Piles and pregnancy

In certain populations, up to 85% of pregnancies are affected by Piles in the 3rd Trimester1.

What are piles?2

Piles, or haemorrhoids, are often described as varicose veins in your bottom, and can be painful. There are several pad-like blood vessels in your anal canal. Your anal canal is the short tube that connects your back passage (rectum) with your anus.

The blood vessels can become swollen and may hang down during or after you have gone to the toilet. You may be able to feel them as small, soft lumps just inside or around the edge of your bottom.

Other symptoms that you may notice are:
  1. Bright red blood after you've been to the toilet. You may see some of this when you wipe your bottom, too.
  2. Itching around your bottom.

Why do pregnant women get piles?2
When you're pregnant, the volume of blood circulating round your body increases. At the same time, high levels of the hormone progesterone relax the walls of your blood vessels.

The veins below your uterus (womb) are more likely to become swollen and stretched, as the weight of your growing baby puts pressure on them. This is why you're more prone to piles and varicose veins when you're pregnant. Constipation, another pregnancy bugbear, can also cause piles.

You may also develop piles when you give birth, during the stage when you push out your baby. It's thought that about one in five mums has piles the day after giving birth. They often disappear in the weeks after you've had your baby.

Piles are very common during pregnancy. If you have had them before you became pregnant, you may get them again. Plenty of women, though, have them for the first time while they're pregnant.

Although piles are the most common cause of bleeding, any bleeding from your bottom should be checked by your doctor.

Can I avoid getting piles?2

Yes. Although piles are common in pregnancy, they're not inevitable. Your best tactic is to make sure that you don't become constipated, so that when you go to the toilet it is quick and easy.

The following tips will help you:
  • Eat a high-fibre diet, including wholemeal bread, pasta and brown rice, and plenty of fruit and vegetables.
  • Drink between six and eight glasses of water per day to avoid dehydration.
  • Try to exercise regularly, even if you only have the time and energy for a short, brisk walk.
  • Go to the loo straight away when you get the urge. Waiting can make your faeces harder and drier.
  • Try putting your feet up on a stool when going to the toilet. It may make opening your bowels easier.

If you still have constipation after trying these tips, you could ask your GP or midwife to prescribe a bulk-forming laxative that is safe to take during pregnancy.

Doing pelvic floor exercises daily may help prevent piles from developing. These exercises increase circulation around your bottom and strengthen the muscles in your vagina and perineum. (Doing the exercises will also help you when you give birth and speed up your recovery afterwards.)

How can I treat piles?2
The steps outlined above will help ease your piles. But you'll probably need to try other treatments as well:
  • Take warm baths to ease the itching and pain. Resist scratching your bottom, as it can make things worse.
  • Use a cold compress, such as an ice pack, to relieve the pain around your bottom.
  • Gently and thoroughly clean the affected area after you've gone to the toilet
  • Wiping with moist toilet wipes can be more comfortable than using toilet tissue. Patting rather than rubbing dry is best.
  • Try pushing the piles gently back into your rectum with a clean finger when you are having a bath or in the shower.
  • Use OTC medications such as Anusol which is effective to relieve the symptoms of piles.

After your baby is born, use a bidet to wash your bottom. If you don't have a bidet, you can set one up yourself. Put a clean plastic washing-up bowl of warm water on a chair that you are comfortable sitting astride. Wash the area after you have gone to the toilet and pat it dry carefully. When you've healed enough to wipe, use unscented, white toilet tissue. This type of tissue is less likely to irritate your skin than coloured, scented types.

If sitting down is really painful, you could try using a specially shaped, inflatable cushion.

You can also ask your midwife or GP to prescribe gentle ointments or suppositories to soothe your bottom. There are many products on the market to relieve piles, but check first that they are safe for you to use.

If creams and suppositories don't help, severe cases can be treated with:
  • Banding, where a type of rubber band is placed around the base of the haemorrhoid. This cuts off the circulation to it, making it shrivel and drop off.
  • Injection with chemicals that cause the haemorrhoid to shrink and drop off.
  • Laser coagulation
In most cases, piles will simply shrink or disappear as your body recovers after your baby's birth.

  1. Motherisk Update. Hemorrhoids in pregnancy. Vol 54: February 2008
  2. http://www.babycentre.co.uk/pregnancy/antenatalhealth/physicalhealth/piles/
Last reviewed: December 2009

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