Hemorrhoids, commonly known as piles, are swollen veins in the anus and rectum that often cause discomfort, itching, pain, and sometimes bleeding. They are a frequent issue for many pregnant women in Australia, particularly during the second and third trimesters. Understanding why hemorrhoids occur during pregnancy, how to manage symptoms, and what treatments are safe can help expectant mothers find relief and prevent worsening.
Why Do Hemorrhoids Develop in Pregnancy?
Pregnancy brings several changes that increase the likelihood of hemorrhoids:
- Hormonal shifts: Increased progesterone relaxes blood vessel walls, making veins more prone to swelling.
- Pressure from the growing uterus: The expanding womb presses on pelvic veins and the inferior vena cava, slowing blood flow and causing vein enlargement around the anus.
- Constipation: Due to hormonal changes and iron supplementation, constipation is common during pregnancy. It causes straining during bowel movements, which exacerbates hemorrhoids.
- Increased blood volume: Pregnancy increases overall blood volume, adding pressure to veins.
Many women may have pre-existing internal hemorrhoids that become symptomatic during pregnancy, while others develop them for the first time.
Recognising Hemorrhoid Symptoms
Pregnant women may notice:
- Itching or irritation around the anus
- Pain or discomfort, especially during or after bowel movements
- Swelling or lumps near the anus
- Bright red bleeding during bowel movements
- A feeling of fullness or pressure in the anal area
If bleeding is heavy or persistent, it’s important to seek medical advice to rule out other conditions.
Managing Hemorrhoids During Pregnancy: Safe and Effective Strategies
Most hemorrhoids during pregnancy can be managed conservatively with lifestyle and home remedies:
- Increase fibre intake: Eating plenty of fruits, vegetables, whole grains, nuts, and seeds helps soften stools and reduce straining. Fibre supplements like Metamucil can also be safe and helpful.
- Stay hydrated: Drinking plenty of water supports digestion and bowel regularity.
- Avoid prolonged sitting or standing: Changing positions frequently helps reduce pressure on pelvic veins.
- Exercise moderately: Activities like walking promote healthy bowel function and circulation.
- Respond promptly to bowel urges: Delaying can worsen constipation.
- Use gentle hygiene: Clean the anal area with warm water and unscented wipes rather than dry toilet paper to reduce irritation.
- Warm Sitz baths: Sitting in warm water for 10-15 minutes several times a day can soothe pain and reduce swelling.
- Cold compresses: Applying ice packs to external hemorrhoids can decrease inflammation and discomfort.
- Pain relief: Paracetamol is considered safe during pregnancy to relieve pain. Avoid codeine as it may worsen constipation.
Medical Treatments Safe During Pregnancy
Certain treatments are considered safe and effective for pregnant women:
- Laxatives: Bulk-forming laxatives and stool softeners can ease bowel movements and reduce straining. These are generally safe but should be used under medical guidance.
- Topical hemorrhoid creams and ointments: Products containing mild corticosteroids or local anesthetics can help reduce itching, pain, and inflammation. Examples include preparations with hydrocortisone or lignocaine. Use should be limited and under healthcare advice.
- Natural remedies: Witch hazel, applied as cooled compresses or pads, can reduce swelling and soothe irritation.
When to See a Healthcare Professional
If hemorrhoid symptoms worsen, bleeding is heavy, or pain becomes severe, consult your GP or obstetrician. Persistent or complicated hemorrhoids may require further evaluation. Most hemorrhoids improve after childbirth as pressure on pelvic veins decreases.
Summary
Hemorrhoids are a common and often uncomfortable part of pregnancy for many Australian women. Hormonal changes, pressure from the uterus, and constipation contribute to their development. Fortunately, simple lifestyle adjustments, dietary changes, and safe treatments like warm baths, ice packs, laxatives, and topical creams can provide significant relief. Always consult your healthcare provider before starting any treatment during pregnancy to ensure safety for you and your baby.