Pregnancy can bring on unexpected changes, and unfortunately piles – or haemorrhoids as we doctors call them – are one of these surprises. Piles occur when a swelling forms of the blood vessels (veins) around the back passage. These can become engorged with blood, and look and feel like little pink cushions.
Piles are very common in the general population, affecting both men and women, but pregnancy makes them more likely, due to the pressure from your growing baby, increased hormones such as progesterone that cause veins to relax, and straining to do a poo, as you’re more likely to be constipated in pregnancy.
Most people notice a bit of fresh red bleeding in the pan, on toilet tissue or around the back passage. You may find the back passage a bit itchy or sore, and it might be uncomfortable to pass a poo. You may notice a soft lump just outside the anus and you may need to push it back in after passing a poo. And some people pass a bit of mucus.
Constipation is one of the main causes of piles. This can be helped with keeping hydrated and maintaining a healthy diet. You should drink plenty of water (around 1.5 to 2 litres per day), especially in pregnancy, as requirements increase. Seek out a good amount of fibre-rich food every day - you can find it in fruits, vegetables, wholegrains, lentils and beans.
These steps will soften your stool, making it pass more easily, and also improve gut health.
Exercise is another important way to ensure that your circulation is optimised, and your bowel is moving. In the late stages of pregnancy, you may not feel like continuing any very demanding exercise, but you try to stay active through walking or swimming.
A simple remedy to soothe pain and itching around the back passage is to apply ice wrapped in a towel. This may also help reduce the size of the pile. You can also use simple painkillers such as paracetamol or ibuprofen. If you have a pile that sticks out, then use a lubricating gel to gently push the pile back in.
If you are unable to push you haemorrhoid back in, or it's suddenly extremely painful, you should seek urgent medical help.
If these simple measures have not sufficiently helped, it’s worth a trip to your pharmacy. Creams and suppositories, such as Anusol, are available over-the-counter. Anusol has a mild anaesthetic, which numbs the area to ease bothersome symptoms. Make sure you let the pharmacist or any doctor know that you are pregnant, so they can offer the safest treatment.
Stool softeners or laxatives can help to relieve any constipation, if increasing dietary fibre and water intake hasn’t helped.
If these don’t work well enough, it’s best to speak to your doctor, who can consider your symptoms, examine you, and prescribe you other medications to help. If there’s any doubt about your diagnosis, you should also book an appointment.
The short and comforting answer is no, piles do usually disappear after you deliver your baby. This occurs as the pressure eases on your bowels and the high progesterone levels gradually reduce.
Piles sometimes become more pronounced during delivery, as the pressure of pushing baby out of the vagina can cause further vein engorgement, but in most cases this is short-lived and you recover. If it doesn’t go away after several days, it’s best to speak with your doctor.
Be mindful that you can become dehydrated after birth, especially if you're breastfeeding, and this can make constipation worse. So remember to stay hydrated, take a look at your diet again, and start from the beginning with these methods to ease your symptoms if they worsen or recur.
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