A large number of women (25% of all pregnant women and 85% of women in their third trimester of pregnancy) suffer from haemorrhoids during pregnancy. The first symptom indicating the condition is, among others, bleeding and discomfort in the form of pain in the anal area. In order to avoid this unpleasant condition, it is important to implement prevention - proper diet and exercise.
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The main cause of the appearance of haemorrhoids (veins in the anal area) during pregnancy, is the weight of the baby putting pressure on the blood vessels located in the pelvic area.
Important! Haemorrhoids usually show up in the third trimester of pregnancy and can also cause discomfort after termination.
Etiology of the condition
The mechanism of the onset of haemorrhoidal disease has not been fully elucidated. It is thought that one of the most significant factors in the aetiology of haemorrhoidal affliction in pregnant women is pregnancy itself, as well as constipation occurring during pregnancy.
Important! It is estimated that 25 - 35% of pregnant women have problems with haemorrhoids, of which, in approximately 85% of cases, the bleeding nodules (haemorrhoids) appear in the third trimester of pregnancy.
The bleeding nodules, which are located in the upper part of the anus (also at its mouth), cause many uncomfortable symptoms, e.g.: burning, pain, itching. For some, the condition also manifests itself as bleeding during defecation.
In pregnant women, haemorrhoids are the result:
- congenital genetic predisposition
- enlarging uterus on the ovaries and abdominal veins (obstructed outflow of blood from the pelvis and lower limbs)
- irregular bowel movements and frequent constipation (effect of hormones causing digestion and excretion to be slower)
- an increase in progesterone, a hormone that affects the tone of the veins (making them more likely to swell).
Haemorrhoids (also known as bleeding nodules and anal varices) are cavernous tissue cushions located in the distal part of the rectum and also in the anal canal. By location, a distinction is made between: external haemorrhoids and internal haemorrhoids.
Important! Varicose veins of the anus are an unpleasant disease, but they do not pose a direct threat either to the mother-to-be or to her child. However, complications may occur in the form of bleeding and thrombosis, which are dangerous. Therefore, the condition should not be underestimated.
Treatment of haemorrhoids during pregnancy, photo: panthermedia
Prevention, treatment
The reduction of the risk of haemorrhoidal disease is influenced by appropriate prophylaxis. One of its main elements is taking care of regular bowel movements (the problem of constipation occurs already in the first months of pregnancy). An appropriate diet rich in fibre is important here. Vegetables, fruit, wholemeal cereals, groats and cereal products should be included in your diet. In addition, dried plums and apricots are also good choices. It is also important to drink enough fluids (2 litres a day).
Important! Avoid spicy foods and unfavourable fats.
Further elements of prevention to be implemented include:
- avoiding prolonged standing and sitting
- exercising the Kegel muscles (this not only improves circulation in the anal area, but also strengthens the muscles that surround it)
- during defecation, the rectal muscles should be stretched as little as possible to avoid excessive pressure on the rectum
- proper hygiene of the intimate area (use of soap designed for pregnant women)
If, despite preventive measures, haemorrhoids have appeared anyway, conservative treatment should be initiated. It helps to alleviate the symptoms:
- calendula ointment (moisturises and strengthens the skin)
- ointments with horse chestnut extract and rutin
- compresses made from damp tea bags (tea leaves contain tannic acid, which has an astringent effect and seals small wounds)
- washing the affected areas with oak bark infusion
- homeopathic pills (fight inflammation in the veins, regulate the function of the digestive system).
In addition, it is recommended to use warm water or anti-inflammatory preparations (e.g. oak bark, chamomile). There are also no contraindications to the use of oral remedies that have in their composition: dry extract of rhuscus spinosus, hesperidin and ascorbic acid.
Important! Before starting treatment, consult an internal medicine doctor, gynaecologist or proctology specialist. Do not treat yourself.
Treatment is mainly conservative. When choosing the best course of treatment, the doctor is mainly guided by the safety of the foetus. Pharmacology can only be started after the first trimester of pregnancy.
Important! When the disease is advanced and conservative and pharmacological treatment has not had the desired effect, the doctor may decide to use instrumental treatment.
There are many treatment modalities, the most common being:
Sclerotherapy treatment - the haemorrhagic nodule is injected with a drug to induce its fibrosis, a thrombus is formed and the nodule dies as a result of the blood supply being cut off.
Cryotherapy - the variceal nodule is removed through a freezing process using an instrument made of a special type of material.
Barron's method (tourniquets) - a rubber band is placed on the haemorrhoid to block the blood supply, resulting in the death of the varicose vein.
Infrared coagulation of varicose veins of the anus - a laser is applied to the tissue, which sends out infrared or ultraviolet rays and thus destroys the vessels that supply blood to the haemorrhoids.
Surgical procedure - this is used in the advanced stage of the disease and involves excision of the bleeding nodule.
Important! Coagulation procedure, Barron's method and surgery - are used as a last resort for pregnant women (advanced haemorrhoidal disease).
Summary
The treatment of haemorrhoidal nodules in pregnant women is selected for each patient on an individual basis, following a prior medical history and examination.
Small-sizedhaemorrhoids should disappear spontaneously after delivery (a period of several months). Unfortunately, the condition has a tendency to recur with subsequent pregnancies.
