Hemorrhoids: Postpartum Concerns and Symptoms

Q: Hemorrhoids: Postpartum Concerns and Symptoms

Hello： Regarding your second question, I would like to share my thoughts： The process of natural childbirth can sometimes result in severe perineal trauma, with rectovaginal fistula being one of its complications. <br>Larger and more obvious fistulas can be detected through a pel

Regarding hemorrhoids?

Hello Dr.
Wang,
I gave birth in August via vaginal delivery and had an episiotomy.
1.
After my one-month postpartum period, I experienced severe constipation and rectal bleeding.
After consulting a doctor, I used a topical ointment, and the bleeding has stopped, but my stool shape has remained abnormal (soft, sometimes poorly formed, but not diarrhea) for two months now (I stopped the medication over a month ago).
Is this normal? Could it be a sign of rectal cancer? 2.
If there is suspicion of a vaginal-rectal fistula, what examinations should be conducted? I look forward to your reply! Wishing you a pleasant day!

vicky, 20~29 year old female. Ask Date: 2004/12/28

Dr. Wang Qichao reply Surgery

Hello: Regarding your second question, I would like to share my thoughts: The process of natural childbirth can sometimes result in severe perineal trauma, with rectovaginal fistula being one of its complications.
Larger and more obvious fistulas can be detected through a pelvic examination or a sigmoidoscopy.
For smaller fistulas, detection can be achieved through lower gastrointestinal imaging or a rectal dye study combined with a vaginal tampon.
As for issues like rectal bleeding, constipation, and changes in stool characteristics, there are many discussions available on the Taiwan e-hospital platform that you can check online.
If you have concerns about rectal cancer, you may consider undergoing a colonography or colonoscopy.
Sincerely, Dr.
Wang Qichao, Surgeon.

Reply Date: 2004/12/28

More Info

Hemorrhoids and related symptoms can be a significant concern for postpartum women, especially after a natural delivery. Given your situation, it’s essential to address both the symptoms you are experiencing and the potential underlying issues.

Firstly, it’s not uncommon for women to experience constipation and rectal bleeding after childbirth, particularly if there was a perineal tear or an episiotomy (side cut) during delivery. The hormonal changes, along with the physical stress of labor and delivery, can lead to changes in bowel habits. The fact that you experienced severe constipation and rectal bleeding, which improved with medication, suggests that hemorrhoids may have been a contributing factor. Hemorrhoids are swollen veins in the lower rectum and anus that can cause discomfort, bleeding, and changes in bowel habits.

Regarding your concern about the shape of your stools, it’s important to note that postpartum women can experience variations in bowel movements due to several factors, including diet, hydration, and physical activity levels. Soft stools that are not well-formed can be a result of dietary changes or insufficient fiber intake. However, if this condition persists, it may warrant further investigation. While it is understandable to worry about serious conditions like rectal cancer, it is relatively uncommon in young women, especially if you have no other alarming symptoms such as significant weight loss, persistent abdominal pain, or changes in appetite.

To address your concerns about potential rectovaginal fistulas (an abnormal connection between the rectum and vagina), it is crucial to consult a healthcare provider. The following tests may be recommended:
1. Physical Examination: A thorough examination by a healthcare provider can help identify any visible signs of a fistula or other complications.

2. Anorectal Manometry: This test measures the function of the rectum and anal sphincter, which can help assess for any abnormalities.

3. Endoscopy: A flexible tube with a camera can be inserted into the rectum to visualize the internal structures and check for any abnormalities.

4. Imaging Studies: In some cases, imaging studies like MRI or ultrasound may be used to evaluate the pelvic area for any signs of fistulas or other complications.

5. Defecography: This specialized X-ray can help visualize how the rectum and anus function during bowel movements.

In the meantime, to manage your symptoms, consider the following recommendations:
- Dietary Changes: Increase your fiber intake through fruits, vegetables, and whole grains to help form more regular stools. Staying hydrated is also crucial.

- Regular Exercise: Gentle physical activity can help stimulate bowel function.

- Over-the-Counter Remedies: Stool softeners or fiber supplements can be beneficial if constipation persists.

- Warm Baths: Soaking in warm water can help relieve discomfort associated with hemorrhoids.

- Follow-Up: If symptoms persist or worsen, it’s essential to follow up with your healthcare provider for further evaluation and management.

In conclusion, while your symptoms may be concerning, they are not uncommon postpartum. However, it is vital to monitor your condition and seek medical advice if you notice any significant changes or if your symptoms do not improve. Your health and well-being are paramount, and addressing these concerns with a healthcare professional will provide you with the best course of action.

Similar Q&A

Postpartum Hemorrhoids: Symptoms, Treatment Options, and When to Seek Surgery

Hello, doctor. I would like to ask about hemorrhoids. I gave birth on May 1st, and afterward, I noticed two small polyps around my anus. They don't hurt when I touch them, but I do see a little blood when I go to the bathroom. I suspect I have developed hemorrhoids. I resear...

Dr. Zhang Shuhao reply Surgery
If there are no specific symptoms during pregnancy and hemorrhoids occur only after delivery, surgery may not be necessary. It is advisable to start with warm sitz baths, use hemorrhoid ointments, and increase fluid and dietary fiber intake to prevent constipation, as these measu...

Severe Anal Pain During Diarrhea: Is It Postpartum Hemorrhoids or Fissures?

Hello, Doctor: I have hemorrhoids and recently gave birth. My obstetrician helped to reduce them. During this time, I had no issues with normal bowel movements and experienced no pain. However, in the past few days, I have suddenly developed diarrhea, and each time I have diarrhe...

Dr. Zhang Shuhao reply Surgery
Hemorrhoids typically cause pain due to thrombosis or when a prolapsed hemorrhoid becomes trapped, leading to impaired blood circulation. Based on your description, it seems more like anal fissures causing pain during bowel movements. In addition to warm sitz baths, topical ointm...

Is It IBS or Hemorrhoids? Understanding Your Digestive Concerns

Hello, doctor. I have a hemorrhoid issue. Over two years ago, I had a severe hemorrhoid episode where I experienced bleeding during bowel movements, along with symptoms similar to irritable bowel syndrome, which made me go to the bathroom multiple times a day. At that time, I con...

Dr. Yang Zhichao reply Gastroenterology and Hepatology
After reviewing, I hope to schedule an appointment for an examination at the outpatient clinic.

Managing Hemorrhoids After Childbirth: Treatment Options and Safety During Breastfeeding

Hello, I have two questions. After giving birth in March, I developed severe internal and external hemorrhoids (3 to 4 swollen areas, with the largest one the size of a ping pong ball, which pops back out immediately after being pushed in). During my postpartum recovery, I was un...

Dr. Ke Fangxu reply Surgery
1. In this situation, I also recommend undergoing traditional hemorrhoidectomy, as conservative treatments such as ligation are not effective for large hemorrhoids that prolapse. The occurrence of anal stenosis typically happens only under special circumstances, such as acute epi...