Medical condition characterized by presence of swollen anorectal varicose veins is termed as hemorrhoids. Pregnant women often suffer with hemorrhoids due to pressure exerted by enlarging uterus on the rectum. Constipation associated with pregnancy also increases the risk for hemorrhoids. Pregnant woman can develop either internal or external hemorrhoids. Women who suffered with hemorrhoids before pregnancy are more likely to develop the disease during pregnancy. Though the problem sounds a little scary it can be managed by knowing how pregnancy and hemorrhoids are related and by taking necessary precautions to avoid complications.
Relation between pregnancy and hemorrhoids
Hemorrhoids develop during pregnancy due to three reasons.
- The size of uterus increases as the fetus grows. The enlarging uterus exerts pressure on pelvic veins and compresses the inferior vena cava (vein carrying blood from the lower part of the body). As a result blood returns slowly from the lower part of the body causing swelling of the veins below the uterus aggravating formation of hemorrhoids especially in the third trimester of pregnancy.
- Constipation and increased straining to pass stools also increases the risk for hemorrhoids.
- Hormone progesterone secreted during pregnancy causes swelling of the veins and slows down the activity of gastrointestinal activity. Both these together contribute to hemorrhoid formation.
- Straining at the time of labor to push the baby causes swelling of the veins of the rectum and anus region. It also worsens the existing hemorrhoids.
Pregnancy and hemorrhoids treatment
Before initiating the treatment process it is essential to know the time of onset of symptoms i.e. before pregnancy or after conceiving the baby. Treatment should be initiated only if the symptoms begin to worse or if the patient is unable to bear the pain. After initial observation of the symptoms physicians generally suggest the patient to take high fiber diet and increase the fluid intake. If symptoms do not subside then procedures such as rubber band ligation are used. Third and fourth degree hemorrhoids should be removed surgically. However, surgery is preferred only after giving birth to baby due to risk of premature labor and perineal infections. In unavoidable circumstances, surgery is performed only after assessing the health status of both the mother and growing fetus.
Majority of pregnant woman suffering with swollen anorectal veins start to feel comfortable after the birth of the baby. If hemorrhoids do not heal after giving birth to the baby then surgical procedures have to be used to get rid of the swollen tissue. But, dealing with surgical procedure and taking post operative medications while taking care of infants is a difficult task for a new mother. A new technique HAL/RAR is a less invasive procedure that identifies the actual site of vascular pressure using Doppler technology and cuts off the blood supply to the hemorrhoid tissue. This procedure is less invasive and the patient can recover fast in just a day or two. Before conducting the procedure the physician will decide if HAL/RAR procedure is right for the patient.
Precautions to be taken by pregnant women suffering with hemorrhoids
In addition to taking measures to prevent constipation, it is essential to follow other precautionary measures to keep hemorrhoids under control and to remain comfortable.
- Keeping the anal area clean by using moist toilet paper. Avoid using moist scented wipes or those containing alcohol.
- If required use medicated pads specifically designed for hemorrhoids. Use of pads soaked in Witch Hazel help to ease the pain.
- Avoid standing or sitting for long hours to reduce pressure on anal muscles. Lay down whenever possible.
- Avoid lifting heavy objects.
- Use mild gels in the anal region to reduce irritation and also to ease passing of stools.
- Reduce the burning sensation to keep pain under control.
- Consider soaking your bottom in warm water by sitting in bathtub filled with warm water.
- Use hemorrhoid cream or other medications as suggested by the physician.
- If constipation does not relieve with natural remedies ask your physician or mid-wife to recommend stool softeners or fiber supplements.
Pregnancy and hemorrhoids prevention
Hemorrhoids can be prevented during pregnancy by making simple lifestyle and dietary changes.
- Taking fiber rich diet.
- Drinking plenty of water at least 8-10 glasses of water.
- Regular practice of simple exercises.
- Do not postpone the urge to pass stools.
- Try to sleep on your left side than on back to reduce pressure in the anus region.
- Practicing Kegel exercise (Holding and releasing of vaginal and rectal muscles) multiple times in a day. This helps to strengthen the muscles of perianal region and improves the circulation to the rectum.