Hemorrhoids occur in approximately 40% of pregnant women and women after delivery, due to the increased pressure on the veins in the rectal or anal area.
In most cases, postpartum hemorrhoids can be treated with home remedies and lifestyle changes. However, in severe cases, medical procedures or surgery may be necessary. (1)
What Causes Postpartum Hemorrhoids?
Hemorrhoids generally develop due to increased pressure on the veins in the rectal or anal area, leading to swelling and enlargement. The likelihood of developing hemorrhoids increases in the third trimester of pregnancy and after delivery due to the following factors: (1)
- Increased pressure on the abdomen and pelvis: As the baby's weight increases, more pressure is exerted on the pelvic and abdominal regions. This slows down blood circulation and increases the likelihood of blood pooling in certain areas, such as the anal and rectal veins.
- Constipation: Hormonal and dietary changes, along with iron supplements taken during pregnancy, contribute to constipation. After childbirth, factors such as reduced physical activity, dehydration, and fear of pain during bowel movements further increase the risk.
- Excessive straining during labor: Prolonged labor and the need to push for extended periods place additional strain on the anal veins, increasing the risk of hemorrhoids.
- Other contributing factors:
- High birth weight: Delivering a baby weighing 4 kg or more.
- Prolonged pregnancy: A pregnancy lasting beyond the typical 40 weeks.
What Are the Symptoms of Postpartum Hemorrhoids?
Hemorrhoids can be either internal or external. Internal hemorrhoids develop inside the rectal wall and are difficult to feel or detect, whereas external hemorrhoids appear around the outside of the anus and can be easily noticed. (2)
The most common symptoms of postpartum hemorrhoids include:
- Noticeable lumps around the anal area (in the case of external hemorrhoids).
- Pain in the anal region.
- Itching in and around the anus.
- Bleeding during bowel movements, which may be visible as blood in the stool.
Treatment of Postpartum Hemorrhoids
Treatment for postpartum hemorrhoids varies from woman to woman. However, in most cases, hemorrhoids improve significantly or disappear completely with simple home remedies and topical medications within a few weeks after delivery. For this reason, doctors typically recommend waiting up to 12 weeks postpartum before considering any surgical or medical procedures for hemorrhoids.
Key Strategies for Treating Hemorrhoids: (2)(3)
1. Relieving Constipation
Since constipation is a major trigger for hemorrhoids, managing and preventing it can significantly aid in treatment. To alleviate constipation:
- Increase your water intake.
- Eat fiber-rich foods, such as vegetables.
- Use laxatives if necessary, under medical supervision.
2. Warm Sitz Baths
Sitz baths are one of the most recommended remedies after a vaginal delivery to relieve pain around the vaginal and anal areas. They can also be highly effective in treating hemorrhoids.
- Try soaking in warm water for about 15 minutes several times a day for maximum relief.
- If you have stitches or wounds in the vaginal area, consult your doctor before taking sitz baths.
3. Physical Activity
Engaging in light physical activities, such as walking, can help reduce constipation and significantly improve hemorrhoid symptoms. However, consult your doctor first to ensure which exercises are safe for you after childbirth.
4. Topical Medications and Pain Relievers
Several over-the-counter products are available to help treat postpartum hemorrhoids, including:
- Hemorrhoid creams or suppositories: These typically contain ingredients such as hydrocortisone, local anesthetics, or natural remedies like witch hazel, which help relieve pain and reduce inflammation.
- Pain relievers safe during breastfeeding: Such as paracetamol (acetaminophen).
5. Additional Tips
Other helpful measures include: (3)
- Avoiding prolonged sitting and straining during bowel movements.
- Lying on your side, especially the left side, to reduce pain and improve blood flow in the area.
- Applying cold compresses to the affected area to reduce swelling and discomfort.
- Performing Kegel exercises to strengthen pelvic floor muscles.
When Should You See a Doctor?
It is important to consult a doctor if: (3)(4)
- Hemorrhoids cause severe pain and discomfort.
- They persist for several weeks after childbirth without improvement.
- You feel a hard lump around the anus.
- There is rectal bleeding from the hemorrhoids.
If symptoms do not improve with home treatments within a few weeks, your doctor may recommend medical interventions such as surgical procedures or other treatment options. Book your consultation now with our Gastroenterology Department for a thorough evaluation and appropriate treatment.
References
- Pubmed - Perianal Diseases in Pregnancy and After Childbirth: Frequency, Risk Factors, Impact on Women's Quality of Life and Treatment Methods
- Mayo Clinic - Symptoms & Causes of Hemorrhoids
- Webmd - What to Do if You Have Postpartum Hemorrhoids
- Healthdirect - Haemorrhoids - treatments, symptoms and complications
