Mithu Kuna 
Research shows that about 25-35% of pregnant women suffer from hemorrhoidal disease.
If you suffered from hemorrhoids before, you’ll likely have them during pregnancy too. And if you never had hemorrhoids, you might experience them for the first time.
Although uncomfortable and sometimes painful, there’s several things you can do at home to treat them.
Keep reading to learn what hemorrhoids are and 11 ways to prevent and treat them.
What Are Hemorrhoids?
Hemorrhoids are a common problem faced by millions of Americans. However, they’re more common during pregnancy.
Hemorrhoids are swollen veins that happen inside or outside the rectum. These swollen veins appear as lumps and can be tiny or up to the size of a grape. Hemorrhoids that are seen sticking out of the anus are called external hemorrhoids. Those inside the anus—which you can’t see—are called internal hemorrhoids.
If the hemorrhoid is small, you may not have any symptoms. However, symptoms can become severe if it becomes too swollen. If the skin breaks open, it can bleed.
Typically, hemorrhoids can worsen over a couple of days and then get smaller over the next few days. Usually home remedies or over-the-counter products can ease discomfort until hemorrhoids go away. However, some people need medical treatment or even surgery in severe cases.
Symptoms of Hemorrhoids When Pregnant
Symptoms of Hemorrhoids are the same for pregnant and non-pregnant people. Many times, you won’t experience pain or any signs unless hemorrhoids become very swollen or a blood clot forms. Symptoms of hemorrhoids when pregnant include:
- Pain can be dull or severe around your anus depending on the swelling of hemorrhoids.
- Sometimes the first sign of a hemorrhoid is an itchy feeling on or inside your anus.
- When you wipe after using the bathroom, you may notice blood on the toilet paper. This may be a sign your hemorrhoid has broken open.
- Urge to poo after already going. You might feel like you need to use the washroom shortly after you went. This can be caused by the pressure of hemorrhoids against your rectum.
- Mucus on toilet paper or underwear. After pooing, you might notice mucus on the toilet paper after wiping.
- If you have external hemorrhoids, when you look at the area in a mirror, you may notice lumps.
Why Are Hemorrhoids Common During Pregnancy?
What causes hemorrhoids and why are they more common during pregnancy?
According to the American Society of Colon & Rectal Surgeons (ASCRS), the exact cause of hemorrhoids isn’t known. One general cause is human’s upright posture—whether sitting or standing, it puts a lot of pressure on our rectal veins, which can lead to bulging.
Other general causes of hemorrhoids may include:
- Chronic constipation or diarrhea
- Pushing too hard while trying to poo
- Straining from being on the toilet too long (ex. reading on the toilet)
- Overuse of laxatives
During pregnancy, hemorrhoids can also be caused by the factors below.
Increased Pressure
As your uterus grows, so does the pressure on the inferior vena cava. This large vein drains the small intestine’s veins. This is why hemorrhoids are most common during the third trimester. A bigger uterus means more pressure and a higher likelihood of hemorrhoids.
Increased Constipation
Constipation is a common side effect of pregnancy. You may have trouble going to the bathroom even when you have the urge. Stools can be hard to pass, which can lead to pushing too hard and straining the veins.
During pregnancy, constipation may be thanks to progesterone. Your body produces more progesterone during pregnancy, which can slow down your digestive system. This is a good thing: It gives the nutrients more time to reach your baby. The downside is that when your digestion works slower, constipation and bloating are more likely.
Read: Constipation in Pregnancy: 7 Fixes
Dehydration
Another factor that can cause constipation—leading to hemorrhoids—is dehydration. If you’re struggling with morning sickness and you forget to rehydrate, it can become difficult to pass stools. All that straining can cause hemorrhoids.
Iron Supplements or Prenatal Vitamins
An overlooked contributor to constipation is iron supplements or the iron contained in your prenatal vitamins. While iron is essential for a healthy pregnancy, sometimes it can trigger digestive problems. This may include a sore stomach and constipation.
Poor Diet
What you eat also plays a role in whether you get hemorrhoids. Getting enough fiber through fruits and vegetables allows you to pass stools without straining. A lack of fiber can cause constipation or make stools too watery, causing diarrhea. Both can cause uncomfortable hemorrhoids.
