Can IBS Cause Piles? Here’s What You Need to Know

If you’re dealing with both Irritable Bowel Syndrome (IBS) and piles (haemorrhoids), you’re not alone.

These two conditions are among the most common gut-related complaints and can cause an enormous amount of discomfort and embarassment. Many patients complain of deabiltating symptoms.

In this blog, you’ll learn what the research says, our clinical experience and how IBS might lead to haemorrhoids, and what you can do to find lasting relief.

What Is IBS?

IBS is a functional gut disorder, which means it affects how your bowel works not because of damage, but because of imbalances in motility, sensitivity, or communication between your gut and brain.

You might have IBS if you experience:

• Cramping or abdominal pain
• Bloating and gas
• Constipation, diarrhoea, or both
• Urgency or a feeling of incomplete evacuation

What Are Piles?

Piles (also known as haemorrhoids) are swollen veins in your rectum or anus. They can cause:

• Bright red blood when you wipe
• Anal itching or pain
• A lump near your anus
• A heavy or incomplete feeling after a bowel movement

They often result from straining, sitting too long on the toilet, or repeated irritation, all of which are common when you have IBS

IBS can cause Piles

Irritable Bowel Syndrome (IBS) can contribute to the development of piles (haemorrhoids) due to the strain and irregular bowel habits commonly associated with the condition. People with IBS often experience frequent episodes of constipation or diarrhoea, both of which can increase pressure in the rectal area.

Straining during constipation, in particular, puts stress on the veins around the anus, leading to swelling and inflammation—key features of haemorrhoids. Additionally, the urgency and repeated bowel movements seen in diarrhoea-predominant IBS can irritate the anal tissues, exacerbating discomfort and inflammation. Over time, these patterns of bowel dysfunction can make individuals with IBS more susceptible to developing piles.

So… Can IBS Cause Piles- what do scientific studies say?

Scientific studies show a clear connection:

• One study found that 33% of people with IBS also had piles, compared to only 15% in those without IBS (PubMed: 25610094).
• Another paper revealed that patients with severe hemorrhoids often have IBS-like symptoms such as bloating, gas, and discomfort when passing stool (PubMed: 15667500).
• There’s even genetic evidence showing that people genetically predisposed to IBS are more likely to develop hemorrhoids, too (PubMed: 37813565).

So now that you know that there is a connection beween IBS and Piles let’s look at the different types of IBS and what you can do to get some relief.

There are different types of IBS.

  IBS-C and Piles- what is the link?

If you have IBS with constipation (often called IBS-C), you might be feeling the urge to go, but struggling to pass stool. Sometimes you may pass small rabbit pellets or other times you may only have a bowel movement every 3-5 days. Stools may be hard to pass and painful.

This can lead to repeated, forceful straining and that’s one of the main contributors to hemorrhoids.

Why does straining can cause hemmorhoids?

• Increased rectal pressure: When you push hard, the pressure inside your rectum rises. This causes the blood vessels in your anal canal to stretch and swell, which can lead to the formation or worsening of hemorrhoids.
  
• Interrupted blood flow: The act of straining can reduce blood return from the veins in your lower rectum, leading to pooling of blood and further engorgement of hemorrhoidal tissue.
  
• Pelvic floor dysfunction: Chronic straining can actually retrain your pelvic floor muscles in a dysfunctional way, making it even harder to pass stool in the future. This can create a vicious cycle of more straining, more constipation, and more pressure on the anal veins.
  
• Delayed transit: Straining often happens when you’re sitting on the toilet for extended periods. But sitting with your hips at a 90-degree angle (like on a standard toilet) isn’t the best position for complete evacuation. It may actually make your bowel movements less efficient, leading to more incomplete stools and more time spent trying to go.

Tips to help with IBS-C and Piles

• Use a toilet stool: Elevating your feet helps mimic a squatting position, which straightens the rectoanal angle and reduces the need to strain. Squatty potty is a good option!|
  
• Improve stool consistency: Make sure your stool is soft and bulky by drinking enough water, eating soluble fiber, and possibly using magnesium citrate-based supplements as these soften your stool.
  
