Quick Guide

• Breath: Always exhale gently during effort; avoid breath-holding.
• Pain scale: Keep daily discomfort under 4/10; stop any move that worsens pain.
• Success signs: Softer stools, shorter toilet time (<5 minutes), reduced swelling/itch, minimal or no bleeding.

Step 1 — Stool Softening Routine (Daily)
Goal: Prevent hard stools from damaging or irritating haemorrhoids

1. Hydration: Drink 1.5–2.5 litres water/day, spaced evenly. Avoid guzzling large amounts in one go; small sips are gentler on the gut.
2. Fibre: Add soluble fibre (psyllium husk) gradually. Start with 1 tsp in water once/day, increasing to 1–2 tbsp as tolerated. Combine with sufficient fluid to prevent worsening constipation.
3. Diet: Prioritise cooked vegetables, whole grains, and soft fruits (e.g., stewed pears, ripe bananas). Include healthy fats like olive oil, avocado, or nuts to help lubricate stool.

Success: Stool consistency at Bristol Stool Chart type 3–4; easy to pass with no strain.

Step 2 — Zero-Strain Toilet Mechanics (1–2 minutes per attempt)
Goal: Empty without pushing or holding breath

1. Place a small footstool in front of the toilet so knees are slightly higher than hips (squat-like position).
2. Lean forward with elbows resting on knees; keep back straight, not hunched.
3. Take 3 slow nasal breaths: inhale into belly, exhale long and gentle. On each exhale, consciously relax the pelvic floor (imagine the anus gently opening like a flower).
4. Do not push or force. If nothing moves within 3–5 breaths, stand up, walk briefly, and try again later.

Success: Stool passes with no sharp pain, minimal bleeding, and without a “forced” feeling.

Step 3 — Circulation Boost Walks (3–5×/day)
Goal: Prevent blood pooling in rectal veins

1. Set a timer to stand up every 30–45 minutes during the day.
2. Walk for 3–5 minutes at a relaxed pace; swing arms loosely to help circulation.
3. Keep waistband loose; avoid holding belly tight.

Success: Less heaviness/pressure in anal area by the end of the day.

Step 4 — Warm Sitz Bath (10–15 minutes, 1–2×/day)
Goal: Soothe itching, reduce swelling, relax sphincter muscles

1. Fill a shallow basin or bathtub with warm (not hot) water — just enough to cover the perineal area when seated.
2. Lower yourself in slowly; keep knees slightly apart.
3. Breathe in through your nose for 4–5 seconds, exhale through your mouth for 6–8 seconds, letting the pelvic floor drop on every exhale.
4. Stay relaxed, no clenching; let water soothe the tissues.

Success: Noticeable reduction in itch and swelling after soaking; bowel movements feel easier later in the day.

Step 5 — Anti-Inflammatory Position Drill (2 minutes)
Goal: Relieve anal pressure between bowel movements

1. Lie on your left side, knees bent, pillow between knees.
2. Inhale into the belly and lower ribs; exhale and consciously soften the anal area.
3. This can also be done in a child’s pose position if comfortable.

Success: Anal area feels less “full” or throbbing after 1–2 minutes.