Hemorrhoids in Pregnancy!

What is hemorrhoids?

Hemorrhoids (hemorrhoids) are varicose veins formed around the anus, which is the lower part of the large intestine. Hemorrhoids are swelling of blood vessels (varicose veins). It is seen in the rectal area. It can cause frequent itching and pain on the right side of the anus, and may even occasionally cause rectal bleeding during bowel movements. Sometimes the enlarged vein hangs out of the anus. At this time, a soft swollen mass is felt. Hemorrhoids are relatively common during pregnancy. This may occur in earlier weeks of pregnancy, especially in those who had hemorrhoids before pregnancy. Sometimes it may appear for the first time during the progression of labor pains and straining.

Why are hemorrhoids more common during pregnancy?

Various reasons such as chronic cough, constipation, familial vascular diseases, obesity, advanced age, standing for a long time can be listed among the risk factors that cause hemorrhoids in pregnancy.

Pregnant women are very prone to hemorrhoids as well as varicose veins, which are common in the legs and even the vulva. The growing uterus during pregnancy puts pressure on the great veins in the pelvis and right side of the body that carry blood from the legs. This slows the return of blood flow from the legs, so the veins swell and expand. Inadequate valves in the veins, genetic predisposition such as weakness of the vessel walls and increased intravascular pressure pave the way for the formation of hemorrhoids during pregnancy. Common problems such as constipation during pregnancy can cause hemorrhoids to grow. Constipation must be prevented and the intestines must be emptied regularly. In case of constipation, the abdomen should not be forced, otherwise risks such as miscarriage and bleeding may occur. Progesterone hormone secreted during pregnancy relaxes venous vessels and paves the way for easier swelling. In addition, the hormone progesterone slows down bowel movements and contributes to the progression of hemorrhoids, causing constipation. In this case, symptoms such as pain, itching and burning sensation around the anus are worsened by standing for a long time. If not treated in time, it will become infected. Especially in the third trimester of pregnancy, women who have hemorrhoids and develop constipation can even see fresh red blood if fissures form around the anus after defecation.

How can pain be reduced?

An ice pack wrapped in a soft cloth should be applied to this area several times a day. Ice application may relieve the patient a little by reducing the swelling.

Filling a plastic cup with warm water and taking sitz baths in it will increase blood circulation and reduce pain.

Applying ice alternately and taking a hot water bath relaxes the patient.

It is more comfortable to use wet napkins instead of toilet paper after bowel movements.

Local anesthetic or medical rectal suppositories can be used temporarily according to the doctor’s advice.

How can hemorrhoids be prevented?

By consuming foods high in fiber, drinking 8-10 glasses of water a day and exercising, one should try not to be constipated and get a regular toilet habit. However, if constipation occurs, the doctor should be consulted about fibrous foods and stool softeners.

When the feeling of toilet comes, it should not wait and the intestines should be emptied immediately, care should be taken not to strain while emptying the intestines. Waiting for a long time in the toilet can accelerate the formation of hemorrhoids by increasing the pressure on this area.

Kegel exercises should be done to strengthen the muscles around the anus, vagina and urethra. Kegel exercises will increase blood flow to this area and hemorrhoids will heal more easily.

Sitting or standing for long periods of time should be avoided. If your job requires you to sit, you should get up every hour and walk for a few minutes. While sitting at home, watching TV, lying on the left side, the pressure on the rectal veins will decrease and the return of blood flow will increase.

Frequent use of anti-inflammatory drugs, corticosteroids, anesthetic drugs used for the treatment of hemorrhoids in the third trimester is harmful to the fetus. In the majority of pregnant women, the problem will resolve spontaneously shortly after delivery.

In conservative treatment for hemorrhoids, it is necessary not to wear tight underwear, to undergo medical treatment and not to gain excess weight. Treatment is based on symptoms in most patients. Despite these precautions, if hemorrhoids progress during pregnancy, options such as laser treatment and surgical treatment are applied.

When to consult a doctor?

If, despite all precautions, hemorrhoids increase and rectal bleeding occurs, consult your doctor. After birth, this usually improves gradually. Rarely, a minor surgical procedure may be required.

Kiss. Dr. Kutlugul Yuksel

Gynecology and Obstetrics Specialist

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