Managing Hemorrhoids During Late Pregnancy: Tips and Treatment Options

Late pregnancy

Hello doctor, I am about 30 weeks pregnant.
I usually don't have constipation, but I have been dealing with external hemorrhoids that are quite large.
I have been using hemorrhoid cream, but it doesn't seem to help much.
I had both internal and external hemorrhoids before pregnancy, and now in the later stages of pregnancy, the external hemorrhoids seem to have worsened.
What other methods can I use to improve this condition? If they are too large, will I need to have them surgically removed after giving birth? Thank you.

Jessica, 30~39 year old female. Ask Date: 2014/03/05

Dr. Lin Wenbin reply Obstetrics and Gynecology

It's advisable to wait and see after giving birth.
Generally, hemorrhoids caused by pregnancy may resolve within six months postpartum.
Whether or not to proceed with surgery can be assessed after this observation period.

Reply Date: 2014/03/05

More Info

Managing hemorrhoids during late pregnancy can be a challenging experience, especially as the body undergoes various changes that can exacerbate this condition. Hemorrhoids, which are swollen veins in the lower rectum and anus, can become more pronounced during pregnancy due to increased blood volume, hormonal changes, and pressure from the growing uterus. Here are some tips and treatment options to help manage your symptoms effectively.

1. Dietary Changes
One of the most effective ways to manage hemorrhoids is through dietary modifications. Increasing your fiber intake can help prevent constipation, which is a common issue during pregnancy. Aim for a diet rich in fruits, vegetables, whole grains, and legumes. Foods high in fiber can soften stools and make them easier to pass, reducing strain during bowel movements. Additionally, drinking plenty of water (at least 8-10 glasses a day) can help keep your stools soft.

2. Regular Exercise
Engaging in regular, moderate exercise can promote healthy digestion and reduce the likelihood of constipation. Activities such as walking, swimming, or prenatal yoga can be beneficial. However, always consult with your healthcare provider before starting any new exercise regimen, especially during pregnancy.

3. Sitz Baths
Taking sitz baths can provide relief from the discomfort associated with hemorrhoids. Soaking the affected area in warm water for about 10-15 minutes several times a day can help reduce swelling and relieve pain. Ensure the water is warm but not hot, as excessive heat can worsen the condition.

4. Topical Treatments
While you mentioned using a hemorrhoid cream, it may be worth trying different over-the-counter options that contain ingredients like witch hazel or hydrocortisone. These can help reduce inflammation and provide temporary relief from itching and discomfort. However, consult your healthcare provider before using any new medication, especially during pregnancy.

5. Avoid Straining
When using the bathroom, try to avoid straining, as this can worsen hemorrhoids. If you feel the urge to go, don’t delay, as prolonged sitting on the toilet can increase pressure on the rectal veins. Consider using a footstool to elevate your feet while sitting on the toilet, which can help facilitate easier bowel movements.

6. Consult Your Healthcare Provider
Since you have a history of hemorrhoids and they seem to be worsening, it’s essential to discuss your symptoms with your healthcare provider. They can assess the severity of your condition and recommend appropriate treatments. If your hemorrhoids are significantly large or painful, they may discuss options such as rubber band ligation or other minimally invasive procedures post-delivery.

7. Postpartum Care
If your hemorrhoids do not improve after childbirth, or if they become more severe, surgical options may be considered. Many women find that their hemorrhoids improve significantly after delivery, but if they persist, a consultation with a specialist may be necessary.

Conclusion
Managing hemorrhoids during late pregnancy requires a combination of dietary changes, lifestyle adjustments, and possibly topical treatments. It’s crucial to maintain open communication with your healthcare provider to ensure that you are taking safe and effective measures to alleviate your symptoms. Remember, while hemorrhoids can be uncomfortable, they are a common issue during pregnancy, and with the right approach, you can find relief.

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