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So last week I’m in my office, right? And this poor bastard walks in looking like he hasn’t slept in months. You know that look – the one where someone’s been dealing with something embarrassing for way too long and they’re just… done. Completely fucking done.
“Doc,” he says, and I can hear the desperation in his voice, “I’ve been battling these goddamn piles for half a year now. I’ve tried every single cream they sell at the pharmacy. Changed my whole diet. My wife even bought me one of those stupid squatty potty things. Nothing. Absolutely nothing is working. What the actual hell am I doing wrong here?”
And you know what? My heart just sank because I hear this exact same story at least three times every single week. Maybe you’re reading this right now thinking the exact same damn thing. Maybe you’ve been up at 3 AM googling “why won’t my hemorrhoids heal” for the hundredth time this month.
Look, I’m gonna be straight with you about the top 5 reasons your piles aren’t healing. No sugar-coating, no medical jargon bullshit. Just the real reasons why your ass is still giving you grief when it should’ve sorted itself out by now.
After dealing with this crap for fifteen years – yeah, fifteen years of looking at people’s butts and listening to their bathroom horror stories – I’ve figured out some patterns. And here’s what pisses me off the most: most people are actually trying really damn hard. They’re doing what they think is right. They’re following advice from Dr. Google, their neighbor’s cousin who “had the same thing,” and whatever random forum they found at 2 AM.
But here’s the thing that nobody tells you about why your piles aren’t healing – sometimes the conventional wisdom is complete garbage. Sometimes the stuff everyone says you should do is actually making things worse. And sometimes you’re doing everything right, but you’re missing one crucial piece that’s screwing up the whole process.
What really gets under my skin is how people beat themselves up about this. They think there’s something fundamentally wrong with them, that they’re disgusting or weak or whatever. That’s complete horseshit. Hemorrhoids are stupidly common – like, more than half of adults deal with this at some point. You’re not special, you’re not broken, you’re just unlucky.
So let’s get into the meat of this, shall we? Because honestly, life’s too short to spend it worrying about your asshole.
Okay, buckle up for this one because it’s going to piss off about 80% of you reading this. You think you’re not straining anymore. You swear up and down that you’ve stopped pushing and forcing things. But I’m calling bullshit on that, and here’s why.
Straining isn’t just the obvious stuff – the grunting, the red-faced pushing, the whole dramatic production. That’s amateur hour straining. The real problem is all the sneaky ways you’re still putting pressure down there without even realizing it. And this subtle straining? It’s hands down the biggest reason your piles aren’t healing.
I had this guy – we’ll call him Dave because his real name is Dave and he said I could use it – who insisted he wasn’t straining. “Doc, I promise you, I’m not pushing at all anymore.” Then I ask him about his bathroom routine, and this moron tells me he sits on the toilet for twenty-five minutes every morning scrolling through Facebook “just to make sure everything comes out.”
Twenty-five fucking minutes!
Dave, if you’re reading this – that’s not relaxing, that’s torturing your hemorrhoids. Every minute you spend sitting there, even if you’re not actively pushing, you’re putting pressure on those swollen tissues. It’s like having a bruise and poking at it every few minutes to “check if it still hurts.”
Here’s what most people don’t get about straining – your body has this amazing ability to know when it needs to go. When you feel that urge, you go, you do your business, and you’re done. The whole process should take maybe three to five minutes tops. If you’re sitting there longer than that, you’re not being thorough, you’re being stupid.
And let’s talk about the breath-holding thing because this one drives me absolutely nuts. People get nervous about going to the bathroom when they have hemorrhoids (which makes sense), so they hold their breath during the whole process. That creates internal pressure that goes straight to your pelvic floor and makes everything worse.
The fix for this major reason your piles aren’t healing? It’s going to sound terrifying at first, but trust me. Only go to the bathroom when you actually feel the urge. Not when you think you should go, not because it’s been a while, but when your body says “hey, we need to do this now.” Sit down, breathe normally like a human being, and let whatever wants to happen, happen. If nothing happens in three minutes – and I mean actually timing it, not estimating – get up and leave.
