Postpartum Hemorrhoids


Postpartum Hemorrhoids

Pregnancy makes you more prone to hemorrhoids (as well as to swollen veins in the legs and sometimes even in the vulva) for several reasons.

Hemorrhoids after Labor

Your growing uterus puts pressure on the pelvic veins and the inferior vena cava, a large vein on the right side of the body that receives blood from the lower limbs. This pressure can slow the return of blood from the lower half of your body, which increases the pressure on the veins below your uterus and causes them to become enlarged.

In addition, an increase in the hormone progesterone during pregnancy relaxes the walls of your veins, allowing them to swell more easily. Progesterone also contributes to constipation by slowing down your intestinal tract. Constipation (another common problem during pregnancy) can cause or aggravate hemorrhoids because you tend to strain when having a hard bowel movement, and straining leads to hemorrhoids.

You may also have developed hemorrhoids while you were pushing during labor.

What can I do to get relief?

Here are some ways to get relief from hemorrhoids:

  • Avoid sitting or standing for long stretches of time to reduce the pressure on your rectal veins. Lie down when you’re nursing, reading, or watching TV.
  • For temporary relief, you can take acetaminophen or ibuprofen, even if you’re breastfeeding. However, don’t take more than the recommended amount, and don’t take aspirin (or products containing aspirin) if you’re nursing. Call your healthcare provider if the pain continues.
  • Apply an ice pack (with a soft covering) to the affected area several times a day. Ice may reduce swelling and discomfort. Some women also find cold compresses saturated with witch hazel soothing.
  • Soak your bottom in warm water in a tub or a small plastic basin that you fill with water and position over your toilet (sitz bath). Using a sitz bath enables you to submerge your rectal area simply by sitting down. If you didn’t get one at the hospital, you can buy a sitz bath at any drugstore. Try soaking a few times a day for 10 minutes or so at a time.
  • Alternate cold and warm treatments. Start with an ice pack followed by a warm sitz bath.
  • After each bowel movement, gently but thoroughly clean your bottom, using the plastic squirt bottle (peri bottle) you were given in the hospital. Or try using wipes premoistened with witch hazel that are made specifically for people with hemorrhoids.
  • Use soft, unscented toilet tissue, which is less irritating than other varieties.
  • Ask your healthcare provider to recommend a safe topical anesthetic or medicated suppository. There are many hemorrhoid relief products on the market, but consult your provider before trying one on your own. And keep in mind that most of these products are intended to be used for only a short course of treatment – one week or less. Continued use can cause even more inflammation.

Note: If you have stitches in the rectal area, be sure to discuss aftercare with your provider. If you’ve had an episiotomy or a tear that extends into your rectum, it’s especially important not to put anything – including suppositories – into your rectum until you get the okay from your provider.

How can I speed the healing process?

Following healthy habits can speed the healing process now and prevent hemorrhoids from developing in the future. First and most important, take steps to avoid constipation:

  • Eat a high-fiber diet that includes plenty of fruits, vegetables, whole grains, and beans.
  • Drink plenty of water (eight to 10 glasses a day).
  • Get regular exercise, even if you only have time for a short, brisk walk. Don’t wait to go to the bathroom when you feel the urge to have a bowel movement. Waiting can make the stool drier and harder to pass. Also, try not to strain when you’re moving your bowels, and don’t sit on the toilet longer than necessary because this puts additional pressure on the area. (You can also ask your healthcare provider about taking a fiber supplement or stool softener.)
  • Do Kegel exercises daily. Kegels increase circulation in the rectal area and strengthen the muscles around the anus, reducing the chance of hemorrhoids. They also strengthen and tone the muscles around the vagina and urethra, which can help your body recover after delivery.

Hemorrhoids after delivery

Hemorrhoids are swollen and somtimes inflamed blood vessels, veins in your anus and lower rectum. As many as half of all pregnant women get hemorrhoids during pregnancy, particularly during the third trimester. If you have had hemorrhoids prior to getting pregnant, you are more likely to develop them during pregnancy. Similarly, if you’ve had hemorrhoids during pregnancy, you are more likely to develop hemorrhoids after your pregnancy.

