Hemorrhoids, often referred to as piles, are swollen veins that can form in or around the anus and lower rectum. They are a common concern, and during the postpartum period, they can become a particular source of discomfort. While generally harmless, these swollen veins can cause various symptoms that new mothers may find challenging to manage.
How Common Are They?
Hemorrhoids are quite common during pregnancy and after childbirth. Studies indicate that approximately 40-43% of women experience hemorrhoids or anal fissures (small tears) during pregnancy and the postpartum period.
These conditions often develop in the third trimester of pregnancy or within the first couple of days after birth. More than 40% of women develop hemorrhoids or anal fissures from early pregnancy up to one month postpartum. The likelihood of developing hemorrhoids can also increase with the number of pregnancies a woman experiences.
Why They Occur
The development of hemorrhoids during and after pregnancy is linked to several physiological changes and pressures on the body. As the uterus expands to accommodate a growing baby, it exerts pressure on the pelvic veins and the inferior vena cava, a large vein that carries blood from the lower body back to the heart. This increased pressure can slow blood flow from the lower half of the body, causing veins around the rectum to swell.
Hormonal changes also play a role, as the rise in progesterone during pregnancy can relax the walls of blood vessels, making them more prone to swelling. Constipation, a common issue during pregnancy, contributes significantly. Straining during bowel movements increases pressure in the rectal area, which can lead to or worsen hemorrhoids. The intense pushing efforts during labor and delivery can further aggravate existing hemorrhoids or cause new ones to form due to the significant pressure placed on the veins around the anus.
Recognizing and Managing Them
Postpartum hemorrhoids can manifest with several noticeable symptoms, including pain, itching, swelling, and irritation around the anus. Blood may be observed in stool, on toilet paper, or in the toilet after a bowel movement. A tender lump or bulging area around the anus is common, and discomfort while sitting or having a bowel movement is frequently reported.
To manage these symptoms and promote healing, several at-home strategies can be beneficial. Warm sitz baths (soaking the anal area in warm water) can help soothe discomfort and reduce swelling. Applying cold compresses or ice packs can provide temporary relief from pain and swelling. Maintaining good hygiene by gently cleaning the area after bowel movements with soft wipes or warm water can prevent further irritation.
Dietary adjustments are important; increasing fiber intake through fruits, vegetables, and whole grains, along with drinking plenty of water, helps soften stools and prevent straining. Stool softeners can be considered to make bowel movements easier. Over-the-counter creams, ointments, or medicated pads containing witch hazel can offer localized relief from itching and pain. Lying down can help reduce pressure on the rectal area, and avoiding prolonged sitting or straining during bowel movements is advisable.
When to Seek Professional Help
While many postpartum hemorrhoids improve with home remedies within a few days or weeks, medical consultation becomes appropriate in some instances. Contact a healthcare provider if symptoms do not improve after a week of consistent home treatment. Persistent or severe pain not relieved by self-care measures warrants medical attention.
Other warning signs include heavy or prolonged bleeding from the rectum, or if a hemorrhoid becomes hard, very painful, or shows signs of infection like pus. These symptoms could indicate a thrombosed hemorrhoid (a blood clot within the vein) or another complication requiring professional intervention. A healthcare provider can offer further guidance, stronger medications, or discuss other treatment options.