Someone has aptly said, “Pregnancy is a beautiful journey and helps you evolve as a loving and caring mother.”
Every day is a new experience. Sometimes you feel nausea, weakness and fatigue. You may also feel constipated and fullness of abdomen. During the third trimester you may notice streaks of blood while you defecate. Nausea is the most distressing condition in the first trimester of pregnancy while hemorrhoid is a great nuisance during the third trimester.

What Are Hemorrhoids During Pregnancy?

Hemorrhoids are also known as ‘piles’ and is a painful and distressing condition that can affect anyone and is seen commonly in pregnant women. Hemorrhoids are the swollen blood vessels of the rectal region. The degree of swelling may range from the size of pea to grape. These swollen vessels can either protrude out of the rectum or remain inside. Technically, hemorrhoids (piles) are dilated varicose veins that form in the rectum and around the anus when valves in the veins that usually prevent back-flow of blood give way under pressure. Swollen veins close to the anal opening are called external hemorrhoids, while those occurring higher up in the anal canal are known as internal hemorrhoids. They can be itchy, quite uncomfortable, and even painful, especially during bowel movements.

What Causes Hemorrhoids In Pregnancy?

The return of the blood from the lower body gets slower when you are pregnant. This happens because of the pressure on pelvic veins that is exerted by the growing uterus. This can inturn cause swelling or dilation of the veins in the lower parts of the body, especially below the uterus.

• Constipation is the chief cause of hemorrhoids. Difficulty in defecation puts extra pressure on the rectum and perineal area and hemorrhoids are the obvious outcome
• The pressure of the womb on the uterus is also a major cause of hemorrhoids
• The pregnancy hormone, progesterone also relaxes the veins, thus allowing them to swell. Also a culprit to the problem of constipation by making the intestines functions slow
• Prolonged sitting and standing are also contributing factors of piles or hemorrhoids

Symptoms Of Hemorrhoids In Pregnancy

If you experience following symptoms, immediately consult your doctor –

• Irritation around anus
• Pain around anus
• Swollen lump around anus
• Bleeding while passing stools

How To Avoid Hemorrhoids In Pregnancy?

Pregnancy makes you prone to hemorrhoids but do not worry! They are not unavoidable. Following are some simple ways to keep them at bay:

• Avoid constipation: Take a lot of fiber-rich diet such as beans, fruits, whole grains and green leafy vegetables. Drinking plenty of water is also helpful in avoiding constipation. You can even take stool softeners and fiber supplements if you feel constipated
• Walking: take out some time to walk as it is important in not only keeping you fit but also eases defecation
• Go when the urge strikes: Immediately go to the toilet as the need arises. Do not linger for long as this puts unnecessary pressure in the rectal area
• Regular Kegel exercise: Do regular Kegel exercises to improve blood circulation in the rectal region. Regular Kegel exercises also makes the muscles of the anal area strong and toned. Read more about Kegel exercises here
• Say ‘no’ to long sitting and standing: Do not stand or sit for long hours. You should walk for few minutes every one to two hours of constant standing or sitting. This eases pressure of your veins and improves blood return from lower extremities to the rest of the body

Pregnancy Hemorrhoids Treatment

Here are some easy ways to ease pain and lessen discomfort caused by hemorrhoids in pregnancy

1. 1. Ice pack: Apply ice pack to the painful area three to four times a day. Application of ice will mitigate the discomfort and swelling
   2. Warm water: Take a tub full of warm water and sit for few minutes. You can use a sitz bath for better results
   3. Watch your diet: Eat a mild, non-spicy, high fiber diet and drink plenty of fluids
   4. Water treatments: Alternate warm and cold treatments can give better results. You can also add baking soda to the warm or cold water treatment
   5. Itchiness: If the area is too itchy, place baking soda either wet or dry
   6. Hygiene: If you scratch at night, try wearing cotton underwear and even cotton gloves. Wear loose cotton underwear, changed at least once a day
   7. Clean: Make sure to clean the affected area after bowel movement. Use a non-scented soft toilet paper instead of the scented type as it causes less discomfort and irritation
   8. Medicated Wipes: Moistened and medicated wipes are better in soothing the irritation around the affected area. Witch hazel medicated wipes are easily available in drug stores
   9. Bathing: Bath or shower every day using un-perfumed soap and finish by spraying the area with cold water. Avoid talcum powder

1. Suppositories: Your doctor may advice you a safe topical medicated suppository or ointment to give prompt relief. Use glycerol suppositories to ease motions and reduce straining; straining can also be reduced by leaning forwards from the hips when opening the bowels
2. Home remedy: Take half teaspoon of nutmeg powder with water early in the morning and while going to bed for three days. This will keep pain and discomfort at an arm’s length
3. Aromatherapy: After the 16th week of pregnancy try adding one drop of peppermint oil and two drops of chamomile to warm water (in a bidet or large, shallow plastic bowl) and sit in the solution for five or ten minutes. If the area feels sore and burning, you can also add two tablespoons of bicarbonate soda. Cypress, lemon and Roman chamomile essential oils form another helpful combination
4. Herbal medicine: Astringent ointments containing comfrey, horse chestnut or witch hazel are used; horse chestnut also strengthens supporting tissues around the veins. The seeds and husks of psyllium are a safe and effective remedy for constipation and hemorrhoids
5. Homeopathy (take four times daily for up to five days):
   • for piles with burning, soreness and bursting feelings take Hamamelis virginica 6c;
   • for sharp shooting paints up the back take Aesculus;
   • for feelings of a full rectum take Nux vomica;
   • for itching and burning take Paeonia;
   • for feelings of heat, burning and itching when overheated, bleeding or associated with painless diarrhea in the morning take Sulphur 6c
6. Acupuncture: Acupuncture can also be highly effective

External piles sometimes become hard, intensely painful and dark purple-black in color if the blood trapped inside them starts to clot (thrombosed pile). This usually resolves spontaneously over two to three weeks, but consulting a doctor, who will anesthetize the area and gently evacuate the clot through a small incision, brings instant relief.

Hemorrhoids In Third Trimester Of Pregnancy

The itchy swollen varicose veins- hemorrhoids are common in pregnancy. Hemorrhoids are usually common as you move in your third trimester of pregnancy. In the third trimester, when the bulk of the womb presses on pelvic veins, it causes congestion. the uterus grows in size and can make you vulnerable to varicose veins in legs or hemorrhoids. The uterus puts excess pressure on inferior vena cava and pelvic veins. This interferes with normal blood return from the lower extremities. Piles form soft, fleshy lumps that may remain inside the back passage or be visible outside. During defecation, rectal bleeding is seen.
They generally subside with the birth of the baby, provided you avoid having constipation. This in turn can enhance pressure on your uterine veins and makes it more swollen and dilated.
**Disclaimer: Please speak to your doctor before taking any medicines