Your hemorrhoids will thank you, and you’ll stop being part of the problem.
Oh boy, here we go with the diet lecture. Except this isn’t going to be what you expect because I’m not going to tell you to eat more fiber and call it a day. That’s lazy medicine, and frankly, it’s often wrong.
I see people all the time who are eating fiber like it’s going out of style, and their piles still aren’t healing. I also see people who think they’re eating healthy but are unknowingly consuming stuff that’s making their hemorrhoids worse.
Let me tell you about Maria. She comes to me frustrated as hell because she’s been eating oatmeal every morning, massive salads for lunch, and quinoa with vegetables for dinner. Fiber everywhere. But she’s also drinking five cups of coffee a day because she works in finance and needs to stay alert, plus she’s hitting up the Thai place twice a week because “it has vegetables so it’s healthy.”
The coffee thing alone was probably screwing her over. Not because coffee is the devil, but because it dehydrates you and can stimulate your gut in ways that create more pressure down there. And the spicy Thai food? Jesus Christ, that’s like pouring gasoline on a fire when you’re trying to heal hemorrhoids.
But here’s the really sneaky stuff that contributes to why your piles aren’t healing – it’s not just what you eat, it’s when and how much. If you’re eating huge meals and then sitting at a desk for eight hours, your digestion gets all screwed up. If you’re eating late at night, your morning bathroom routine becomes this whole complicated ordeal.
And can we talk about stress eating for a second? Because dealing with hemorrhoids is stressful, and when people are stressed, they make shitty food choices. They grab fast food, they eat too much, they skip meals and then overeat later. All of that works against proper piles recovery.
Here’s what I tell people: keep a simple food diary for one week. Nothing fancy, just write down what you eat and how you feel later that day or the next morning. You might be shocked at the patterns. Maybe your piles flare up every time you have pizza. Maybe they’re worse on days when you drink alcohol. Maybe that “healthy” smoothie with tons of fruit is actually causing problems.
The goal isn’t to eat nothing but rice and boiled chicken forever. It’s to figure out what your body can handle right now while it’s trying to heal. Once your hemorrhoids are better, you can probably go back to your normal habits. But right now, work with your body instead of against it.
This one makes me want to throw things because people try so goddamn hard to do the right thing, but they end up making everything worse. It’s like watching someone try to put out a fire with gasoline.
Piles aren’t just swollen veins that magically shrink back to normal size. They’re inflamed, angry tissue that needs specific conditions to heal properly. And inflammation is picky as hell about what it likes and what it doesn’t.
I had this patient – let’s call her Karen because, well, she was kind of a Karen – who was cleaning the area with antibacterial soap four times a day, applying hemorrhoid cream every two hours, and taking scalding hot baths twice daily. She was doing everything she found on the internet and then some.
Her hemorrhoids weren’t healing. In fact, they were getting worse.
Here’s what was happening: all that cleaning, scrubbing, and constant application of products was actually keeping the inflammation going. The skin around your anus is about as sensitive as it gets, and Karen was basically torturing it in the name of “proper hygiene.”
The inflammation management that actually works for piles recovery is boring as shit, but it’s effective. Gentle cleaning with plain water or very mild soap. Pat dry, don’t rub like you’re trying to start a fire. Use treatments exactly as the package says – not more, not less. And for the love of everything holy, stop constantly checking and messing with things down there.
I know it’s hard because when something hurts, your brain says “do something!” But sometimes the best thing you can do for inflamed tissue is leave it the fuck alone. If you kept poking and prodding and treating a scraped knee every hour, would it heal faster? Hell no. Same principle applies here.
Your body has been dealing with inflammation since before you were born. It knows what it’s doing. Your job is to create the right conditions for healing and then get out of the way. That means gentle care, consistent habits, and the patience to let your body do its thing.
