What lifestyle modifications should I advise to patients to prevent the recurrence of haemorrhoids?

Lifestyle modifications to prevent recurrence of haemorrhoids include:

• Advise patients to maintain a high-fibre diet by gradually increasing intake of whole grains, fruits, and vegetables to ensure soft, well-formed stools and reduce straining during bowel movements.
• Encourage adequate fluid intake, aiming for at least 1.5 litres per day unless contraindicated, to help maintain stool softness and prevent constipation.
• Advise patients to avoid straining and prolonged sitting on the toilet, and to adopt good toilet habits such as responding promptly to the urge to defecate and using a comfortable position (e.g., sitting or squatting) to facilitate bowel emptying.
• Recommend good anal hygiene, including gentle cleansing and patting the area dry to reduce irritation and itching.
• Discourage stool withholding and excessive straining, as these increase shearing forces on the anal cushions and contribute to haemorrhoid recurrence.
• Encourage regular physical activity to support bowel function and overall health.

These measures should be continued even after haemorrhoids have healed to reduce the risk of recurrence.

Simple analgesia may be offered for symptom relief, but opioid analgesics and NSAIDs should be avoided if rectal bleeding is present.

Referral to secondary care should be considered if symptoms persist despite conservative management.

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