• Retrain your bowels: Consider setting a consistent time to sit on the toilet each day (ideally after meals when the gastrocolic reflex is strongest), and relax with deep breathing instead of pushing.
  
  
• Eat Foods Rich in Soluble Fibre (To Help Relieve Constipation
  
  
  Soluble fibre absorbs water in your gut to form a gel-like substance, helping soften your stool and make bowel movements easier  which reduces the need to strain and lowers the risk of piles.
  
  
  Here are some gentle, gut-friendly sources of soluble fibre:
  
  Vegetables
  Carrots, courgettes, sweet potatoes (peeled), turnips, beetroot
  
  Fruits
  Bananas (just-ripe), apples (peeled), pears, blueberries, oranges
  
  Grains
  Oats, oat bran, barley, psyllium husk
  
  Legumes
  Lentils, split peas, chickpeas (if tolerated in small amounts)
  
  Nuts & Seeds
  Chia seeds, flaxseeds (ground), sunflower seeds
  
  Supplements
  Psyllium husk, partially hydrolysed guar gum (PHGG), acacia fibre
  
  
  Tips:
  
• Start slowly: Adding too much fibre too quickly can worsen gas or bloating
  
• Stay hydrated: Soluble fibre needs water to do its job — aim for at least 1.5–2 litres daily.
  
• Cook your veg: Lightly steaming or roasting makes fibre gentler on your gut if you’re sensitive.
  
• Avoid the “just in case” trip: Sitting on the toilet without an actual urge can train your body to associate the position with anxiety or straining, which reinforces the cycle.
  

IBS-D and Piles what is the link?

On the flip side, IBS with diarrhea can also cause hemorrhoids frequent wiping, urgency, and inflammation all irritate the anal area.

Spending extra time on the toilet  whether you’re waiting for a bowel movement or dealing with incomplete evacuation increases pressure and puts you at risk of hemorrhoids.

What you can do if you have IBS-D and Piles

Living with both IBS-D and hemorrhoids can be very distressing. Frequent loose stools and urgency can worsen irritation, inflammation, and discomfort in the anal area. Here are some tips:

• Try to understand why you have IBS-D
  
  
• Are you experiencing loose stools due to a food intolerance? Stress? SIBO?

• Use a bulking agent like partially hydrolysed guar gum (PHGG) to firm up stools without causing constipation.
  

• Avoid high-irritant foods (e.g., alcohol, caffeine, spicy foods, fried foods) which may worsen urgency and diarrhea.
  

• Try a low-FODMAP diet to identify and eliminate fermentable triggers that worsen bowel movements.
  

• Use barrier creams or wipes with soothing ingredients like aloe vera or witch hazel to reduce inflammation from frequent wiping.
  

• Take sitz baths regularly to soothe irritation and promote healing of external hemorrhoids.
  

• Avoid rushing or prolonged sitting on the toilet respond promptly to urges but don’t sit and strain unnecessarily.
  

• Test for the underlying causes of IBS- Diarrhea- is it causes by a bacterial overgrowth in the small intestine? if so consider testng for SIBO test

IBS caused by Stress, and Piles: The Missing Link

Stress can also lead to piles (haemorrhoids) by making constipation or straining more likely.The gut-brain axis is the two-way communication network between your digestive system and central nervous system. It’s how your brain affects your gut and how your gut, in turn, influences your mood, immune system, and inflammation.

Stress → constipation or urgency → more time on the toilet → increased pressure → hemorrhoids

What Happens to Your Gut When You’re Under Chronic Stress or Anxiety

When you’re feeling stressed or anxious all the time, it can have a big effect on your digestion and bowel habits. Here’s how:

1. Slower Gut Movement
   Stress lowers the activity of your vagus nerve, a key nerve that helps your gut move food and waste along. When this nerve isn’t working well, your digestion slows down. This can lead to constipation, bloating, and discomfort.
   
