What to know about hemorrhoids and constipation
Learn about whether hemorrhoids can cause constipation and how to treat them, according to Hinge Health pelvic floor physical therapists.
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Hemorrhoids and constipation often go hand in hand. Constipation is one of the most common causes of hemorrhoids because straining puts extra pressure on the veins around the anus. But the relationship works both ways: hemorrhoids can also make it harder to have a bowel movement comfortably.
Both hemorrhoids and constipation often improve with simple, at-home treatments. Along with eating more fiber and staying hydrated, gentle movement and pelvic floor exercises can help make bowel movements easier and reduce the cycle of pain, straining, and stool withholding.
"Understanding the relationship between hemorrhoids and constipation is important because treating one often helps improve the other," says Amy Bock, PT, DPT, a physical therapist with Hinge Health.
Read on to learn why hemorrhoids sometimes make it difficult to poop, plus practical strategies — including constipation-relieving exercises recommended by Hinge Health physical therapists — to support healthy bowel movements.
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Can hemorrhoids cause constipation?
Hemorrhoids don't directly slow your digestive system or cause constipation, but they can make bowel movements more difficult and uncomfortable.
Constipation often comes first. Straining to pass hard stool increases pressure around the anus, which can cause hemorrhoids or make existing hemorrhoids worse.
Once hemorrhoids develop, they can contribute to constipation in several ways. "If your hemorrhoids are painful, you may start avoiding bowel movements because you're worried they'll hurt," says Dr. Bock. Waiting too long allows stool to become drier and harder, making your next bowel movement even more difficult.
Pain can also cause your pelvic floor muscles to tighten (a protective response known as muscle guarding) without you realizing it. Normally, these muscles need to relax and lengthen during a bowel movement. When these muscles stay tense, stool becomes harder to pass.
In some cases, large internal hemorrhoids can also narrow the anal canal, making it more difficult for stool to move through comfortably.
The result can become a frustrating cycle: constipation leads to hemorrhoids, hemorrhoids make bowel movements more uncomfortable, and avoiding bowel movements makes constipation worse.
How movement can help ease constipation
Movement can help your digestive system and pelvic floor work together more efficiently. Gentle exercise encourages the natural movement of stool through your intestines while helping the pelvic floor muscles relax and lengthen, so bowel movements are easier to pass. It can also improve circulation, reduce muscle tension, and make it easier to establish regular bowel habits.
"Easing muscle tightness in this area can help treat and prevent constipation," says Dr. Bock.
The exercises below, recommended by Hinge Health physical therapists, are a great place to start.
Exercises that help alleviate constipation
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- Supine diaphragmatic breathing
- Cat cow
- Child’s pose
- Deep squat
The above stretches help ease tension in the pelvic floor muscles and nearby muscles, such as those that support your hips. These movements may not alleviate constipation immediately, but doing them often — in addition to staying active, hydrated, and consuming a high-fiber diet — can help promote regular bowel movements. A pelvic floor physical therapist can help you develop an exercise program to ease constipation and strengthen or relax your pelvic floor muscles.
The information contained in these videos is intended to be used for educational purposes only and does not constitute medical advice or treatment for any specific condition. Hinge Health is not your healthcare provider and is not responsible for any injury sustained or exacerbated by your use of or participation in these exercises. Please consult with your healthcare provider with any questions you may have about your medical condition or treatment.
Pelvic floor physical therapy is more than just kegel exercises. Various exercises tailored to your symptoms and needs are key to getting relief. Pelvic floor PT can relieve many different pelvic issues, such as pelvic pain, painful sex, and urinary incontinence.
Members of the Hinge Health pelvic health program experience an average 67% reduction in pelvic pain and 54% reduction in urinary incontinence within the first 12 weeks. Learn more*.
Treatments for hemorrhoid-related constipation
The goal of treatment is to make bowel movements easier while reducing irritation from hemorrhoids. A combination of healthy bowel habits, symptom relief, and gentle movement often works best.
Try physical therapy and targeted pelvic floor exercises. Targeted exercises, such as the ones above, help relax your pelvic floor muscles so you can pass stool more comfortably. You can do exercise therapy at home or work with a pelvic floor physical therapist who can guide you through movements tailored to your needs. You can see a physical therapist in person or use a program like Hinge Health, where you may access a PT via telehealth/video visit.
Use a toilet stool to ease passage. Using a toilet stool (like a Squatty Potty) to elevate your feet places your knees slightly above your hips, helping straighten the pathway stool travels through. "In that position, you help relax the muscle that loops around the rectum, creating more space for stool to pass," explains Dr. Bock.
