Pregnancy hemorrhoids are so common that their prevention should begin early by every future mother. Treatment of hemorrhoids in pregnancy is difficult. First of all, not all drugs and methods can be used during pregnancy. Secondly, therapy should be performed as effectively as possible, since even the initial stages of hemorrhoids can not only cause discomfort, but also affect the health of a woman and the fetus. Thirdly, untreated before birth, hemorrhoids can be significantly aggravated in the process of delivery, especially during the period of birth contractions. And after childbirth this delicate problem brings mothers a lot of inconvenience both in the process of defecation, and while carrying the baby on the hands. Lifting even minor weights can cause pain and bleeding. So, what are the causes of the development of pregnancy hemorrhoids? How does it affect a woman and the baby? And what are the treatment methods?
Hemorrhoids are a disease associated with inflammation and pathological expansion of the hemorrhoidal veins, forming nodes around the rectum. This is a very common disease. The main cause of it is usually the stagnation of venous blood in the lower part of the body and in the legs. The development of hemorrhoids passes gradually – at the initial stage, there is the heaviness and itching in the anus, pain, constipation, later bleeding, sagging and prolapse of elastic hemorrhoids are noted.
The factors that cause hemorrhoids are a sedentary lifestyle, malnutrition, obesity, alcohol abuse, cirrhosis of the liver, etc.
This ailment often accompanies pregnancy. About half of the women who are expecting a child suffer from hemorrhoids pregnancy. This happens because apart from the main reasons, during pregnancy there is pressure of the growing uterus on the lower abdomen. As a result, it compresses the veins. Constipation due to the low motor activity of the intestine also plays its role.
In healthy women, hemorrhoids can develop in the second half of pregnancy, but if there is a hereditary predisposition, or hemorrhoid symptoms appeared before pregnancy, hemorrhoids can develop at an earlier time – as early as the 12th week.
Causes of Hemorrhoids in Pregnant Women
The main factors for the development of pregnancy hemorrhoids are the following:
- Chronic constipation. With chronic constipation, the stretching and tension of the rectum walls increase during the act of defecation, which in turn leads to the formation of hemorrhoids.
- In pregnant women, the frequency of constipation is much higher, mainly due to a decrease in intestinal tone during pregnancy.
- Sedentary lifestyle. Hypodynamia (sedentary lifestyle) promotes stagnation of blood in the venous plexus of the rectum, which eventually leads to vein thrombosis and the formation of hemorrhoids. Pregnant women, because of their condition, are forced to lead a more or less sedentary lifestyle and therefore the risk of developing hemorrhoids is significantly higher than that of other people.
- Violation of blood circulation in the lower part of the body is very typical for pregnant women. During pregnancy, the developing uterus squeezes the lower vena cava. As a result, there is stagnation of blood in the veins of the legs and rectum. During labor, intra-abdominal pressure in a woman rises very strongly. This can be the cause of hemorrhoids after childbirth.
Stages of Hemorrhoids Development in Pregnant Women
The risk of hemorrhoids increases with the progression of pregnancy. Especially often hemorrhoids occur in the third trimester of pregnancy or after childbirth. However, the occurrence of hemorrhoids in the first or second trimester of pregnancy can still take place.
The development of hemorrhoids occurs as follows: under the influence of the factors described above, a gradual expansion of the blood vessels of the hemorrhoidal (cavernous) plexus of the rectum occurs. Expanding, the walls of the veins of the rectum lose elasticity. Eventually, this leads to the formation of protrusions of the veins under the mucous membrane.
Doctors speak about the hemorrhoids of the first stage, when the hemorrhoidal nodes protrude only into the lumen of the rectum and do not leave the anal opening. As the disease develops, the hemorrhoidal nodes increase and begin to sag from the anus.
The second stage of hemorrhoids is characterized by the sagging of the hemorrhoidal nodes from the anus, which, however, are recirculated back into the rectum when the body position changes.
At the third stage of hemorrhoids in pregnant women, the hemorrhoidal nodes sag from the anus and do not get back to the rectum when the body position changes.
Symptoms of Hemorrhoids in Pregnancy
Hemorrhoids during pregnancy can occur in two forms – acute and chronic. The acute form is characterized by the sudden formation of a thrombus in the veins of the rectum, which causes burning pain, especially after the defecation process. Dense outer nodes are formed. Their diameter can reach 2-3 cm. The skin under them swells and reddens.