   
2. Tight Pelvic Floor Muscles
   Stress hormones like cortisol and adrenaline cause your muscles to tighten including the muscles in your pelvic floor. These muscles need to relax for you to have a comfortable bowel movement. If they stay tight, it becomes much harder to pass stool, and you may start straining.
   
   
3. Increased Pain Sensitivity
   When you’re stressed, your body becomes more sensitive to pain. Even a small issue like mild piles (haemorrhoids) can feel much worse than it actually is. You may notice more pain, burning, or discomfort when going to the toilet.
   
   
4. Avoiding the Toilet
   Because going to the bathroom feels uncomfortable or painful, you might start holding in bowel movements. But delaying them can make the stool harder and drier, which leads to even more straining — creating a cycle that worsens constipation and piles.

How to help IBS and Piles due to stress

Balancing your gut-brain axis doesn’t require eliminating stress entirely — it’s about building nervous system resilience:

• Stimulate the vagus nerve: Use humming, cold face plunges, or deep diaphragmatic breathing
  
• Practice gut-directed hypnotherapy: Proven to help IBS symptoms and reduce pain perception- I often recommend the Nerva App
  
• Try restorative practices: Like yoga, walking outdoors, or progressive muscle relaxation
  
• Don’t suppress the urge to go: Holding it in out of fear or embarrassment can lead to incomplete evacuation and worsening piles

Some tests to consider if you have IBS with Haemorrhoids

1. Comprehensive Stool Test
– Assesses gut health, digestion, inflammation, and pathogens
– Examples: GI-MAP, Genova GI Effects, Doctor’s Data

2. Fecal Calprotectin
– Detects gut inflammation
– Helps distinguish IBS from IBD (e.g. Crohn’s, ulcerative colitis)

3. SIBO Breath Test (Hydrogen & Methane)
– Identifies bacterial overgrowth in the small intestine
– Useful for IBS symptoms like bloating, gas, diarrhoea, or constipation

4. Thyroid Function Tests (TSH, Free T3, Free T4)
– Checks for hypothyroidism, which can slow gut motility
– Useful if constipation is a prominent symptom

5. Iron Studies + Full Blood Count
– Detects iron-deficiency anaemia
– Important if haemorrhoids cause chronic blood loss

6. Coeliac Disease Serology (tTG-IgA)
– Screens for coeliac disease, which can mimic IBS
– Helps identify if gluten is a factor

7. Colonoscopy or Sigmoidoscopy (if needed)
– Visual check for IBD, polyps, or cancer
– Consider if red flag symptoms like bleeding, weight loss, or anaemia are present

The often Overlooked Role of SIBO in IBS and Piles

Small Intestinal Bacterial Overgrowth (SIBO) is a condition worth investigating if you have both IBS and piles, as it may be an underlying driver of digestive dysfunction contributing to both.

SIBO occurs when bacteria that are normally confined to the large intestine overgrow in the small intestine, leading to symptoms like bloating, gas, and altered bowel habitshallmarks of IBS.

However, what often goes overlooked is how SIBO-related constipation or diarrhoea can increase pressure and irritation in the rectal area.

Frequent straining from constipation, or urgency and multiple bowel movements from diarrhoea, can place additional stress on the anal veins, raising the risk of haemorrhoids.

Identifying and treating SIBO may not only ease IBS symptoms but also reduce one of the key mechanical triggers for piles, making it a valuable area of investigation in persistent or complex cases. There are two main type of SIBO.

In methane-dominant SIBO:

• Gut transit slows down and you may experience constipation
• Stool becomes dry and hard
• Straining increases rectal pressure

In hydrogen-dominant SIBO:

• You may have loose, urgent stools
• Frequent wiping irritates the anal region
• Chronic inflammation adds to local tissue stress

Both patterns can increase your risk of developing hemorrhoids.

