Hemorrhoids in pregnancy and after childbirth: why do they arise, how to treat them?

Haemorrhoids are nodularly dilated veins of the lining of the anal canal (up to 3 cm of the last part of the rectum), which help in defecation.

They are a normal part of the human body. When diseased, hemorrhoids become enlarged, swollen, inflamed, and symptoms begin to develop.

Hemorrhoids are located in the rectal area. They can vary from the size of a pea to the size of a grape.

Occasionally, hemorrhoids form a painful blood clot - a hemorrhoid.
These blood clots are not dangerous, but they can cause a lot of pain.

The most common symptom is rectal bleeding after defecation.

Where are hemorrhoids located?

Depending on where hemorrhoids occur, they are divided into external and internal.

They can be located in the lower part of the rectum. This is when they are referred to as external haemorrhoids.
They can be seen around the rectum as knots around the anal (anus) opening.
They often thrombose (form blood clots), are swollen and painful.

Internal haemorrhoids occur in the lining of the rectum. Veins inside the sphincter are affected.
They are present above the external sphincter, under the lining of the rectum.
They are visible when examined with a rectoscope.
They manifest as rectal bleeding or pushing out, depending on the stage.

The pain is not usually pronounced, but after bleeding it suddenly eases anyway.

What do hemorrhoids look like?

Internal haemorrhoids are divided into 4 stages:
Stage 1 - no protrusion, only blood vessels visible
Stage 2 - protrusion is outward when bent but retracts when straightened
Stage 3 - protrusion when bent and requires manual retraction
Stage 4 - permanent protrusion

This disease is quite widespread. Hereditary factors are involved, but constipation, diarrhea, lifestyle, sedentary lifestyle, overweight, pregnancy, postpartum condition all contribute to it. In short, all conditions that promote blood accumulation and pressure in the area contribute to it.

You can read more in the article Do I have hemorrhoids? What are hemorrhoids, their causes, symptoms and treatment

Common occurrence of hemorrhoids in pregnancy

Many women experience these problems for the first time during pregnancy or after childbirth for several reasons.

Because of the increased production of the hormone progesterone, which causes both dilation of blood vessels and internal pressure and constipation.

In pregnancy and after childbirth, they occur in almost 40% of women.

They are often present before pregnancy in an asymptomatic form, i.e. without any symptoms.
They worsen during pregnancy and can strike with great force towards the end of pregnancy and after childbirth and make themselves known.

It causes big problems if the hemorrhoids become inflamed.

It is in pregnancy that hemorrhoids tend to be swollen and large.

They manifest themselves with swelling, burning, itching or pain.

They often bleed. The blood is a bright red color, which you notice when you expel stool on toilet paper.

Why do hemorrhoids occur in pregnancy?

During pregnancy, the female body undergoes various changes in the anatomy, and in the internal environment of the body. These changes also affect just the venous system and the formation of hemorrhoids.

The body has to give about a quarter more power than before pregnancy. These changes are aimed at the delivery of the fetus and the survival of the woman during childbirth.

After childbirth during the six months of pregnancy, the body returns to its pre-pregnancy state.

During pregnancy, the baby exerts extreme pressure on the rectal area.

Haemorrhoids arise due to increased intra-abdominal pressure, due to the pressure of the growing fetus in the uterus. The ligamentous walls of the rectum relax and their wall is weakened.

The outflow of blood in the veins of the rectum is made more difficult by the pressure of the uterus and the growing fetus in it.

In pregnancy, constipation often occurs, which also results in the formation of hemorrhoids.

The pressure of the enlarged uterus, especially in the 2nd and 3rd trimesters, compresses the pelvic veins, the inferior vena cava, with greater force, which in turn circulates blood to the lower limbs.

It is this pressure of the uterus on the veins that brings with it the risk of varicose veins and haemorrhoids.
Due to insufficient blood flow, which has to be returned with greater force.
The blood thus stagnates in the veins and dilates them.

Because of this, hemorrhoids can develop during and after pregnancy.

They are particularly common after vaginal births.

Do hemorrhoids go away on their own?

Haemorrhoids often plague women even before pregnancy. However, during and after childbirth, the condition often worsens.