After 5-10 days, the acute form turns into chronic. The nodes soften and swell only when straining. The process is accompanied by unpleasant sensations in the anus and itching.
In the fecal masses, blood appears, sometimes in fairly large quantities. What’s more, the hemorrhoidal nodes may fall out of the anus, self-adjusting after a while. The pain may not take place. At the same time, there may be a feeling of incomplete emptying of the intestine, discomfort, and bloating. Walking and sitting become painful.
The appearance of pain, itching, discomfort and small bleeding from the rectum during pregnancy gives the doctor the right to suspect pregnancy hemorrhoids. Mostly, hemorrhoids in pregnant women often develop in the third trimester of pregnancy or after childbirth (postpartum hemorrhoids).
The appearance of hemorrhoids that sag from the anus allows you to accurately determine the diagnosis of hemorrhoids. Still, even in this case, an additional examination of the pregnant woman is necessary. It allows establishing the stage of hemorrhoids and distinguish it from other diseases (or to establish the presence of other diseases with similar symptoms).
To clarify the diagnosis, a finger examination of the rectum is performed. Thus the doctor can feel internal hemorrhoids, estimate their arrangement, sizes and quantity. Also, finger examination of the rectum allows determining the presence of a rectal fissure. This disease often accompanies hemorrhoids, has similar symptoms, but is treated differently.
Precise diagnosis of hemorrhoids in pregnant women is important for prescribing the proper treatment. In case of pregnancy hemorrhoids, treatment strictly depends on the form (stage of hemorrhoids).
Is It Necessary to Treat Pregnancy Hemorrhoids?
Treatment of the disease, sometimes even of severe stages, is often postponed to the postpartum period because of fears to harm the fetus. Specialists categorically do not support this approach to therapy, since with hemorrhoids, a successful pregnancy can be complicated by severe consequences provoked by this disease.
The combination of pregnancy and hemorrhoids, especially at acute stages, leads to a gradual deterioration of well-being. Constant discomfort, pain, inability to normally go to the toilet exhaust the woman. Thus, pregnancy period becomes much harder. And this, in turn, is reflected in the health of the baby.
Large hemorrhoidal nodes cause inflammation and tissue death. It “opens the way” to all possible infections. And as we all know, during pregnancy, any infectious disease can be dangerous for the child. In the most severe cases, the infection can penetrate into the child’s blood, triggering intrauterine infection.
An even more severe consequence of neglected hemorrhoids is anemia, which causes permanent bleeding from the anus. Lack of hemoglobin can lead to fetal hypoxia and oxygen starvation. This is extremely dangerous for a growing baby.
An unpleasant consequence of untreated hemorrhoids during pregnancy can be a sharp deterioration in the patient’s condition immediately after birth, regardless of the mode of delivery.
It is necessary to understand that during pregnancy the development of hemorrhoids can proceed swiftly. Therefore it is necessary to begin treatment as early as possible. Modern drugs allow you to minimize the risk of complications and quickly cope with the disease. Pharmacological companies offer a range of medications approved in the most sensitive first trimester of pregnancy. Hemorrhoids of early stages of development also successfully yield to the prevention of exacerbations, while observing diet, physical activity and hygiene procedures.
If a drug therapy for pregnancy hemorrhoids is necessary, it is better to entrust the choice of a drug to a specialist.
Conservative treatment is the safest for the mother and the baby method of treating hemorrhoids during pregnancy. Depending on the term and the stage of the disease, the proctologist prescribes preparations in the form of ointments, creams, anal suppositories with different effects.
If conservative treatment is not effective, surgery may be required. Still, usually during pregnancy the surgery is performed only in extreme cases, with careful monitoring of the proctologist and surgeon. Usually, if there is a need for surgical intervention, the operation is postponed for the postnatal period.
After childbirth, during the first two months, hemorrhoids can continue to bother, but usually – with the normalization of lifestyle and increased physical exertion – it passes. Nevertheless, if you face the problem off hemorrhoids pregnancy, consult a doctor. This will help avoid complications, reduce uncomfortable sensations, and also distinguish the disease from those that occur with similar symptoms (anal fissures, tumors), but requiring other treatment.