What are hemorrhoids and why particularly during pregnancy?
Generally, hemorrhoids occur when a vein, or other vascular tissue, swells out of shape and develops a sac or bulb. Under normal circumstances, when a person has a bowel movement, additional blood flows to the rectum and colon to assist the muscular function in the area. If a person overly strains or pushes, they may also be pushing extra blood to the veins in and around the anus, causing those veins to stretch. Those stretched veins can then develop into hemorrhoids. In the same way, the straining brought on by diarrhea or constipation can cause hemorrhoids.
Internal pressures
Many women find themselves suffering from hemorrhoids to some degree during pregnancy, and often post-partum as well. Your growing uterus puts pressure on the pelvic veins and the inferior vena cava which is a large vein on the right side of the body that returns blood from the lower half of your body back to the heart. This pressure from the uterus can slow down the blood return, increasing pressure on the veins below the uterus and causing them to dilate, or become swollen.
Varicose veins
Because of this added pressure during pregnancy, you may find yourself prone to varicose (swollen) veins in the legs, vulva, or elsewhere. Hemorrhoids are simply the same kind of swollen and bulging veins, but in the rectum. Hemorrhoids can occur singly or in clusters, they can be as small as a pea to the size of a grape and can occur singly or in clusters, and can occur both inside the rectum or protrude through the anus.
Statistically, up to 50 percent of pregnant women get hemorrhoids, particularly in the third trimester. If you’ve had them in the past, you are more prone to have them again now.
What increases my susceptibility for hemorrhoids?
During pregnancy, your body’s blood volume increases greatly and the increased pressure will cause veins to enlarge. The expanding uterus also puts pressure on the veins in the rectum.
An increase in the hormone progesterone during pregnancy causes the walls of the veins to relax in the anorectal area’s supporting muscles, and the baby will press more and more on the veins below it. The relaxed veins can also swell out of shape more readily.
Furthermore, the hormone progesterone slows down your intestinal tract. That slowdown, combined with the added physical pressures often cause constipation, and of course constipation and the resulting straining during bowel movements can aggravate the situation. Hemorrhoids can be itchy and mildly uncomfortable – or downright painful. Sometimes they will result in rectal bleeding, especially during a bowel movement.
The good news is that hemorrhoids usually resolve after delivery of your baby, especially if you are are careful with your diet to avoid constipation.
What might help reduce my susceptibility while I’m pregnant?
- Drink plenty of plain water (eight to ten glasses a day).
- Fiber-rich foods, like whole grains, beans, raw or cooked leafy green vegetables, and fruits like apples and pears will keep your bowel movement regular.
- A stool softener, or plenty of fruits and fruit juices can also help regularity. The soluble fiber (pectin) in fruits, like apples and pears, will keep your movements loose as well as regular.
- Keep as active as you can, a regular walking regimen will keep your bowels moving also.
- Avoid sitting or standing for long periods of time. Even lingering on the toilet after a bowel movement adds extra strain on the area.
- Try not to strain with bowel movements.
- The Kegel exercises that you should already be doing to tone the muscles around the vagina and urethra will also serve to strengthen the muscles around the anus.
- Because the inferior vena cava, that large vein on the right side of the body, is under pressure during pregnancy… when you are lying down you can relieve some of that pressure by remembering to lie on your left side while resting or sleeping.
- Talk to your doctor about using topical ointments or suppositories to soothe and alleviate hemorrhoids.
How can I get quick symptomatic relief?
- A sitz bath, or just sitting in the tub with a few inches of plain warm water can provide relief. A typical sitz bath is taken with Epsom salts, but keep in mind if you have bleeding hemorrhoids that Epsom salts will sting.
- Ice packs will help decrease swelling and discomfort. Simply prepare a frozen gel pack by wrapping it in a soft cloth before applying for short periods of time.
- Alternating the cold compresses and warm sitz baths often helps.
- Use pre-moistened baby wipes to gently clean the area after a bowel movement, or use the commercially available wipes containing witch hazel, a traditional herbal anti-inflammatory.