The 9 Ps you Need to Know about Hemorrhoids during Pregnancy

What are hemorrhoids?
Hemorrhoids, otherwise known as ‘piles’ originate from the Latin word pila which means a ‘ball’, owing to the round shape of this bothersome mass that protrudes in the anus.  In human anatomy, the final section of the large intestine is the rectum, which ends in the ring shaped anus.  

Hemorrhoids are enlarged veins (blood vessels that carry oxygen-depleted blood back towards the heart) in and around the anus or rectum. Piles may remain inside the rectum (internal) or slip outside (external).


What causes hemorrhoids?
Commonly, prolonged standing by action of gravity or any body changes that causes blood to pool and exert pressure in the dependent portion of the rectum causes the veins around it to swell and become painful. There are a number of culprits to this nagging disorder.  In some rare instances, piles may mask a more serious underlying condition such as colon or rectal cancer. Therefore, proper diagnosis and treatment by a specialist cannot be undermined.


The First Four Ps to Remember: Piles Prevail in Pregnancy due to Progesterone
The following can be a handful of information but is vital to trace the route leading to the 4 Ps:
Progesterone is known as the major hormone supporting pregnancy.  It is produced by the corpus luteum or simply from the empty house (follicle) of the mommy’s egg when it is released to meet the daddy’s sperm to form into a baby.  Progesterone causes the lining of the mommy’s womb to secrete special proteins so that the baby could cling, be nourished, and survive.

This precious hormone softens and smoothes body tissues such as the womb to prevent premature labor contractions and, more importantly, to relax the intestinal tract. The latter’s purpose is to slow down the digestive process so that more nutrients can be extracted from the food taken by the mother to be utilized by her baby.  However, this results to constipation which is among the most common complaints of ‘preggies’. Straining during defecation then increases pressure and swells the anorectal veins causing pain, discomfort and bleeding…hence the piles of pregnancy.

 

Click here to see the other five Ps to know about hemorrhoids during pregnancy.

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Read on to see the other five Ps to know about hemorrhoids during pregnancy.

 

The Next 3 Ps to Remember: Preventing Piles in Pregnancy
In the absence of other intestinal problems, functional constipation as the prequel to piles is relieved by increased oral fluid intake, fiber-rich foods, and moderate prenatal exercises which may improve the movement of the digestive tract.

A word of caution on the immoderate use of laxatives on desperate attempts to soften stools : they function by stimulating the bowels to move which, in turn, stimulates muscles of the womb to have preterm contractions.  It is therefore prudent to hold off on them.

Iron supplements, too, though vital to prevent anemia among expectant mothers, are linked to constipation. Iron is a metal that transports oxygen to the muscles for cell growth that, according to some studies, can send electromagnetic charges in the nerves and muscles of the bowels.  This aggravates the progesterone-induced constipation among moms-tobe, which is why it is opted to take durule forms of iron instead which have a reduced rate of release of the active substance which keeps the adverse effects like constipation at bay.


The Final 2 Ps to Remember: Piles Panacea
Here’s the panacea, or universal remedy, to hemorrhoids:

• A basic thing to do is keep the anorectal area clean with mild soap or diluted antiseptic like povidone iodine, as strong cleansers might irritate the inflamed pile and cause it to bleed.
• Use donut rings, inflatable floaters, or rolled thick towels when sitting to minimize the pressure on the area.  Lie on your side when sleeping as this position is also of great benefit to the developing fetus. The weight of the womb when you lie on your back (supine position) hampers the oxygen, blood and nutrient supply of the fetus.
• Anti-inflammatory creams with steroidal components are to be applied to ease swelling, itchiness and pain but with caution if there is concomitant or an accompanying infection.
• Bland soothing creams/ointments with witchhazel, zinc oxide, petroleum can ease discomfort.
• Strong painkillers are a no-no especially during the early trimester.  Instead, ice pack may be pressed on the area for 15-30 minutes for acute bouts of pain.
• Do a hot sitz bath by submerging the pile on warm - not hot - water for at least 30 minutes.  Sitz baths are chair-shaped bathtubs in which one bathes in a sitting position, immersing only the hips and buttocks.  You can improvise with what you have at home.  The heat draws more blood circulating towards the pile and enhances wound healing.
• Remember to pat - not rub - the area dry, as moist attracts bacteria and delays wound healing.

Most pregnancy-caused piles settle upon childbirth as progesterone levels decline in the maternal blood.  Meantime, proper care and management must be followed to keep your pregnancy pain- and hassle-free.


Dr. Lalaine Cartago-Garcia is a Diplomate and Fellow at the Philippine Obstetrics Gynecology Society, and a Fellow at the Philippine Society of Ultrasound in Obstetrics Gynecology.  She specializes in OBGyn Sonology and is affiliated with Asian Hosiptal Medical Center in Alabang and Perpetual Help Medical Center in Las PInas.


Photo from flickr.com