Nutrition for hemorrhoids - what you can and cannot eat, diet for hemorrhoids

cardiovascular surgeon, 1st category doctor

Publication date: 01/27/2021

If you don't move much, spend long hours in the office without getting up from your chair, don't watch your diet, or are overweight, your risk of getting hemorrhoids increases. Other factors include: pregnancy and childbirth, heredity, alcohol abuse, constipation, increased physical activity. Hemorrhoids are enlarged hemorrhoids in the lower rectum and/or anus. The disease occurs in 10–15% of adults worldwide.

Hemorrhoids require complex treatment, which may include the use of medications, surgical methods and lifestyle changes. Nutrition is important. What can you eat if you have hemorrhoids, and what foods should you avoid? How to create a menu? How to eat after surgery? Read in the article.

Principles of proper nutrition for hemorrhoids

Your doctor will tell you in detail what nutrition should be like for hemorrhoids. The best way to prevent or reduce hemorrhoids is to soften your stools and relieve constipation.

A diet for hemorrhoids for women and men is usually based on the following principles:

• Eat about 25–30 grams of fiber per day to keep your stools soft, formed, and bulky. Add fiber to your diet slowly to avoid bloating;
• Drink more water to prevent hard stools and speed up healing. Ask your doctor how much fluid you should drink each day;
• Limit your intake of low-fiber foods because they can cause or worsen constipation.
• Consult a healthcare professional before taking dietary supplements as some may cause digestive problems.

Strictly follow the prescribed diet during an exacerbation of hemorrhoids to bring the disease under control.

Manifestations

With hemorrhoids, the external and internal hemorrhoids become inflamed. This leads to burning, itching and pain in the affected area. Many patients complain of a sensation of a foreign body in the rectum.

Discomfort increases with bowel movements, physical labor and prolonged sitting. If the external venous node is affected, the patient may see negative changes during self-examination. A sign of the disease is a burgundy-bluish swelling, similar to a lump. The knot becomes dense to the touch, and touching causes pain.

If, when signs of pathology appear, a person does not consult a proctologist, chronic hemorrhoids develop. It is dangerous due to exacerbations. With them, hemorrhoids fall out, complications arise in the form of thrombosis and regular bleeding.

The symptoms of internal and external hemorrhoids coincide with other diseases of the rectum. If alarming symptoms occur, you should make an appointment with a proctologist. The patient is prescribed an examination to confirm the diagnosis and adequate treatment is selected.

Allowed foods: what you can eat

“Eat more fiber” is good advice, including after hemorrhoid removal. Let's figure out what this means and what you can eat if you have hemorrhoids.

Fiber-rich foods that are good for your diet include:

• fresh fruits (apples, peaches, pears, tangerines);
• berries;
• fresh or cooked vegetables, including greens (lettuce, carrots, spinach, broccoli, celery, cucumbers, artichokes, zucchini, potatoes with skin, beets);
• dried fruits (figs, dried apricots, dates, prunes);
• legumes;
• whole grain products, including whole grain bread, barley, brown rice, oatmeal;
• nuts, seeds.

Leave the skins on fruits and vegetables if they are thin: not only is this a source of fiber, but also flavonoids, which can help stop bleeding from hemorrhoids. Also, some fruits, vegetables and berries contain a lot of water: for example, cucumbers, watermelons, celery.

Your doctor may also recommend fiber supplements.

Dishes to prevent constipation

If hemorrhoids are inflamed, you should add oatmeal and pearl barley to your diet. They contain a lot of fiber and are useful for people prone to constipation. You can make crumbly and viscous porridges from oatmeal, and pearl barley can be added to soups and side dishes. To improve intestinal motility, dried prunes, dried apricots, and other dried fruits can be added to oatmeal dishes. Pearl barley porridge is consumed with fresh vegetables and vegetable oil.

To prevent constipation, first courses should be included in the diet. Vegetable soups are the most beneficial for digestion. Too fatty and rich meat broths should be avoided.

Prohibited foods: what not to eat

What foods should you avoid or limit for hemorrhoids? First of all, these are low fiber foods that cause constipation; causing bloating; heavy food that is poorly digested; food that has a negative effect on blood vessels.