Go when your body tells you to. Avoid delaying bowel movements whenever possible. When you respond to the urge to go, your intestines are already working to move stool through your digestive tract, making it easier to pass without excessive straining.
Eat plenty of fiber. Fiber-rich foods such as fruits, vegetables, beans, lentils, and whole grains help soften stool by drawing water into it, making bowel movements easier and reducing strain on hemorrhoids.
Stay hydrated. Water works together with fiber to soften stool. Drinking enough fluids throughout the day helps stool move more comfortably through your digestive system.
Consider stool softeners or fiber supplements. If dietary changes aren't enough, your healthcare provider may recommend a stool softener or fiber supplement to reduce straining during bowel movements.
Soothe hemorrhoid discomfort. Over-the-counter creams, suppositories, and warm sitz baths can reduce irritation and discomfort. As hemorrhoid pain improves, bowel movements often become easier and less intimidating.
How to prevent hemorrhoids from constipation
Healthy daily habits can help reduce straining and lower your risk of both constipation and hemorrhoid flare-ups. Consider trying these proactive strategies to help reduce your risk:
Prioritize nutrition. Eating plenty of fiber and staying hydrated are simple but effective ways to promote healthy, regular bowel movements, which can reduce pressure, straining, and the likelihood of developing hemorrhoids.
Exercise regularly. Regular physical activity helps stimulate your digestive system while supporting healthy bowel function. Walking, cycling, swimming, and other enjoyable forms of movement can all help keep things moving.
Avoid straining and prolonged sitting. Both straining and prolonged sitting put pressure on the anus, a risk factor for developing hemorrhoids. “Try not to sit on the toilet for more than five minutes if nothing is happening, because sitting too long can lead to excessive pressure on the rectal veins, and this can increase the risk of hemorrhoids,” says Dr. Bock.
Relax during bowel movements. Holding your breath and pushing hard increases pressure around the hemorrhoids. Instead, practice slow breathing and try making a “shh” sound as you exhale. This will help your pelvic floor muscles stay relaxed throughout the bowel movement.
Manage stress. Stress can contribute to muscle tension throughout your body, including your pelvic floor. Regular movement, deep breathing, mindfulness, and good sleep habits can all help.
When to see a doctor
Both hemorrhoids and constipation often resolve on their own with time and at-home treatments. If you experience any of these signs, it’s a good idea to check in with your doctor, who may refer you to a gastroenterologist or colorectal specialist.
Blood in stool or persistent bleeding
Severe pain or swelling
Constipation lasting longer than a week
Signs of infection or fever
No relief with home remedies
PT tip: Exhale instead of straining
"When you're trying to have a bowel movement, avoid holding your breath and pushing hard," says Dr. Bock. "Instead, take a slow breath in and gently exhale as you push. This helps your pelvic floor relax instead of tighten, making stool easier to pass while putting less pressure on hemorrhoids."
How Hinge Health can help you
If you have pelvic pain, bladder, bowel, or other pelvic symptoms that are affecting your quality of life, you can get the relief you've been looking for with Hinge Health’s online exercise therapy program.
The best part: You don’t have to leave your home because our program is digital. That means you can easily get the care you need through our app, when and where it works for you. Through our program, you’ll have access to therapeutic exercises and stretches for your condition. Additionally, you’ll have a personal care team to guide, support, and tailor our program to you.
See if you qualify for Hinge Health and confirm free coverage through your employer or benefit plan here.
This article and its contents are provided for educational and informational purposes only and do not constitute medical advice or professional services specific to you or your medical condition.
References
1. Cui, J., Xie, F., Yue, H., Xie, C., Ma, J., Han, H., Fang, M., & Yao, F. (2024). Physical activity and constipation: A systematic review of cohort studies. Journal of global health, 14, 04197. doi:10.7189/jogh.14.04197
2. Gao, R., Tao, Y., Zhou, C., Li, J., Wang, X., Chen, L., Li, F., & Guo, L. (2019). Exercise therapy in patients with constipation: a systematic review and meta-analysis of randomized controlled trials. Scandinavian journal of gastroenterology, 54(2), 169–177. doi:10.1080/00365521.2019.1568544
3. Fontem, R. F., & Eyvazzadeh, D. (2023). Internal hemorrhoid. In StatPearls [Internet]. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK537182/
4. Lawrence, A., & McLaren, E. R. (2025). External Hemorrhoid. In StatPearls. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK500009/
5. Sandler, R. S., & Peery, A. F. (2019). Rethinking What We Know About Hemorrhoids. Clinical Gastroenterology and Hepatology, 17(1), 8–15. doi:10.1016/j.cgh.2018.03.020