After childbirth and after the pregnancy hormones have disappeared, hemorrhoids usually disappear spontaneously.
It depends on what condition the hemorrhoids were in before pregnancy. It also depends on their size, location and how the body flattens out after childbirth.

This can take a few days to a few weeks.

Haemorrhoids after childbirth

If you have successfully avoided them during pregnancy, they can still appear after childbirth because of the exertion during delivery and subsequent constipation.

If you have already had them during pregnancy, they may get worse.

Women after childbirth most often complain of problems with hemorrhoids.

Symptoms are reported by 28% to 48% of women in the first four weeks after giving birth.

You can probably imagine how the pressure of the uterus due to carrying the fetus and then pushing the baby out during vaginal delivery can cause hemorrhoids.

From several cases, women after childbirth are also prone to the occurrence of constipation.

Here, a vicious cycle of needing to defecate and developing pressure on the stool can begin, during which they may experience an outbreak of hemorrhoids.
They are afraid to go to the toilet to defecate because of the pain and subsequent rectal bleeding, so they hold back their stool. It then hardens and the process repeats again.

Haemorrhoids: how do they manifest themselves?

Pregnant women and women after childbirth often have discomfort in the rectal area.

It is here that the formation of hemorrhoids occurs, which affects the emptying of stool with abdominal pain.

Haemorrhoids are manifested by bleeding of bright red blood after stool.
Sometimes with only a small admixture of blood and in some to quite massive bleeding.

In pregnancy, when bleeding from haemorrhoids, it is always necessary to rule out whether it is bleeding from the genitals.

In addition to bleeding, you may experience itching and burning in the rectal area.

These discomforts can range from irritating to very painful.
The good news, however, is that in most cases hemorrhoids are not serious and tend to go away with home treatment.

Prevention is constipation treatment, strict rectal hygiene and sports.

What is the treatment of hemorrhoids from the comfort of home?

Treatment depends on what stage the hemorrhoids are at.

• It consists mainly in the regulation of the stool, prevention of constipation, the stool should be soft.
  It is best to avoid sharp and spicy foods, which irritate the rectum during defecation.
• Add fibre to your diet.
  Eat plenty of fruit, vegetables and foods containing fibre (whole grains, pulses, psyllium).
  Fibre helps to increase bowel movements, regulates stool consistency, which helps prevent constipation. However, remember to drink plenty of fluids at the same time, otherwise fibre can cause constipation.
• Keep to a drinking regime of at least 1.5-2 litres of water a day.
• Don't hold back stools for fear of painful defecation.
  The longer you wait, the harder the stools will become and the worse the haemorrhoids can get.
• Avoid pushing hard on the stool when passing stool.
• Sports are recommended for pregnant women that are safe for her and the baby.
  By playing sports, vascular flow will improve. By moving around, the veins will stabilize.
• If sport is not close to you, at least take enough exercise in the fresh air.
• Do Kegel exercises to strengthen the pelvic floor.
  This will prevent the muscles that surround the anal opening, the urethra and the vaginal entrance from weakening.
• Avoid sitting for long periods of time.
• Sleeping on your side is recommended.
• The anus requires thorough hygiene, by gently cleaning it and then applying a soft dry cloth or soft towel.
• Instead of dry toilet paper, use mild moistened wipes without perfumes and dyes.
• Try a sitz bath, which can be done several times during the day.
• A sedentary bath with chamomile or oak bark is recommended.
• Apply a cold pack or ice wrapped in a towel to the rectum for 10 minutes.
• Alternate warm baths and cold compresses.
• Try using over-the-counter ointments or suppositories with anti-inflammatory action to help relieve pain and treat hemorrhoids at the same time.

However, when buying medication, read the instructions carefully and note the recommended length of treatment.
Most medications should not be used for more than one week.
And beware!
Some medications are not recommended for use in the first trimester of pregnancy or while breastfeeding.

If home treatment does not work

If you have already tried everything and the problem with hemorrhoids has not subsided, it is a good idea to visit a specialist (surgeon). He will choose the best way to treat hemorrhoids.

Painless outpatient treatment, or gentle surgical treatment up to surgical solution, is an option.

Surgical treatment of hemorrhoids is recommended after the end of the sixth month.