Haemorrhoids

An old assumption that's more complicated than it looks

Haemorrhoids are swollen, engorged blood vessels around the anus, and the long-standing assumption has been that low fibre intake and straining are the main cause. That link is genuinely less clear-cut than it's often presented. Some research has failed to find low fibre or straining to be as central as once assumed, and researchers now think inflammation and disrupted blood vessel regulation in the area play a bigger role in why haemorrhoids form in the first place than previously thought.

An emerging gut bacteria connection

A newer theory, still at an early stage of evidence, proposes that local dysbiosis, an imbalance in the bacterial community of the anal canal itself, may be a starting point for the inflammation that leads to haemorrhoids, rather than just something that shows up afterward. Researchers suggest this local inflammation damages the connective tissue that normally holds the anal cushions in place, allowing them to slide and swell. This remains a theory built mainly on review and mechanistic evidence rather than large clinical trials, so it should be read as a promising early direction rather than an established fact.

Source: Altered Gut Microbic Flora and Haemorrhoids: Could They Have a Possible Relationship?

Whatever the root cause, fibre still helps symptoms

Regardless of how haemorrhoids start, the evidence that fibre helps once they're present is considerably stronger. A meta-analysis of 7 randomised controlled trials, covering 378 patients, found fibre supplementation, most often psyllium husk, reduced the risk of persisting haemorrhoid symptoms by 47% and cut the risk of bleeding by 50%, compared with no fibre. Softer, bulkier stools reduce the straining and irritation that aggravate existing haemorrhoids, even if fibre turns out not to be the original cause.

Source: Fiber for the treatment of hemorrhoids complications: a systematic review and meta-analysis

What this means for you

Rectal bleeding should always be checked by a doctor at least once, even if haemorrhoids seem like the obvious explanation, since other more serious causes of bleeding need to be ruled out first. Once haemorrhoids are confirmed, a gradual increase in fibre, along with plenty of fluids, is a well-supported, low-risk first step, and it can take several weeks to show its full benefit. A varied, plant-rich diet delivers fibre gradually and gently, which is generally easier on the gut than a single concentrated supplement introduced all at once. That's the same idea behind GutLab, everyday gut health starts with regularly feeding the microbiome a broad range of plant-rich ingredients.