Hemorrhoids during and after pregnancy are often one of the unpleasant surprises new mothers face. Various theories exist about why pregnant women are more prone to hemorrhoids than women who are not pregnant. Women who have had hemorrhoids before pregnancy or hemorrhoids after previous pregnancies are also more susceptible.
Many of the normal discomforts of pregnancy can lead to hemorrhoids because of increased abdominal pressure. Because hemorrhoid problems are caused by increased abdominal pressure, hemorrhoid problems that occur during pregnancy usually begin during the last trimester.
During pregnancy, the growing fetus and uterus put pressure on the pelvic veins and the inferior vena cava, a large vein on the right side of the body that receives blood from the lower limbs. This can slow the return of blood from the lower half of the body, thereby increasing pressure on the veins below the uterus. Weight gain above amounts recommended by your doctor can increase risk of hemorrhoids during pregnancy, as it can increase pressure in the pelvic region. Staying in the same position, whether sitting or standing, for long periods of time can also contribute to hemorrhoids during pregnancy.
The hormonal changes of pregnancy also affect the enlargement of hemorrhoid vessels. During pregnancy, the natural increase in the hormone progesterone causes the walls of veins to relax, allowing them to swell up more easily. Progesterone can also slow digestion, causing constipation during pregnancy. Straining of the pelvic muscles caused by anything from constipation to childbirth can cause, or aggravate, hemorrhoids as blood gets trapped in the swollen veins.
What can pregnant women do to avoid hemorrhoids?
Any of these factors, or a combination of them, can lead directly to hemorrhoid problems during pregnancy, hemorrhoids during childbirth, or hemorrhoid problems after pregnancy. The good news is, many of the good habits pregnant women are encouraged to include their daily routine will counteract these risk factors for hemorrhoids during and after pregnancy.
Avoiding constipation, which is common during pregnancy and a major cause of hemorrhoids, is an important prevention method. Pregnant women should drink plenty of water: at least 8-10 glasses per day. Prune juice can also be useful in avoiding constipation during pregnancy. High fiber foods such as fruit and vegetables and whole grain products will help with constipation as well, lowering risk of hemorrhoids.
Like constipation, delaying trips to the bathroom will also contribute to hemorrhoids during and after pregnancy by increasing the risk of a hard bowel movement. Staying on the toilet longer than necessary will also put additional pressure on the rectal area.
After checking with a doctor, regular exercise during pregnancy will keep blood circulating in the pelvic area and can help prevent the vascular pressure that contributes to hemorrhoids. Kegel exercises, which are recommended during pregnancy to strengthen the pelvic muscles, have the additional benefit of increasing rectal circulation. Changing positions regularly, a few minutes for every hour awake, is also very important for pelvic circulation.
In general, to prevent hemorrhoids during pregnancy, women should try to avoid putting any unnecessary additional pelvic pressure and make sure to keep good circulation in the pelvic area.
Can anything be done by pregnant women at home to relieve the pain and discomfort of hemorrhoids?
If these techniques aren't enough, or hemorrhoids are already present, a few natural hemorrhoid home treatment options are appropriate for pregnant women. If a pregnant woman has any hemorrhoid bleeding, she should always contact her doctor. If minor pain from swelling or anal itching is present, these home hemorrhoid treatment techniques may help.
Gently cleaning the anal area and applying ice packs or cold compresses for up to 10 minutes at a time, four times a day, can reduce hemorrhoid swelling and itching.
Soaking the bottom in a warm sitz bath for 10-20 minutes a few times a day can sooth hemorrhoids during pregnancy and after childbirth. Soaking in a full warm tub is not advised for pregnant women, but a shallow lukewarm sitz bath will help sooth and clean the rectal area, minimizing hemorrhoid discomfort.
If hemorrhoids prolapse, or protrude outside the anus, during pregnancy, it may be possible to gently push them back into the rectal canal. If it is uncomfortable or difficult, do not try to push prolapsed hemorrhoids back, but contact a doctor.
Pregnant women with hemorrhoids should always contact a doctor when they feel concerned, especially if they experience severe discomfort or bleeding. A medical professional will be able to provide specific advice about dealing with hemorrhoids during pregnancy, and be able to discuss appropriate hemorrhoid treatment.
HAL/RAR hemorrhoid treatment for hemorrhoids after childbirth
The most conservative hemorrhoid treatment is normally prescribed for hemorrhoids occurring during pregnancy and soon after childbirth, given the complexity of physical changes a woman's body must go through during pregnancy. Often, fiber supplements, over-the-counter ointments, and cold packs are enough to treat hemorrhoids after pregnancy.
Sometimes, however, a more intensive hemorrhoid treatment is necessary to provide relief from hemorrhoids after childbirth. This can leave women dealing with severe hemorrhoid problems after pregnancy to choose between an invasive surgical hemorrhoid treatment and conservative treatments that may not be helping. Dealing with the impact of surgery and pain medication on breastfeeding and caring for an infant can be daunting, but so can continued hemorrhoid discomfort.
Surgical hemorrhoid treatment options can be painful and invasive, but a new doppler guided surgical procedure has a shorter recovery time and often the patient requires less pain medication. HAL/RAR debuted in the United States in 2006, and offers a minimally invasive surgical hemorrhoid treatment procedure without cutting or stapling to postpartum women. Doppler technology is used to find the source of vascular pressure causing the hemorrhoid problem. Sutures (which will disappear in weeks) are then used to cut off the blood flow feeding the hemorrhoid and to lift any prolapsed tissue back into place.
Unlike older surgical hemorrhoid treatment procedures, there is no cutting or stapling. Because HAL/RAR is less invasive, patients usually experience a lower level of pain than with other surgical hemorrhoid treatment procedures. Recovery time is typically only a day or two, and often, a minimal amount of post surgery pain medication is prescribed or required.
If conservative treatment options aren't working, women suffering from hemorrhoids after pregnancy and childbirth may want to discuss the option of HAL/RAR hemorrhoid treatment with their doctor.

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