If you have IBS and persistent piles, testing for SIBO may help identify a treatable root cause.

Irritable Bowel Syndrome (IBS) can play a significant role in the development or worsening of piles (haemorrhoids), primarily due to the irregular bowel habits it causes. Repeated straining during constipation or frequent, urgent trips to the toilet with diarrhoea can increase pressure on the veins around the anus, leading to inflammation, swelling, and eventually piles.

Find the root causes of IBS may help Piles

For many individuals, addressing the root causes of IBS—whether that involves improving diet, managing stress, supporting gut health, or treating underlying imbalances like SIBO—can help normalise bowel movements. By reducing episodes of straining and irritation, treating IBS may not only relieve digestive discomfort but also significantly reduce the severity or frequency of haemorrhoid flare-ups.

When to Speak with a Practitioner

If you’re noticing persistent bleeding, severe discomfort, or nothing seems to help — it’s worth getting professional advice. Functional medicine can help identify the root causes of both IBS and hemorrhoids so you can heal from the inside out. Book a consultation with our sister clinic ibs-solutions.co.uk

References

1. Oğuz S, et al. (2014). The relationship between irritable bowel syndrome and hemorrhoid. Eurasian J Med. 2014 Apr;46(1):48–51. PMID: 25610094
2. Johanson JF, Sonnenberg A. (2004). The prevalence of hemorrhoids and chronic constipation: An epidemiologic study in a representative sample of the US population. Dis Colon Rectum. 47(4):547–52. PMID: 15667500
3. Papoutsopoulou S, et al. (2023). Mendelian randomization study supports shared genetic background between irritable bowel syndrome and hemorrhoids. Gut. Published online Oct 2023. PMID: 37813565
4. Oettle GJ. (2002). Surgical treatment of mucosal prolapse syndrome improves bowel function in IBS patients. Br J Surg. 89(6):733–8. PMID: 12355216
5. Lembo A, Camilleri M. (2003). Chronic constipation. N Engl J Med. 349(14):1360–8. PMID: 14523146
6. Rao SS. (2004). Dyssynergic defecation and biofeedback therapy. Gastroenterol Clin North Am. 33(3):539–55. PMID: 15313193

If you are struggling with IBS and Piles or SIBO and need specialist advise visit our sister clinic ibs-solutions.co.uk

We also can book  you in for a consultation

We can help you identify the root cause of IBS

Candida tests

Small intestinal Bacterial Overgrowth

Gut Microbiome testing

Author – Victoria Tyler BSc Hons MBANT

Victoria Tyler owns and runs two busy clinics : Nutrition and Vitality and the IBS and Gut Disorder Clinic.

Nutrition and Vitality, along with the IBS and Gut Disorder Clinic, were founded with the goal of helping patients alleviate IBS symptoms by uncovering and addressing the root causes of their digestive issues.

As a Registered Nutritional Therapist, Victoria holds a BSc (Hons) in Nutritional Therapy and has trained with the Institute of Functional Medicine. She is also accredited by BANT and CNHC.

Before transitioning into health, Victoria earned a degree in Economics and an MBA, working with corporations including Canon and Vodafone. However, her own health challenges led her to pursue a career in Nutritional Therapy.

With a passion for learning, Victoria is committed to staying at the forefront of Functional Medicine. She helps patients manage IBS and other digestive disorders, including SIBO, Candida, and IBD, by identifying and addressing their root causes.

Victoria strongly believes that every symptom has an underlying cause, and there is always a solution to every health condition. To learn more, or to see patient reviews, visit Victoria’s profile on Google.

DISCLAIMER: The information provided in this article is intended for general informational purposes only and should not be construed as medical advice, diagnosis, or treatment. The products and methods mentioned are not a substitute for professional medical advice from a trained healthcare specialist. Always seek the guidance of your doctor or other qualified health professional with any questions you may have regarding your health or a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. Use of the information and products discussed is at your own risk.

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