Why are Hemorrhoids so Common?
This blog was created using an AI model of Carmen’s book, Constipation Nation.
If you’ve found yourself wondering, Why are hemorrhoids so common?—you’re not alone. In fact, the prevalence of hemorrhoids is part of a much larger, and largely overlooked, national health issue. In Constipation Nation, colorectal surgeon Dr. Carmen Fong pulls back the curtain on what’s truly going on at the intersection of constipation, diet, behavior, and butt health.
Hemorrhoids: Not Rare, Not New, and Not Hopeless
Let’s start with the basics. Hemorrhoids are swollen veins in the anus or lower rectum. They are a type of benign anorectal disease—non-cancerous, but uncomfortable and sometimes debilitating. While hemorrhoids themselves are not new, the rates at which people are experiencing them have risen due to a complex mixture of lifestyle, dietary, and behavioral factors.
So, why are hemorrhoids so common?
1. Constipation Is Rampant—and Hemorrhoids Are Its Consequence
The single biggest driver behind the rise in hemorrhoids is chronic constipation.
Constipation is not just a temporary inconvenience—it’s a condition that leads to straining, prolonged toilet sitting, and hard stools, all of which put excess pressure on the rectal veins.
Constipation affects up to 30% of Americans, especially women, older adults, and those with lower socioeconomic status. What’s more, the true number is likely higher because many suffer silently and never seek care.
And while poor diet and sedentary behavior are major culprits, a newer contributing factor is the rise in GLP-1 receptor agonist medications—like semaglutide (brand names include Ozempic and Wegovy)—which are increasingly used for weight loss.
These medications slow gastric emptying and can reduce gut motility, leading to constipation. As Dr. Fong notes, “with slowed gastric emptying and slowed intestinal motility, it’s a recipe for harder poop”. So even though GLP-1s can be effective for managing blood sugar or body weight, they often come with an unfortunate side effect: a higher risk of hemorrhoids.
And here’s the kicker: most people with hemorrhoids don’t actually need surgery. What they need is better poop.
2. We Ignore the One Poop Commandment
As Dr. Fong writes: “Go when you have to go, and don’t go when you don’t have to.” This is The One Poop Commandment, and ignoring it can wreak havoc on your anorectal health.
Many people delay pooping—because of embarrassment, work obligations, or social stigma around public bathrooms—and in doing so, they’re training their bodies to hold stool longer. Over time, this leads to harder stools, which are more difficult to pass, increasing pressure and leading to hemorrhoids.
3. The Way We Poop Is All Wrong
Believe it or not, how you poop matters. In a fascinating study referenced by Dr. Fong, all mammals poop in about 12 seconds. That’s it. If you’re sitting on the toilet scrolling through your phone for 20 minutes, you’re not just wasting time—you’re risking hemorrhoids.
Extended sitting leads to blood pooling around the anus, causing hemorrhoidal veins to swell. And if you’re straining during that time, you’re practically begging for a flare-up.
4. Modern Diets Are Hemorrhoid Fuel
Let’s talk food. The standard American diet is low in fiber and high in processed carbohydrates, animal fats, and sugar. This dietary pattern leads to slower-moving stool and harder poop, which then results in—you guessed it—constipation and hemorrhoids.
What’s even more telling is that when cultures transition from traditional high-fiber diets to Western ones, rates of constipation and hemorrhoids go up. In other words, this is not just genetic—it’s deeply behavioral and dietary.
5. Poop Shame Starts Early
Another underrecognized cause? Potty training and poop shaming.
Many adults with chronic constipation and hemorrhoids were taught from a young age that pooping is gross, shameful, or should be done only in private. This early conditioning leads to lifelong avoidance behaviors like stool withholding, especially in women. Over time, this contributes to harder stools, straining, and—you guessed it again—hemorrhoids.
6. Pregnancy and Pelvic Pressure
Pregnancy also plays a significant role in why hemorrhoids are so common, particularly among women. Hormonal changes, pressure from the growing uterus, iron supplements, and reduced physical activity all combine to slow gut motility and make constipation worse. Add the pressure of childbirth to that equation, and it’s no wonder many women see their first hemorrhoid during or after pregnancy.
7. The COVID Era—and Sedentary Lifestyles—Made It Worse
According to Dr. Fong, there was a noticeable spike in hemorrhoid and fissure complaints during the COVID-19 pandemic. Why? Because people were suddenly more sedentary, more anxious, and often not eating well—all factors that contribute to constipation and poor anorectal health.
And that sedentary behavior didn’t end when lockdowns did. Many people are still working from home or in desk-based jobs, sitting for 8 to 10 hours a day without much physical activity.
Long periods of sitting increase pressure on the pelvic floor and reduce blood flow, which can lead to swelling in the hemorrhoidal cushions. Over time, this chronic pressure contributes directly to hemorrhoids flaring or worsening.
In short: sitting too much, pooping too hard, and moving too little are a dangerous trifecta for your butt.
The good news: Bummed has educations and prescription solutions to treat all of your anorectal issues. Not sure what you need? Take our quiz to determine the best treatment for you.
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