Contraindications for hemorrhoids:

• white bread and other products made from white flour;
• dairy products (cheese, milk);
• red meat;
• prepared foods (frozen meals, fast food);
• foods high in salt (for example, chips);
• spicy dishes;
• ice cream;
• alcohol - the ban applies even to low-alcohol drinks;
• caffeine.

Prevention

Experts emphasize the importance of preventing inflammation of hemorrhoids. Here is a list of recommendations given by proctologists:

• Avoid inactivity, which causes blood to pool in the pelvic area.
• Stop smoking and minimize alcohol consumption.
• If you are prone to constipation, it is necessary to identify and eliminate their cause and normalize your diet.
• Avoid situations that can lead to damage to blood vessels and the appearance of cracks in the anal mucosa.

Nutrition after surgery

What to eat after hemorrhoid surgery? Medical nutrition is one of the main components of rehabilitation. According to the Clinical Guidelines of the Russian Association of Coloproctologists for the diagnosis and treatment of hemorrhoids, the menu after hemorrhoids may include foods rich in fiber. This includes wheat bran, seaweed, and flaxseed. It is also possible to prescribe nutritional supplements that soften the stool and help with regular bowel movements.

After surgery, bleeding may occur for several weeks. The diet for hemorrhoids with bleeding should be strictly followed.

Causes

The disease occurs due to varicose veins of the anus. Proctologists treat hemorrhoids. Among the main causes of the pathology are improper diet, indigestion and frequent constipation, genetic predisposition, and numerous pregnancies in women.

People who spend a lot of time sitting are at risk of developing hemorrhoids. The same applies to those who engage in strength sports and work that involves lifting weights. Hemorrhoids in teenagers are not as common as in adults. The reason for the development of pathology at a young age is a tendency to varicose veins, chronic constipation, damage to the vessels of the anus.

Diet during exacerbation

In case of acute hemorrhoids, you need to follow a special diet (slag-free) to avoid bowel movements and irritation of the mucous membrane of the anus and hemorrhoids.

In the first three days the following menu is shown:

• meat broth;
• egg white omelette;
• oatmeal;
• white bread crackers (3 pieces per day);
• boiled lean meat minced through a meat grinder.

The patient is advised to drink plenty of fluids (water, herbal teas). At night you need to drink a glass of herbal infusion (senna, yarrow, licorice or buckthorn).

General rules

An anal fissure is a linear or triangular defect in the rectal mucosa.
Its origin is associated with many reasons, but the most common is mechanical trauma to the mucous membrane from feces or foreign bodies. In some cases, the initial cause of cracks is also inflammatory processes that are associated with impaired local immunity . In some patients, a risk factor for the disease is vascular diseases of this area - hemorrhoids , which are considered as a predisposing factor, since anal fissures are often combined with it. According to statistics, women are more likely to experience anal fissures.

First, a defect occurs in the rectal mucosa, which becomes infected, then gradually heals. immunity plays a major role in the regeneration (healing) process . Elimination of the main manifestations of hemorrhoids (blood stagnation and improvement of blood flow) promotes their healing. Elimination of spasm of the anal sphincters (external and internal) plays a significant role in wound healing. If immunity is reduced, chronic cracks occur. In this case, the defect is an ulcer with scarred edges.

With an anal fissure, pain occurs during defecation, lasting for half an hour. Prolonged pain syndrome and ineffectiveness of analgesic therapy indicate the presence of sphincter spasm, which can increase pain. A vicious circle may occur: defect - pain syndrome - persistent sphincter spasm - slow healing of the defect. Sometimes the pain is constant.

At the time of the formation of an acute crack, there is slight bleeding: patients notice blood discharge on toilet paper or blood in the toilet, which is observed quite rarely. With chronic fissures, severe pain and spasm rarely occur, and bleeding is associated with stool disorders. The chronic process has a cyclical course. The defect heals, but with slight straining it opens again. It should be remembered that diarrhea can also lead to cracks, as can constipation .