Prevention & Treatment for Hemorrhoids in Pregnancy
Whether you’re trying to prevent or treat hemorrhoids, keep the following tips in mind.
Don’t Strain
If you’re having difficulty passing a stool, it feels natural to keep pushing. But that’s exactly what causes hemorrhoids. Instead, get up and try again later. Although you won’t feel relief yet, you’ll decrease your chances of developing hemorrhoids, which can make pooping even worse.
Don’t Stay on the Toilet
After you’re finished pooping, do you sit on the toilet reading or scrolling through your phone? That’s a bad habit that can lead to hemorrhoids. Since your body is still in “pooping position,” there’s added pressure to the rectal area. This can cause hemorrhoids, even if you’re not constipated. To avoid this, leave the toilet once you’re finished and don’t prolong bathroom breaks.
Eat a Balanced Diet
Aim to get fiber each day by eating plenty of fruits, vegetables, and whole grains. But not too fast: Increasing your fiber intake quickly can cause a backup. If you don’t currently get enough fiber, slowly incorporate more into your diet. Getting enough fiber helps bulk up your stool, making it easier to pass with less stain.
Stay Hydrated
Dehydration means your stools don’t receive enough water. This makes them too hard to pass, causing straining and hemorrhoids. Especially if you’re vomiting from morning sickness, make sure to stay hydrated. Water, herbal teas, and soups all count toward hydration.
Read: 17 Hydration Hacks: How to Keep Hydrated During Pregnancy
Exercise
Exercise is safe and recommended for most pregnant people. That’s because there’s a variety of benefits to getting physical activity while expecting. One of those advantages is better digestion. When you go to the bathroom easier, you strain less and are less likely to develop hemorrhoids.
According to a 2021 study, exercises that are safe and effective for hemorrhoid prevention and management include:
- Walking
- Swimming
- Controlled-movement exercises to strengthen abdominal and rectal tissues (ex. yoga)
If you have hemorrhoids or a history of them, you should avoid activities that put extra pressure on that area, like cycling and horseback riding.
Change Your Iron Supplement or Prenatal Vitamin
If your iron supplement or the iron contained in your prenatal vitamin is causing constipation, switch to a different brand. Some iron supplements are easier on your stomach than others. You can also try different forms of iron—like liquid iron as opposed to pill form. If you’re having trouble finding an iron supplement that works for you, talk to your doctor.
Avoid Sitting Too Long
Sitting for long periods, especially on hard surfaces, can add pressure to the rectal area. If your job requires you to sit, stand up to stretch or walk to the water cooler for a break. Consider adding a cushion to your seat to minimize the hardness.
Lie On Your Side
When you go to sleep or watch TV, try lying on your side instead of your back. This can relieve your rectal area of pressure throughout the night.
Use a Donut Pillow
Try using a donut-shaped pillow to sit on. This can add support while minimizing the pressure on your behind.
Soak in a Warm Bath
A warm sitz bath can relieve the discomfort of hemorrhoids. It may also help shrink them.
Use Ice Pack Compresses
Apply an ice pack to the area to soothe pain.
Ask Your Doctor About Over-The-Counter Treatments
Over-the-counter treatments, like Preparation H, can be applied to hemorrhoids to soothe the area. While Preparation H is generally considered safe during pregnancy, you should ask your doctor first. Sometimes hemorrhoids are best treated through other methods.
Make an Appointment with Your Doctor
If you have hemorrhoids, it’s always a good idea to make an appointment with your doctor. Especially because you can’t see internal hemorrhoids, a doctor can properly diagnose the issue and offer the best course of treatment.
Hemorrhoids that reoccur or don’t go away may require more invasive treatment, like surgery. With that being said, most go away after pregnancy.
Summary: Hemorrhoids During Pregnancy
Hemorrhoids are commonly experienced during pregnancy thanks to added pressure in the rectal area and changing hormones. Home remedies and lifestyle changes are often effective at treating and preventing hemorrhoids. Make sure to talk to your doctor before trying over-the-counter treatments. If your hemorrhoids don’t go away or are severe, make a medical appointment.
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