Hemorrhoids, also called piles, are a common pregnancy complication that several mothers experience during pregnancy. In several cases, hemorrhoids eventually subside after delivery. However, it continues beyond pregnancy sometimes and is called postpartum hemorrhoids. Hemorrhoids affect the anal region and make passing motions painful for many. Although they can cause severe discomfort, hemorrhoids are generally not harmful and can be treated with prompt home care and medical support. Read this post to learn about hemorrhoids after pregnancy, including the types, symptoms, causes, treatment, and management strategies.
What Are Hemorrhoids (Piles)?
Hemorrhoids are swollen and engorged veins (varicose veins) in the anal region (1). They feel like a soft mass that sticks out of the anus. The size of hemorrhoids can be as small as a raisin to as big as a grape. You are more likely to develop hemorrhoids after pregnancy if you have had them during pregnancy, and also experienced constipation. Hemorrhoids could be painful, you may even bleed while passing stools, and they can make the rectum itchy (2). The symptoms of the condition can vary based on the type of hemorrhoids you develop.
Types And Symptoms Of Postpartum Hemorrhoids
Hemorrhoids are of two types – internal and external (3).
Internal hemorrhoids lie inside the rectum or anal canal and are not visible. They are less painful as they are only a few pain-causing nerves inside the rectum. They cause intermittent bleeding along with mucus discharge while passing stools. Some internal hemorrhoids may protrude outside the anal sphincter and appear as small grape-like lumps. In this case, these tiny hemorrhoids can be pushed back into the anus using your fingertips.
External hemorrhoids protrude outside the anus and are easily noticeable. They are painful and cause discomfort. They also make it difficult to clean the anal region after bowel movements. In rare cases, they form blood clots (thrombosis), which is another painful condition.
The common symptoms of internal and external hemorrhoids include:
Itching and burning sensation in the anal region Anal pain that aggravates when you sit Bleeding from the rectum Pain while passing stool Tender mass near the anal region that can crack and bleed
Causes Of Postpartum Hemorrhoids
Here are a few reasons why you may develop hemorrhoids after pregnancy.
Stress on the perineum before and during delivery The stress of carrying a baby, and pushing it out during labor (1) Constipation or straining for a bowel movement Hormonal changes during pregnancy and childbirth affect the blood vessels that cause the veins in the legs and pelvis to swell (4)
How Long Do Postpartum Hemorrhoids Last?
Based on the size, location, and severity, hemorrhoids usually take around a few days to several weeks to disappear. Severe cases of hemorrhoids, which result in the formation of blood clots known as thrombosed hemorrhoids, can be treated using a minimally invasive procedure (5). Chronic hemorrhoids that last for months also need medical assistance. In some mild cases, a few homecare remedial tips may help address hemorrhoids after pregnancy.
How To Manage Postpartum Hemorrhoids At Home?
Here are some of the ways to manage hemorrhoids at home (2).
Apply ice compress (wrap some ice in a clean cloth) on the hemorrhoids and leave it for about ten minutes. This will reduce swelling and discomfort. Try a warm water bath. You may take a sitz bath, which is a small water tub that fits over the toilet seat. You can also soak yourself in a bathtub. Sitting on the sitz bath for about 20 minutes after each bowel movement, or for two to three times a day, could soothe the irritation. You can add Epsom salt to the water to help further reduce swelling and pain.
Clean the anal region gently after each bowel movement. Use a hand-held squirt bottle and wet wipes for relief from pain. Use dye-free and unscented hygiene products such as menstrual pads, toilet paper, and wet wipes. Drink enough water and consume foods high in fiber to ease constipation and reduce discomfort.
Rest or lie down as much as possible as it takes off the pressure from your back. Do not control your urge to urinate because it can make the stools dry and aggravate the condition. Practice kegel exercises as they could improve blood circulation in the rectal region, and the perineum. They could also improve the muscle tone around the vagina.
If these homecare measures do not provide relief from the symptoms of postpartum piles, you should talk to your healthcare provider for medical treatments.
Treatment For Postpartum Hemorrhoids
Your doctor may prescribe oral or topical medications to treat hemorrhoids. The treatments include:
Stool softeners: They soften the stool, improve its consistency, and trigger bowel movements. Docusate sodium (Colace) and docusate calcium (Surfak) are a few such medicines you may be prescribed (6). Medicated wipes: They relieve itching, inflammation, and pain. Some of the most prescribed wipes are hydrocortisone, witch hazel, and lidocaine (7).
Hemorrhoid creams and suppositories: They treat pain and inflammation of both internal and external hemorrhoids. Glycerin and bisacodyl are some frequently used suppositories to treat constipation and alleviate the symptoms of hemorrhoids (8). Fiber supplements: Fiber supplements include psyllium (Metamucil, Konsyl, others), methylcellulose (Citrucel) and calcium polycarbophil (FiberCon, Equalactin) (9).
Pain relievers: Tylenol (acetaminophen) or ibuprofen are recommended for temporary relief (9).
In extreme and rare cases, surgery is needed. Your doctor may recommend any of the following surgical treatments if necessary (10).
Rubber band ligation: A special rubber band is tied around the base of the hemorrhoid to cut off the blood supply. The banded part then shrinks and falls off within a week or so. Sclerotherapy: A chemical solution is injected into the internal hemorrhoids and the surrounding area. It will affect the blood flow and shrink the hemorrhoids. Coagulation therapies: These treatments use infrared light or electricity to burn and remove the internal hemorrhoids. Hemorrhoidectomy: This traditional surgical procedure removes large hemorrhoids and prolapsing internal hemorrhoids by giving anesthesia. It is done for both internal and external hemorrhoids. Hemorrhoid stapling: It uses a special device to staple and removes the internal hemorrhoids.
