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Less strain, more gain. Prolonged sitting or straining, often associated with constipation or diarrhea, may lead to hemorrhoids. By straining you are causing more hemorrhoids and creating more symptoms, Dr. Wolf says. Don't delay bowel movements during hemorrhoid flare-ups.
When an internal hemorrhoid becomes inflamed, it can cause swelling. This in itself does not cause pain because there are no pain fibers attached to the veins above the pectinate line. Passing a hard stool can scrape off the thinned lining of the hemorrhoid causing painless bleeding.