Hemorrhoids During Pregnancy? You're not alone! In some cases, up to 85% of pregnant women develop hemorrhoids in the third trimester or postpartum period!

WRITTEN BY: TANVI LODHIA, DOCTOR OF PHARMACY. 

What are Hemorrhoids?

Hemorrhoids occur when the veins around the anus or lower rectum become swollen and inflamed. This can cause symptoms like rectal bleeding, itching, and pain.

Why are Hemorrhoids so Common during Pregnancy?

Pregnancy and vaginal delivery predispose women to develop hemorrhoids because of the hormonal changes and increased pressure on the abdomen.

During pregnancy, a hormone named progesterone is increased. Progesterone relaxes the smooth muscles in the abdomen to help the uterus grow. Unfortunately, this increased progesterone also relaxes the intestines. When the intestines are relaxed, there is less motility leading to increased constipation in pregnant mothers. Additionally, moms will need to nourish their baby with nutrients. They do this by circulating their blood to the uterus. This causes increased blood flow and added pressure to the abdomen.

In some cases, up to85% of pregnant women develop hemorrhoids in the third trimester or postpartum period!

Some other conditions that may predispose you to develop hemorrhoids during pregnancy include  

• Personal history of disease around the anus or rectum
• Straining during delivery for more than 20 minutes
• Birth weight of newborn over 8.4 lbs. (3,800 grams)

Can I Prevent and Treat Hemorrhoids while I am Pregnant?

A study was performed recently in April of 2022 to evaluate the effectiveness of dietary and behavior interventions for the prevention of hemorrhoids during pregnancy and after delivery. Four hundred and five pregnant women were separated into two groups – the intervention or treatment group and the control group.This was required to compare which group had better outcomes i.e., did not develop hemorrhoids. The pregnant women in the study had a mean age of 30 years, and more than half of the women were giving birth for the first time.

• Intervention Group: In the treatment group, pregnant women received specific dietary and behavioral recommendations known to prevent hemorrhoids
  • Eat meals in regular time intervals
  • Consume at least 1.5 L (~6 cups) of fluid,
  • Avoid food that causes constipation such as fast food
  • Consume a tablespoon of bran and 2 to 5 prunes daily
  • Consume around 300 g of fruits, 500 g of vegetables, and 30 g of nuts daily
  • Exercise and/or walk daily for 30–60 min, 3 to 5 times per week
  • Do not ignore the urge to defecate
    1. Try to spend less than 3 min on the toilet
    2. Attempt to defecate every morning and 30 to 40 minutes after eating

• Keep your area clean by washing it after a bowel movement

Clickhere to learn more about why these interventions were selected

• Control Group: Pregnant Women received standard physical and dietary pregnancy recommendations. These were not specific recommendations to prevent hemorrhoids.

Results
The study found a lower hemorrhoid rate in the intervention group (40.8%) at the time of discharge than the control group (15.4%). Additionally, the intervention group did not report any side-effects that would contribute towards a miscarriage.

Hemorrhoid Rate

What Hemorrhoid Products are safe to use during pregnancy?  

It is important to note that in most women hemorrhoids will pass soon after giving birth. Treatment can be started if symptoms persist. It is always important to speak with your OBGYN before using any over-the-counter creams and suppositories. Most of these products are widely accessible and can be purchased in the comfort of your own home.

1. Sitz baths – Warm water baths or Sitz Baths may be useful for soothing anal itching or burning, as they often contain anti-inflammatory substances. Sitz Soak can be added to warm water for additional relief. In case of any allergens, be sure to check the ingredients of Sitz Soaks before purchasing. This Sitz Bath Salt is made of Epsom salt, organic coconut oil, witch hazel, chamomile oil, ale vera, and other natural ingredients to soothe pain and support hemorrhoid recovery.
2. Witch Hazel is often an ingredient in Sitz Baths, but it can also be bought as pre-made pads. Witch hazel pads usually come as round cotton pads that are soaked with witch hazel solution.  If you only have the solution handy, no worries, you can make your own pads by dipping the cotton into the solution. Once you prepared your pad, gently press on the area for about a minute. You should feel relief quickly. Witch hazel has anti-inflammatory properties that may be beneficial for symptom relief.
3. Topical Anesthetics such as lidocaine – You may have used lidocaine in the past if you had any dental work done or needed minor surgery. However, you may have not known that lidocaine can also be used to help decrease the pain of hemorrhoids! It is applied topically to the rectum. Physicians usually recommend trying lidocaine after the first trimester. Generally, it is common practice to avoid medications in the first trimester since the fetus is developing during this phase. Revivol-XR contains 5% lidocaine, soothing aloe, and Vitamin E. This can be a suitable treatment option if the pain is your primary concern.
4. Laxatives, Bulk-forming agents & Stool Softeners – If constipation is your biggest concern, and increased fiber doesn’t seem to cut it, it may be time to try a laxative or stool softener. Your physician may recommend taking a mild laxative like Milk of Magnesia, a bulk-producing agent like Metamucil, or a stool softener like  Colace (docusate sodium). These products will help your stool pass quickly and prevent future constipation.  

Key Takeaways

• Hemorrhoids during pregnancy are common – don’t be alarmed!
• If you are scared you will develop hemorrhoids during your pregnancy, there are many preventative treatments you can try. Some include increasing your fiber intake, ensuring you are maintaining adequate hydration, and continually following proper toilet hygiene.
• Remember, medications can be taken if symptoms persist. Speak to your doctor about treatments such as sitz baths, witch hazel, topical anesthetics, and medication for constipation.

Disclaimer:

No content on this site, regardless of date, should ever be used as a substitute for direct medical advice from your doctor or other qualified clinician. The information provided on this site is for informational purposes only and is not intended as a substitute for advice from your physician or other health care professional or any information contained on or in any product label or packaging. You should not use the information on this site for diagnosis or treatment of any health problem or for prescription of any medication or other treatment. You should always consult with a healthcare professional before starting any diet, exercise, or supplementation program, before taking any medication, or if you have or suspect you might have a health problem. Statements regarding dietary supplements have not been evaluated by the FDA and are not intended to diagnose, treat, cure, or prevent any disease or health condition