Complications of rectal fissure include:

• persistent spasm of the sphincter with impaired defecation and coprostasis;
• acute paraproctitis ;
• internal fistula of the rectum;
• massive bleeding is extremely rare.

Treatment of this pathology involves the local use of suppositories, ointments, and gels that have anti-inflammatory, antiseptic and regenerative effects. An important point is the normalization of stool, especially in patients with irritable bowel syndrome , diverticular disease or colitis .

In patients with severe constipation, it is permissible to take petroleum jelly orally for the period of treatment (up to 3 weeks). A plant-based drug, Mucofalk (contains the shell of psyllium seeds), can also be used, which retains water in the intestines, so the volume of stool increases and its consistency becomes softer. The drug does not cause pain in the abdomen, which is typical for many laxatives.

At the same time, adjustments are made to the patient’s diet. The diet for anal fissure excludes the consumption of spicy and irritating foods, alcohol, spices and fried foods, spicy foods, pickled vegetables, dressings with vinegar and mustard. Dry food is not allowed.

For constipation, Diet No. 3 , which is high in fiber, is recommended. Dietary fiber is a plant-based product that contains cellulose , hemicellulose or lignin , which can regulate the consistency of stool and speed up its movement through the intestines. Dietary fibers include wheat bran, agar-agar, flaxseed, Laminaride . Wheat bran is added to food (3-6 tablespoons), after dousing it with boiling water. They do not immediately exert their effect, and this period can be 5 days.

The nutrition of this table is physiologically complete, and it has some features:

• Vegetables, berries, fruits, dried fruits, and cereals predominate. Vegetables can be eaten raw; if there is concomitant colitis or proctitis , they can be eaten boiled. Fiber should be present at every meal.
• Products are boiled or baked; dishes should not be ground or crushed.
• Fractional meals are recommended, without overloading the digestive organs.
• It is important to adhere to the drinking regime - drinking liquid softens the stool. If there is a lack of fluid, water is absorbed from the stool, it hardens and this makes it difficult for them to pass through the rectum. The amount of liquid can be increased to 2.5 liters, especially when consuming bran.
• Products that impair bowel movements are excluded: strong tea, coffee, pasta and baked goods, any products made from yeast, puff pastry and unleavened dough, lingonberries, blueberries, cocoa, chocolate, cheeses, cottage cheese, dogwood, pomegranate, rice, slimy soups, pears , jelly, red wine. The consumption of meat, as well as foods that enhance fermentation (fried foods), is limited.

For nutritional constipation, you need to increase physical activity. In more complex cases, use bacterial preparations ( Bifiform , Linex ). If the function of the gallbladder is impaired - decoctions of chamomile, peppermint, immortelle or tansy.

Alcohol

If you have hemorrhoids, alcoholic drinks are prohibited. They thicken the blood, dilate veins, draw fluid from the intestines and promote swelling of soft tissues. When they are consumed in large quantities, there are frequent exacerbations of the disease, it progresses, new nodes appear, and old ones increase in size.

Alcoholic beverages are not allowed to be consumed in any form or stage of hemorrhoids.

What can you eat?

Bleeding hemorrhoids are a complicated form of the disease that brings a person a lot of painful and uncomfortable sensations and interferes with leading a normal lifestyle. Here it is important to act immediately, and you should start by building your diet.

In the list of permitted products:

1. porridge with water;
2. lean meat and steamed fish;
3. whole grain bread (with flax seeds);
4. ripe fruits and berries;
5. lightly salted vegetable soups, broths;
6. low-fat fermented milk products: kefir, cottage cheese, yogurt;
7. honey;
8. vegetables;
9. bran;
10. vegetable oils (preferably linseed and olive);
11. greenery.

Compliance with all of the above rules, consumption of approved products and avoidance of the most dangerous ones will guarantee relief from the disease and relief from unpleasant sensations.

