Hemorrhoids do not directly cause incontinence, but they can make it worse or create symptoms that feel similar

Hemorrhoids are swollen blood vessels in or around the rectum. Incontinence is the loss of control over bowel or bladder function. These are separate conditions with different causes — but they often happen together in older adults, and hemorrhoids can make incontinence symptoms harder to manage.

The confusion usually comes from two things. First, both conditions involve the rectal area and can cause leakage or spotting. Second, the straining that causes hemorrhoids can also weaken the muscles that control bowel movements over time. If you have both, treating the hemorrhoids may make incontinence easier to live with, even if it does not cure the incontinence itself.

Key Takeaways

  • Hemorrhoids and incontinence are separate conditions, but straining from hemorrhoids can contribute to the muscle weakness that leads to incontinence.
  • Hemorrhoid bleeding or leakage can be mistaken for incontinence, so your doctor needs to know which symptom came first.
  • Treating hemorrhoids — usually through diet, stool softeners, or medical procedures — may reduce straining and ease incontinence symptoms.
  • If you have both conditions, tell your doctor about both; treatment for one can affect how you manage the other.

How hemorrhoids and incontinence are connected

The connection is mostly about what causes them, not about one causing the other. Both hemorrhoids and incontinence become more common with age, and both are made worse by straining during bowel movements.

When you strain repeatedly — whether from constipation, hard stools, or pushing too hard — you put pressure on the blood vessels in the rectum (leading to hemorrhoids) and on the muscles and nerves that control bowel movements (leading to incontinence). Over years, this repeated straining can weaken the anal sphincter, the ring of muscle that holds stool in place. Once that muscle is weakened, you may leak stool or have trouble controlling when you go.

So hemorrhoids and incontinence often share the same root cause: constipation and straining. Treating the constipation can help both problems at once.

Symptoms that might be confused with incontinence

Hemorrhoids can produce leakage or spotting that feels like incontinence but is actually hemorrhoid bleeding or mucus. Internal hemorrhoids (inside the rectum) often bleed, leaving blood on toilet paper or in the bowl. External hemorrhoids (under the skin around the anus) can leak mucus or cause itching that leads to spotting.

This matters because the treatment is different. If what you are experiencing is hemorrhoid bleeding, stool softeners and topical hemorrhoid creams may solve it. If it is true incontinence — loss of control over when stool comes out — you need a different approach.

When you see your doctor, describe exactly what happens: Do you feel the urge to go but cannot hold it? Does stool come out without warning? Or do you see blood or mucus on the toilet paper? The answers help your doctor figure out which condition you actually have.

When hemorrhoids make incontinence worse

If you already have incontinence, hemorrhoids can make it harder to manage. The pain and itching from hemorrhoids can make you avoid the bathroom or rush through bowel movements, which can trigger accidents. Hemorrhoid pain can also distract you from noticing the urge to go, so you do not have time to reach the toilet.

Some people with hemorrhoids also develop fecal urgency — a sudden, strong urge to have a bowel movement that is hard to ignore. This is not the same as incontinence, but it can feel similar and can make incontinence worse if you already have it. Treating the hemorrhoids often reduces the urgency.

What your doctor will ask and examine

Your doctor will want to know the timeline: Did the hemorrhoids start first, or the incontinence? Have you always had constipation? How much straining do you do? Do you take medications that affect bowel movements, like opioids or anticholinergics?

The doctor will also do a visual exam and may perform a digital rectal exam (inserting a gloved finger into the rectum to feel for problems). If incontinence is the main concern, they may refer you to a colorectal specialist or a urogynecologist, depending on whether the problem is bowel or bladder control.

Be honest about both conditions. Hemorrhoids are common and nothing to be embarrassed about, and your doctor cannot help you manage incontinence well if they do not know you also have hemorrhoids.

Treatment options that help both conditions

The first step for both is usually the same: soften the stool and reduce straining. This means eating more fiber (from food or a supplement like psyllium), drinking more water, and using a stool softener like docusate if needed. These changes alone often shrink hemorrhoids and reduce incontinence episodes.

For hemorrhoids specifically, your doctor may recommend a topical cream or ointment (like hydrocortisone or witch hazel), sitz baths (sitting in warm water for 10 to 15 minutes several times a day), or over-the-counter pain relievers. If hemorrhoids are severe, a colorectal surgeon can remove them or shrink them with procedures like rubber band ligation or infrared coagulation.

For incontinence, treatment depends on the type and cause. Pelvic floor exercises (Kegel exercises) can strengthen the anal sphincter if weakness is the problem. Bowel training — going to the toilet at the same time each day — can help you regain control. Your doctor may also recommend dietary changes or medications.

The good news is that treating hemorrhoids often improves incontinence symptoms because it reduces the straining that weakens the sphincter in the first place.

When to contact your doctor

See your doctor if you have bleeding from the rectum, especially if the bleeding is heavy, lasts more than a few days, or is accompanied by pain. Also contact your doctor if you develop new incontinence or if existing incontinence gets worse.

Seek urgent care if you have severe rectal pain, fever, or signs of infection (like pus or warmth around the anus). These can signal a complication like a blood clot in a hemorrhoid or an abscess.

If you are already being treated for incontinence and hemorrhoids develop, tell your incontinence doctor. The two conditions may need to be managed together, and treating one can affect the other.

Frequently Asked Questions

Can hemorrhoid surgery fix my incontinence?

Hemorrhoid surgery alone will not fix incontinence, but it may improve it. If your incontinence is caused partly by straining from hemorrhoids, removing the hemorrhoids reduces that straining and may strengthen the sphincter over time. However, if the sphincter is already permanently weakened, you will still have incontinence after the hemorrhoids are gone.

What if I have bleeding and I am not sure if it is hemorrhoids or incontinence?

Incontinence does not cause bleeding — only hemorrhoids do. If you are seeing blood, it is coming from hemorrhoids, not from incontinence. However, you can have both conditions at the same time. Tell your doctor about both the bleeding and any loss of stool control so they can address each one.

Will treating my constipation help both the hemorrhoids and the incontinence?

Yes, in most cases. Constipation and straining are the main drivers of both conditions. Eating more fiber, drinking more water, and using stool softeners reduce straining, which shrinks hemorrhoids and takes pressure off the sphincter muscle. This often improves both conditions together.

Is it normal to have both hemorrhoids and incontinence at the same time?

Yes, it is common in older adults. Both become more frequent with age, and both are often caused by constipation and straining. Having one does not mean you will get the other, but if you have one, your risk for the other is higher. The good news is that many treatments help both.