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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.
Any trigger that creates an inflammatory response can/will cause a flare up - especially if you are not on maintenance medications. For some patients - even ones in remission, triggers such as GI infection, systemic illness, significant change in diet and activity, or severe emotional stress can result in a flare up.