Fully or partially limited products

• Spicy dishes, sauces, marinades, pickled vegetables, horseradish and mustard, all types of peppers - these products irritate the gastrointestinal mucosa, support inflammation and impede the healing process.
• Dishes containing tannins: decoctions, infusions, jelly and compotes from quince, blueberry, dogwood, bird cherry, pear, strong tea, chocolate and coffee.
• Baked goods made from any dough are consumed in a limited manner; if constipation worsens, they are excluded. Products with cream - cakes, pastries - are prohibited.
• Difficult to digest fatty meats (duck, lamb, goose), smoked meats, canned food, hard-boiled eggs.
• Products that can cause constipation are rice water, rice porridge, semolina dishes, noodles, vermicelli, pasta, potatoes.
• Dishes with a viscous consistency - slimy soups, sticky mashed potatoes, jelly, pureed porridge.

Table of prohibited products

General Tips

• To prevent constipation, you should eat protein foods (meat, fish, eggs, cottage cheese) in moderation.
• If you have frequent diarrhea, before changing your diet, you need to find out the cause.
• In case of gas formation, you need to remove legumes, white cabbage, and rye bread from your diet.
• Outside of an exacerbation, a small amount of low-alcohol drinks is allowed: cider, wine, cocktails.
• For constipation, instead of laxatives, it is recommended to eat dried apricots and prunes.
• You can add cilantro, dill, basil, and parsley to ready-made dishes.

Vegetables and fruits, sweets

If you have hemorrhoids, you should include peaches, apples, plums, melons and watermelons in your diet. Experts advise eating juicy fruits to prevent constipation. Fruits that are not ripe enough or that are too sour should be avoided. Such food can lead to stool upset, and diarrhea aggravates hemorrhoids due to irritation of the mucous membrane. Overripe fruits are undesirable, as they contribute to the fermentation process and cause flatulence.

Dried fruits are good for digestion, and nuts and seeds enrich the body with vegetable protein. Sweets allowed are honey, jam, marshmallows, marshmallows, and dry cookies. Sweets are consumed in small quantities, since simple carbohydrates lead to fermentation.

Food composition

It is advisable to balance food according to basic nutritional indicators. The daily diet should not be too high in calories, but not meager either, about three thousand kilocalories. The upper limit of calories consumed per day should not exceed 3600 kcal. It is advisable to keep the total daily consumption within the following limits.

The required consumption of clean (!) water is about one and a half liters per day.

Reviews and results

Patients suffering from constipation and anal fissure must constantly monitor their diet. This diet is easy to follow. The main principle is not to overload the gastrointestinal tract with indigestible food, giving preference to vegetable dishes, and also to maintain a drinking regime. Its effectiveness was appreciated by many, leaving positive reviews.

• “... Constant constipation and my reluctance to follow a diet led to the appearance of a fissure in the rectum. This forced me to monitor my diet more carefully. It took at least two weeks until the stool finally improved. The diet really helps - less bread, meat, pastries, potatoes, rice and pasta. Prunes, beets, baked pumpkin, dried apricots, pumpkin porridge and figs worked well for me. I added dried fruits to all dishes in which they were appropriate, and ate them on an empty stomach and at night. All this must be done constantly, otherwise an exacerbation can be provoked again”;
• “... With this diet, intestinal function is restored in a week, but if the fissure worsens, you need to have soft stool from the first day - this is very important for healing. Therefore, for the first days I drink a herbal laxative and at the same time introduce proper nutrition. I eat meat once a week, add more stewed vegetables (fresh ones cause pain in the intestines and bloating), vegetable oil, water-based porridge and salads with beets 3 times a day. I noticed that they fix pasta, flour products, dumplings, pancakes - everything that has to do with flour and dough. You still can’t eat a lot of meat and sausage. I eat kefir with bran and prunes for breakfast and in the evening, sometimes I add vegetable oil”;
• “... Often an aggravated fissure forces you to eat properly and correct your stool by drinking plenty of fluids. First of all, I eat beetroot dishes every day (salad with vegetable oil, cutlets, caviar). Secondly, I eat more prunes and figs, apples in any form. I try to have a vegetable dish at every meal. In the summer there is no problem with this, but in the winter seaweed, beets, pumpkin, carrots and Chinese cabbage help out. I make yoghurts with pharmaceutical sourdough - they are especially healthy. If you adapt and develop a certain nutritional algorithm, you can recover normally and not have exacerbations. I can say that nutrition really helps, but you need to stick to it all the time.”