Almost everyone has haemorrhoids - they are a normal part of anal anatomy and help seal the anus when holding gas. They only become a problem once they enlarge, prolapse, bleed and hurt.
That enlargement usually comes down to everyday mechanics: straining with constipation, holding the breath while emptying the bowel, long sitting on the toilet, and a position in which the rectum has no way to empty. Add excessive pelvic floor tension, which impedes blood flow out of the anal area, and the cycle closes - pain makes the patient tense even harder.
Physiotherapy does not remove haemorrhoids and does not replace a proctologist - the decision about a procedure and any medication belongs to the doctor. Physiotherapy addresses the causes that load them daily, which is why it makes sense both before a procedure and after one: without changing how you empty your bowel, the symptoms come back.
Therapy
- Detailed history and a bowel diary
- Functional examination of the pelvic floor and sphincters
- Learning to empty the bowel without straining or holding the breath
- Correcting toilet posture
- Releasing an overactive pelvic floor
- Breathing and diaphragm work
- A home programme