I almost didn’t include this one because it sounds like new-age bullshit when we’re talking about hemorrhoids, but I’ve seen this connection too many times to ignore it. Stress and poor sleep are absolutely among the top 5 reasons your piles aren’t healing, and most people have no clue how connected these things are.
Your digestive system is basically your second brain – it’s got more nerve endings than your spinal cord, and it reacts to stress like a teenager reacts to criticism. When you’re stressed out, your body pumps out hormones that can slow down digestion, mess with your gut bacteria, and interfere with how well your tissues heal.
I remember this one guy, Tom, who came to see me after four months of failed hemorrhoid treatment. We’d try something, it would work for a few days, then everything would go back to shit. Literally.
Turns out Tom was in the middle of a messy divorce, working seventy-hour weeks at a job he hated, and sleeping maybe four hours a night because he was too wired to shut his brain off. Once we addressed the sleep thing and talked about some basic stress management, his hemorrhoids started improving within two weeks.
But here’s the real kicker – stress about your hemorrhoids can actually make them worse. You’ve got piles, which stresses you out, which affects your sleep and digestion, which makes the hemorrhoids worse, which stresses you out more. It’s like being stuck on the world’s shittiest merry-go-round.
The solution isn’t to eliminate all stress from your life because that’s not realistic unless you’re planning to become a monk. It’s about breaking the cycle wherever you can. Maybe that means turning off your phone an hour before bed. Maybe it means taking a walk when you feel overwhelmed instead of doom-scrolling social media. Maybe it means admitting that you need help managing your stress right now, and that’s okay.
Sleep is huge for piles recovery. Your body does most of its healing work while you’re asleep, and if you’re not getting enough quality rest, everything takes longer to heal. I’m talking basic sleep hygiene here – go to bed at roughly the same time each night, keep your room cool and dark, and for the love of God, stop looking at screens right before bed.
This last one is probably the most frustrating of the top 5 reasons your piles aren’t healing because it’s about expectations, and nobody wants to hear that their problem is going to take actual time to fix.
People come to me expecting hemorrhoids to heal like a headache – take some medicine, feel better in a few hours, move on with life. But hemorrhoids aren’t like that. They involve blood vessels, connective tissue, and inflammation, and all of that takes weeks to heal properly. Most hemorrhoids need at least four to six weeks to heal completely, and that’s assuming you’re doing everything right and haven’t been dealing with them for months already.
But here’s what kills me – during that healing time, people don’t want to give their bodies what they actually need for proper piles recovery. They want a quick fix, not lifestyle changes. They’ll religiously use expensive creams but won’t drink enough water. They’ll buy every supplement on the market but won’t take a fifteen-minute walk after dinner.
Your body needs adequate hydration to keep your stool soft and your tissues healthy. Most people think they’re drinking enough water, but if you’re trying to heal hemorrhoids, you probably need more than you think. I usually tell patients to aim for urine that’s clear or very pale yellow – that’s your hydration gauge.
Movement matters too, but I’m not talking about training for a marathon. Just regular movement throughout the day. Sitting for hours puts pressure on your anal area and reduces blood flow to the region. Even getting up and walking around for five minutes every hour can make a real difference in your piles recovery.
And posture – yeah, I’m going to be that annoying guy who talks about posture. How you sit, especially on the toilet, affects the angle of your rectum and the pressure on your hemorrhoids. Using a small stool to elevate your knees while you’re on the toilet (so your knees are higher than your hips) can reduce straining and support healing. It looks stupid, but it works.
If you’re in Ahmedabad and you’ve been trying to handle this shit on your own without success, it might be time to talk to someone who deals with this stuff every day. Dr. Ankur K. Patel at Bharatkare has been handling these cases for sixteen years, and sometimes you just need someone with real experience to look at your specific situation.
What I like about places like Bharatkare is that they understand it’s not just about the hemorrhoids themselves. They look at the whole picture – all the stuff we’ve been talking about that contributes to why your piles aren’t healing. Sometimes, even when you’re doing everything right, you need more advanced treatment. That doesn’t mean you failed or screwed up. It just means your particular situation needs a different approach.
