How to treat Hemorrhoids during Pregnancy

Medically reviewed by: Gary H. Hoffman, MD

Pregnancy hemorrhoids are common and occur in around 30% of pregnancies. In some ethnicities, up to 80% of pregnant women suffer from the condition. If you are pregnant and have developed hemorrhoids, this article will answer all your questions about the illness. 

We’ll discuss what hemorrhoids are, why they occur during a pregnancy, how long they last, when to call your doctor, and how to prevent them. 

We’ll also take a look at how you can treat them during pregnancy, and what you should do if they persist after you deliver. 

What are hemorrhoids? 

Hemorrhoids, also known as ‘piles’, are swollen, blue-colored veins found inside the anal canal. These are called internal hemorrhoids. If the swollen veins are found closer to the skin (or pop out of the anal canal), they are called external hemorrhoids.

Veins carry blood away from the anal region. When pressure inside the body increases, it compresses these veins and prevents normal blood flow. This causes blood to collect in these veins, making them engorged. And these engorged veins are called hemorrhoids. 

Situations in which pressure inside the body increases include straining during bowel movements, coughing, lifting weights, obesity, and pregnancy. And these are some of the most common causes of hemorrhoids

Usually, the first symptoms of hemorrhoids are pain and bleeding when passing stool. Itching and swelling around the anus might also occur.

Why do hemorrhoids occur during a pregnancy?

Hemorrhoids occur during a pregnancy because of hormonal effects, weight of the developing baby, and increased amount of blood in the body. Let’s discuss each of these in detail.

Hormones 

The body undergoes many changes during a pregnancy. One change is the excessive release of hormones (like estrogen and progesterone), which cause veins to relax. This prevents blood from effectively moving away from the anus, causing it to pool inside the veins. 

Pregnancy-related hormones also decrease bowel movements, which leads to constipation. This leads to straining when you’re passing stool, which increases the pressure in the area and puts you at risk for hemorrhoids. 

Size of the baby

The fetus (developing baby) grows in size as a pregnancy continues. This causes pressure inside the mother’s body to increase. And as discussed previously, increased pressure is one way how hemorrhoids form.

Increased blood quantity

During a pregnancy, the amount of blood in the body increases. This causes veins to enlarge as they have to carry more blood, causing them to stretch and appear dilated. When veins are unable to handle the increased amount of blood, they swell and enlarge, leading to hemorrhoids.

How long do pregnancy hemorrhoids last? 

Hemorrhoids in a pregnancy usually last till the birth of the baby and go away on their own once you deliver. They commonly appear in the third trimester, during child-birth, or immediately after the birth of the baby. 

In some cases, hemorrhoids might persist after the pregnancy is over and require medical treatment (more on that later).

When should I call my doctor for hemorrhoids during pregnancy?

You should call your doctor when your hemorrhoids cause intense pain or begin to bleed. You should also consult a doctor before taking any medicines for hemorrhoids. It’s not a good idea to self-medicate during pregnancy because some drugs can harm the baby

How to prevent hemorrhoids during a pregnancy?

Hemorrhoids can be prevented during a pregnancy by consuming a healthy diet, exercising regularly, and using stool softeners.

Diet 

Constipation leads to straining during bowel movements, increasing the risk for hemorrhoids. Pregnant women are at a higher risk for constipation than normal individuals, which is why you must take extra steps to prevent it.

This can be done by consuming a fiber-rich diet and avoiding processed foods. Foods rich in fiber include vegetables, fruits, and whole grains.

Kegel exercises

Kegel exercises strengthen the pelvic muscles. These muscles support the bowels, bladder, and uterus (where the baby grows). Contracting these muscles improves blood circulation in the rectum, which might be helpful for preventing hemorrhoids

Stool softeners

After consultation with your doctor, you may take stool softeners like docusate, which help prevent constipation.

How do I get rid of hemorrhoids during a pregnancy?

Once they develop, you might not be able to get rid of hemorrhoids entirely during a pregnancy. 

But you can reduce the severity of your symptoms by having an appropriate diet, using a sitz bath, using cold compresses, maintaining good anal hygeine, avoiding sitting for too long, and doing Kegel exercises.

Sitz bath

In a sitz bath, you sit in warm water for 10-15 minutes at least three times a day. This soothes your anal area and helps relieve pain. 

Ice packs

Cold therapy involves applying ice packs to the anal area several times daily. This reduces swelling and pain.

Keep the anus dry and clean

Moisture irritates the anus if you have hemorrhoids, causing pain. Baby wipes can be used to carefully pat the anus after toileting. Be sure to not wipe, as it can further irritate the anus. 

 

You can also use wipes that contain witch hazel (a plant used as a natural remedy) to pat the anal area after passing stool. They are very effective at reducing swelling.

Avoid sitting for too long

Sitting directly puts pressure on veins near the anus. This can irritate hemorrhoids and cause discomfort. Therefore, hemorrhoid patients are advised to avoid sitting for long periods. It’s a good idea to lie on your side or stand when you can. If you can’t avoid sitting for long periods, use ring cushion to keep the anal area comfortable.

Medicines

Medicines such as hydrocortisone are available as ointments. These can be applied directly on the hemorrhoid and are good at reducing pain and swelling.

What are treatments for hemorrhoids that persist after a pregnancy?

Hemorrhoids that persist after a pregnancy may require surgical treatment. Treatment options include sclerotherapy, rubber band ligation, cauterization, hemorrhoidectomy, and stapling. 

Sclerotherapy

In sclerotherapy, a doctor injects the hemorrhoid with a solution. The solution damages blood vessels and causes a scar to form, which reduces blood flow to the hemorrhoids and shrinks their size. 

Rubber band ligation

This method uses a rubber band, which is placed at the base of the hemorrhoid. This constricts the hemorrhoid, cutting off its blood supply and causing it to wither away. The dead hemorrhoid simply falls off. 

Although rubber band ligation has several advantages over other procedures, some patients may develop pain, bleeding, or an abscess after treatment. In some patients, hemorrhoids might return (and are usually bigger when they grow back). 

One limitation of rubber band ligation is that it can treat only internal hemorrhoids. 

Hemorrhoidectomy

During a hemorrhoidectomy, your doctor cuts away the hemorrhoid using a laser or scissors.

The wound may then be left open or closed off by stitching, depending on whether it’s an open or closed hemorrhoidectomy. Open wounds take longer to heal than stitched wounds, but are less likely to cause problems such as a bruise later on.

Some complications of a hemorrhoidectomy include:

  • Pain
  • Bleeding
  • Wound infection
  • Narrowing of the anal area — this is called a stricture

Stapling

In stapling, a doctor removes some part of the hemorrhoid. The remaining part is then stapled to the normal anus. 

Stapling causes less pain compared to a hemorrhoidectomy and has a shorter downtime. However, itching and bleeding are common side-effects. 

In some cases, hemorrhoids might return in a bigger size after stapling. 

Remember, pregnancy hemorrhoids are common and nothing to worry about

Most women develop pregnancy hemorrhoids. Although these are usually harmless, they may cause discomfort and irritation, which can be treated with a sitz bath, cold packs, and medications. Once you deliver, there’s a high chance your hemorrhoids will go away on their own. 

If they persist, you might need a medical procedure like sclerotherapy or rubber band ligation.

Sometimes, hemorrhoids might bleed or cause extreme pain during a pregnancy. It is important to seek medical attention when this happens.