Haemorrhoids

I think I have haemorrhoids.

Haemorrhoids or piles are swelling and inflammation of veins in the rectum and anus. Haemorrhoids are common during pregnancy, especially in advanced pregnancy and with a vaginal delivery.

In pregnancy haemorrhoids are probably due to pressure effects of the baby lying above the rectum and anus, straining with pregnancy-induced constipation and the impact of pregnancy hormones on the veins in that region. Pushing, especially prolonged pushing, in second stage labour can cause and increase the size of haemorrhoids dramatically. Some people may inherit a weakness of the wall of the veins in the anal region.

Sometimes there can be minor bleeding from the haemorrhoids.

What can be done?

Eat plenty of fibre such as fruit, vegetables, cereals, wholemeal bread, etc. Have lots to drink. Aim to drink at least two liters of water per day. Take fibre supplements and bran. Avoid painkillers that contain codeine as they are a common cause of constipation. Go to the toilet as soon as possible after feeling the need. Do not strain on the toilet. Haemorrhoids may cause a feeling of ‘fullness’ in the rectum and it is tempting to strain at the end to try and empty the rectum further. Resist this. Do not spend too long on the toilet which may encourage you to strain.

proctosedylMedications such as Rectinol, Anusol, Preparation H or Proctosedyl can be applied as needed in pregnancy and postnatally. Rarely is surgery needed in pregnancy.

Haemorrhoids usually settle dramatically after pregnancy though they will recur with another pregnancy. If they persist after your family is complete and are a nuisance and uncomfortable then ask your doctor to refer you to an appropriate surgeon for management.

Posted by Dr Gary Sykes on -

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