Causes of Postpartum Hemorrhoids
Hemorrhoids are bulging and swollen veins in the rectum. They can be internal hemorrhoids that are located inside the lower intestine or they can be external hemorrhoids, where they protrude out from the anus.

During pregnancy, an enlarged uterus puts pressure on these veins. Add the extra weight you are carrying, along with constipation and the straining and pushing you had during labor, and you might see yourself with a case of postpartum hemorrhoids.

Symptoms of Postpartum Hemorrhoids

The most common symptoms of hemorrhoids are discomfort, itching, bleeding, and pain. You may notice streaks of blood on the toilet paper after using the bathroom. Bleeding hemorrhoids may seep mucus that can leave your skin irritated. If your hemorrhoids are internal, it not unusual to see blood on your stool. In some cases, you may feel a lump near your anus as a result of hemorrhoids.

Treatment of Postpartum Hemorrhoids

Fortunately, there are a number of things you can do to get relief from postpartum hemorrhoids:

  • Place an ice pack to your hemorrhoidal area a few times a day. Ice is helpful to reduce your discomfort and decrease the swelling of your hemorrhoids.
  • Use a witch hazel cold compress.
  • Soak you bottom in a warm sitz or tub bath.
  • Use premoistened wipes after each bowel movement instead of dry toilet paper. It is important to keep your rectum and anal area clean if you have postpartum hemorrhoids.
  • Drink plenty of water and eat foods, like fruits and vegetables, that are high in fiber. Doing so will help reduce constipation.
  • Speak to your healthcare provider about recommending a topical hemorrhoid-relief ointment or medicated suppository.

The important point to note is that hemorrhoids are common both during pregnancy and after. However, while postpartum hemorrhoids may linger for several months after birth, they only last a short time after delivery.

Hemorrhoids Postpartum

Such problem as hemorrhoids after the labor or during pregnancy, has always been and remains actual. It is confirmed by its extensive discussion at forums of future and already realized mothers. What is hemorrhoids? What to do with it before and after labor? What are its symptoms? And can hemorrhoids appear after C-section? Hemorrhoids is called the disease of venous system which is shown by knotty expansion of veins of the lower part of rectum. These expansions are haemorrhoidal exactly.

Reasons of the Disease

Development of hemorrhoids is connected with the reasons causing congestion and increasing of blood pressure in rectum vessels:

  • congenital features of a venous side;
  • insufficient physical activity;
  • systematic taking of some medicines, for example, hormonal contraceptives;
  • excessive body weight;
  • pregnancy;
  • tendency to constipations.

Hemorrhoids after the delivery often “arise” during pregnancy. It happens because of increasing of intra-abdominal pressure and stagnation of blood circulation in vessels of small pelvis. During labor pressure upon venous walls increases sharply that leads to formation of the haemorrhoidal tumor.

According to location tumors can be external and internal. The external form of the disease differs because these tumors are available to checkup. They look like small formations of circular section, in size they are from a pea to a cherry. Quite often external tumors form a gathering in the form of an aureole around an anus.

If the hemorrhoid is internal the tumors are located inside behind the anal sphincter. They can’t be seen, but they are often shown by haemorrhoidal bleedings. As a result bleeding anemia develops that is dangerous during pregnancy and after the delivery. There are also other symptoms of the decease when the tumors are inside.

The Symptoms of Hemorrhoids

Post-natal hemorrhoids can be severe and chronic. At the same time childbirth can be physiological or by Cesarean section. The severe case develops suddenly, and chronic differs in long and softer course.

The first symptoms of hemorrhoids after the delivery – are an itch, feeling of heat and burning in anus, which become stronger during defecation. Intensive pain appears because of traumatizing of mucous membrane by dejection. But after defecation it is over.

In time tumors increase in sizes, and as a result the inflammation redden and become swollen. Pain in anus becomes constant, growing stronger on movements and in a sitting position. Severe hypostasis of tissues of a perineum leads to a spasm of a sphincter of a urinary bladder and a delay of an urination. Severe hemorrhoids can be complicated by a necrosis of tumor tissues, haemorrhoidal bleeding, formation of cracks or an inflammation of tissues around a rectum – periproctitis.