The key is not waiting until things get really bad. If you’ve been working on addressing the top 5 reasons your piles aren’t healing for six to eight weeks without improvement, or if you’re dealing with serious bleeding, severe pain, or hemorrhoids that are hanging outside and won’t go back in, it’s worth having a conversation with someone who specializes in this.
There are some situations where you shouldn’t try to handle things on your own, no matter how much you want to avoid the embarrassment:
Heavy bleeding – A little bright red blood on toilet paper can be normal with hemorrhoids. But if you’re seeing blood in the toilet bowl, blood on your underwear, or if it’s dark or clotted, get your ass to a doctor.
Severe pain – Hemorrhoids can be uncomfortable, but they shouldn’t make you want to curl up in a ball and cry. Severe pain might mean you have a thrombosed hemorrhoid or something else entirely.
Stuff hanging out – If you have hemorrhoids that protrude outside and won’t go back in on their own, that needs professional attention. Don’t try to shove them back in yourself.
Weird changes – If your hemorrhoid problems come with changes in your bowel movements, unexplained weight loss, or other digestive weirdness, don’t ignore it. That could be something else entirely.
Nothing’s working – If you’ve been consistently addressing the reasons your piles aren’t healing for two months without any improvement whatsoever, it’s time to call in the professionals.
Look, I could give you a perfect plan for addressing the top 5 reasons your piles aren’t healing, but perfect plans are useless if you can’t actually follow them. Real life is messy. You’re going to have stressful days, eat the wrong thing, or sit too long because of work or kids or whatever chaos you’re dealing with.
The goal isn’t perfection because perfection is bullshit. The goal is progress. Pick one or two things to focus on first. Maybe start with the straining issue and drinking more water. Get those handled for a week or two, then add in some dietary changes. Once that feels manageable, work on the stress and sleep stuff.
Don’t try to completely overhaul your entire life overnight because that never works. Small, consistent changes will get you further than dramatic gestures that you can’t maintain long-term.
And please, for the love of everything holy, be patient with yourself. Piles recovery isn’t a straight line – you’ll have good days and shitty days (sometimes literally). That’s completely normal and doesn’t mean you’re not healing. It means your body is working through a process, and processes take time.
Most importantly? Stop beating yourself up about having this problem in the first place. Hemorrhoids are incredibly common, they’re not your fault, and you’re definitely not alone in dealing with this crap.
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Maybe, maybe not. Small hemorrhoids sometimes do resolve on their own if whatever caused them in the first place gets better naturally. But most of the time, ignoring them means you're not addressing the underlying reasons your piles aren't healing, so they just stick around being annoying. It's like ignoring a weird noise your car is making - it might not kill you, but it's probably not going to fix itself either.
Most people don't need surgery, even when they're convinced they do. You might need surgical intervention if you have large, prolapsed hemorrhoids that don't respond to anything else, thrombosed hemorrhoids causing severe pain, or if you've tried appropriate self-care for two to three months without any improvement. A specialist can help you figure out what makes sense for your particular brand of misery.
Healing usually isn't a straight line - you'll have good days and days where you want to set everything on fire. Generally, you might notice less bleeding first, then less swelling, and finally less discomfort. The whole damn process typically takes one to three months depending on how bad things are and how well you address the underlying causes. Don't panic if you have setbacks - that's totally normal.
Unfortunately, yes. Hemorrhoids can absolutely come back if you go back to the same habits that caused them in the first place. This is why addressing the top 5 reasons your piles aren't healing is so important - it's not just about fixing the current problem, it's about preventing future ones.
For many people, yes, they're actually helpful. The warm water increases blood flow to the area, can reduce inflammation, and helps keep things clean. Just use plain warm water (not scalding hot), limit baths to 10-15 minutes, and don't overdo it. Some people swear by them, others don't notice much difference.
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