It is believed generally that constipation and straining to have bowel movements promote hemorrhoids and that hard stools can traumatize existing hemorrhoids. It is recommended, therefore, that individuals with hemorrhoids soften their stools by increasing the fiber in their diets. Fiber is found in numerous foodstuffs including fresh and dried fruits, vegetables, grains, and cereals. Generally 20-30 grams per day of fiber are recommended whereas the average American diet contains less than 15 grams of fiber. Supplemental fiber (psyllium, methylcellulose, or calcium polycarbophil) also may be used to increase the intake of fiber. Stool softeners and increased drinking of liquids also may be recommended. Nevertheless, there is no strong, scientific support for the benefits of fiber, liquids, or stool softeners.
Diarrhea is believed to aggravate the symptoms of hemorrhoids and it is recommended that diarrhea be controlled with fiber and anti-motility drugs.