Chronical hemorrhoids after the delivery develop gradually, imperceptibly for the patient. Periodically after defecation there is burning and an itch in anus, there is a feeling of insufficient rectal expulsion. Pain in the area of rectum is changeable and short-term. Rectum bloody wastes appear and gradually increase after defecation.

During pregnancy symptoms of decease can miss and appear only in the postnatal period. It is connected with the fact that at the delivery time the head of the baby squeezes vascular formations of a small pelvis. It causes sharp venous derivation and increasing of pressure in rectum vessels.

After the delivery the increased internal haemorrhoidal tumors periodically drop out of a rectum. It occurs during defecation, and then they independently leave back. Later prolapsus of tumors can appear during heavy lifting. But they do not leave back independently, but only with the help of hands. In the neglected case of hemorrhoids the tumors don’t leave at all, the necrosis develops in them, or there is massive haemorrhoidal bleeding.

Diagnostics of Hemorrhoids

If the tumor has got out outside, the diagnosis of a disease is simple and based on checkup of anus. External hemorrhoids after the delivery look typically – in the form of the formations of circular section reminding peas. For identification of internal haemorrhoidal tumors, definitions of their quantity and the sizes anus is examined by manual checkup. Besides, sigmoidoscopy is applied for finding the tumors (endoscopic test of a rectum) and an irrigoscopy (radiological test with contrast substance).

Treatment of a Disease After the Delivery

If the disease symptoms have appeared, you shouldn’t wait for its recovering by itself. It is necessary to begin treatment immediately, so that no to get complications. The inflammation of soft tissues and haemorrhoidal bleedings are dangerous during pregnancy and after the delivery. The treatment of a disease has to be complex, including not only medicines, but also dietary nutrition, physiotherapy exercises and, perhaps, some folk remedy.

Physical Activity

For the prevention of venous stagnation in vessels of a small pelvis it is necessary:

  • to dose physical activities and lifting of weight;
  • to walk daily in the fresh air, passing not less than 1,5-2 km in quiet speed;
  • to do special exercises from physiotherapy exercises regularly.

Medicated Treatment

Drug treatment of hemorrhoids after the delivery consists of prescription of laxative, venotoniks, the means improving blood microcirculation. Antihaemorrhoidal ointments and candles are used as local treatment.

Treatment by Folk Remedies

Traditional medicine offers for treating hemorrhoids means both for external, and for internal application.

Local usage:

  • medical enemas with broth from bilberry fruits, cold water and tannin;
  • sitting bathtubs with broth of seeds of a chestnut and inflorescences of a chamomile, broth of onions and alum.

The increased external tumor is recommended to be greased with the cocoa butter, Ichthyol candied with honey. And internal one is influenced candles from raw potatoes or the candied honey. It is recommended to drink broths and infusions of medicinal herbs during treatment, and also vegetables and fruit juices. By the way, you can find different national recipes on pages of our website.

Prevention of the Decease

It is necessary just to know how to get rid of postnatal hemorrhoids, but it is not enough. Prevention of a disease is much more important. It is simple, and it is necessary to do it throughout the pregnancy, and then and after the delivery if you really want that the tumor hasn’t got out.

First of all prevention consists in an active way of life. Foot walks are obligatory and have to be daily. If you also do special exercises regularly, then you will strengthen muscles of a pelvic and improve blood circulation in it. It is necessary to avoid wearing of constringent clothes. And of course, you should keep a diet for normal work of intestines and the prevention of constipations.

And some more recommendations how to get rid of risk of hemorrhoids:

  1. Try not to make an effort strongly during defecation.
  2. Observe personal hygiene. Wash area of an anus with cool water and blot it with a napkin after each defecation, but don’t rub with a towel.
  3. Use an light laxative if you have a constipation.
  4. Exclude from a diet rye – bread, cabbage, beans that is the products causing excessive gas generation. Limit eating of hot spices and seasonings.
  5. Include the vegetables and fruit rich with pectin in daily nutrition, low-fat meat and fish, honey, bread and bakery products from coarse flour, bran, prunes and dried apricots.

Also you should remember that hemorrhoids after the delivery and during pregnancy – is not a rarity at all. But it can be avoided if you do the prevention.

Reviewed by the QSota Medical Advisory Board