Pregnancy can be a joyous time in a woman’s life, but sometimes it means dealing with an unwelcome condition — hemorrhoids.
Getting hemorrhoids while pregnant is no fun, and it means treating this condition is a high priority.
It’s not exactly cocktail party conversation but as many as 10 million people in the United States get hemorrhoids. These enlarged or swollen veins in the anus and lower part of the rectum are often thought about as the varicose veins of this area of the body. For a quick anatomy lesson, the anus — the opening of the lower gastrointestinal tract — is located at the bottom of the rectum, which stores your stool.
An earlier Canadian study found that 25 to 35 percent of pregnant women experience this condition. In some populations, up to 85 percent of pregnancies are affected by hemorrhoids during the third trimester.
“Pregnant or not, because we can’t easily see our own hemorrhoids and often can’t feel them, many of us don’t even know we have them — that is until they become annoying and uncomfortable,” said Laurie McKechnie, a nurse practitioner at Lynn Women’s Health, a gynecology and obstetrics practice affiliated with Lahey Health. By understanding what causes hemorrhoids and knowing more about treatments, managing your pregnancy and hemorrhoids can be easier and will leave you with more time to think about wonderful days to come.
Types of Hemorrhoids
Hemorrhoids are classified in two ways, by these symptoms:
- External: These are on the outside of the body and may cause anal itching and pain, including burning, particularly when sitting. They may form lumps close to the anus.
- Internal: This type on the inside of the body may cause rectal bleeding, and when it passes through the anus to the outside, it’s a prolapsed hemorrhoid.
“Keep in mind that other, more serious conditions, such as colon or rectal cancer, Crohn’s disease and ulcerative colitis may also cause rectal bleeding,” said McKechnie. “If you have any bleeding, please consult your doctor to confirm a hemorrhoid diagnosis.”
Causes of Hemorrhoids
These include, in addition to pregnancy:
- Chronic constipation or diarrhea
- Sitting too long, including too much time on the toilet
- Straining when you have a bowel movement
- Inadequate consumption of fiber in the diet
- Aging that weakens the tissues of the anus and rectum
To diagnose hemorrhoids, your doctor will take your medical history and examine your anus during a digital rectal exam — using a lubricated, gloved finger. If necessary, to confirm internal hemorrhoids, your doctor may use a diagnostic tool such as an anoscope or protoscope to look further up the rectum.
Pregnancy and Hemorrhoids
“During pregnancy, your uterus gets larger,” said McKechnie. “Your baby creates more pressure on large veins adjacent to your uterus.”
There’s another reason you may develop hemorrhoids. “Many pregnant women also get constipated because there’s more progesterone in their system,” she said. “This actually causes relaxation of the body’s smooth muscles, and that slows down the rate that food moves through the intestines.”
When you’re constipated, you may strain, and that repeated action can help create hemorrhoids. Other reasons for developing hemorrhoids include reduced levels of exercise and the actual pushing action that occurs during labor. That being said, most symptoms will resolve after you give birth.
Of course, not all symptoms resolve in all women, but you don’t have to live with uncomfortable hemorrhoids. After all, as an expectant mother, you have plenty on your plate already. To be proactive about hemorrhoids:
- Increase your fiber intake with food or a fiber supplement. Prunes, prune juice, and pear juice, with no added sugars, are good options.
- Drink more fluids, especially water.
- Don’t strain or hang out on the toilet too long.
- Sit in a sitz bath, filled with a few inches of warm water and Epsom salts, a couple times a day for up to 15 minutes.
- Use over-the-counter hemorrhoid creams, ointments or suppositories to relieve mild symptoms. Witch hazel pads can also be soothing.
Talk to your doctor if your symptoms aren’t better after a week. If conservative measures don’t help, your doctor may decide to perform the following treatments:
For external hemorrhoids, your doctor may recommend a treatment called rubber band ligation. A special type of rubber band is placed around the hemorrhoid base to cut off blood supply. The hemorrhoid shrinks and eventually falls off. This treatment is used for bleeding or prolapsing internal hemorrhoids.
These methods initially cause the formation of scar tissue, which cuts off the hemorrhoid’s blood supply. This usually shrinks the hemorrhoid.
- Sclerotherapy: A solution is injected into the hemorrhoid
- Electrocoagulation: An electric current is directed into the hemorrhoid
- Infrared photocoagulation: An infrared light is directed at the hemorrhoid
More advanced treatments
Your doctor may recommend these more advanced treatments, which would require anesthesia:
- Hemorrhoid stapling: This tool helps position an internal or prolapsing internal hemorrhoid in the anus where it belongs.
- Hemorrhoidectomy: This surgery is effective for large external hemorrhoids or for prolapsing internal hemorrhoids.
“Don’t just put up with or tolerate your hemorrhoids,” said McKechnie. “With so many options available to treat them, you and your doctor can find the right one for your unique situation.”
For more information on treating hemorrhoids, contact your Lahey Health provider.