but also regular eating habits. Eating meals at consistent times stimulates the gastrocolic reflex, a natural signal prompting the intestines to move contents toward the rectum. Maintaining a regular rhythm helps the body adapt to consistent bowel movements, minimizing stool retention and hardening. Avoiding long gaps between meals and ensuring that the last meal is light helps maintain smooth intestinal transit without sudden increases in abdominal pressure.
Proper defecation habits are equally important. Prolonged sitting on the toilet, often associated with distractions like phone use, should be avoided. This position promotes continuous straining and venous congestion, contributing to enlargement of hemorrhoidal nodules and weakening of the supporting structures of the anus. Time spent on the toilet should be limited to the necessary minimum, and defecation should occur without excessive straining. Using a small footstool to elevate the feet (creating an angle of about 35° between
the torso and thighs) can help relax the puborectalis muscle and facilitate easier stool passage.
Moderate physical activity complements diet and proper toilet habits. Activities such as walking, swimming, or light exercise naturally stimulate intestinal peristalsis and prevent venous stasis in the pelvis. However, activities involving heavy straining and sudden increases in intra-abdominal pressure, such as heavy weightlifting, should be avoided. For individuals with sedentary lifestyles, taking regular breaks to change position is essential to improve circulation and reduce constant pressure on the blood vessels in the anal region.
Professional support at our clinic
Treatment of piles at our clinic is based on thorough diagnostics and the selection of therapy that enables a rapid return to full health. Our specialists assess each case individually, combining pharmacological treatment with precise dietary guidance, which significantly enhances the effectiveness of the therapeutic process. We encourage you to book a consultation, during which we will create an optimal treatment plan to eliminate discomfort and prevent recurrence of the condition.
