Hemorrhoids in Pregnancy

Hemorrhoids are a rather common health concern that affects a significant proportion of individuals at some point in their lives. They are particularly prevalent during pregnancy, with up to 30% of expectant mothers experiencing this condition. It's crucial to address this issue openly, without unnecessary taboos, to prevent complications such as anemia or anal fissures.

What are Hemorrhoids?

Hemorrhoids, also known as piles, are swollen and inflamed veins located in the lower part of the rectum and anus. They resemble varicose veins and can develop either inside the rectum (internal hemorrhoids) or under the skin around the anus (external hemorrhoids).

Common symptoms include:

• Pain or discomfort, especially during or after bowel movements
• Itching or irritation in the anal region
• Swelling or a lump near the anus
• Bright red blood on toilet paper or in the stool

While hemorrhoids are not usually dangerous, they can significantly affect quality of life if left untreated.

Causes of Hemorrhoids

Hemorrhoids can occur due to a variety of reasons, but they are particularly common during pregnancy due to the various stresses placed on the female body. One of the most straightforward reasons is the enlarging uterus, which can exert pressure on the intestine and anorectal veins, leading to constipation and hemorrhoids.

However, this is just one of many factors. Hormonal changes at the start of pregnancy can cause the dilation of hemorrhoids. The increase in estrogen and especially progesterone leads to a general relaxation of the connective tissues. The venous vessels' resistance is also tested by the increase in blood volume and abdominal pressure. This pressure becomes more pronounced as the birth approaches due to the uterus's enlargement and a general reduction in physical activity.

The accumulation of venous blood, along with vascular weakness, facilitates the onset of excessive vessel dilations. These dilations can cause swelling and prolapse of the hemorrhoidal plexuses, leading to varicose veins.

Treating Hemorrhoids

It is essential to treat hemorrhoids promptly to prevent them from becoming a significant issue. The treatment varies depending on the severity of the condition. Hemorrhoids that have recently developed and are not particularly painful can often be managed with simple behavioral therapy. This therapy includes measures to reduce inflammation and restore elasticity to the venous walls. Some of these measures include:

• Regular Physical Movement
  Regular exercise stimulates intestinal motility and promotes venous blood return to the heart, reducing the risk of varicose veins, swelling, and constipation. Walking is an ideal exercise, but strenuous activities should be avoided.
• Increasing Fiber Intake
  Gradually increasing the amount of fiber in the diet, along with adequate fluid intake, can make stools softer and more abundant. This change can alleviate constipation and reduce the risk of hemorrhoids protruding and bleeding during defecation.
• Anal Hygiene
  Maintaining anal hygiene with warm water and mildly acidic soap can speed up healing and reduce the risk of infection. However, washing with ice-cold water should be avoided as it can cause the anal muscles to spasm, leading to strangulation of the hemorrhoidal nodules.

Ointments and suppositories with decongestant, anesthetic, and/or disinfectant properties can also be used to treat hemorrhoids in the initial stage and alleviate their symptoms. The primary substances used for this purpose are corticosteroids and local anesthetics. However, these treatments only relieve the symptoms and do not address the underlying causes of hemorrhoids. Therefore, they should only be used under medical supervision.

During pregnancy, the use of cortisone is generally avoided. Instead, phytotherapy is commonly used, which, despite being less effective in the short term, has fewer side effects than synthetic drugs.

In conclusion, hemorrhoids are a common condition that can cause significant discomfort if left untreated. Understanding the causes and knowing how to manage the condition can help prevent complications and improve quality of life.