Treatment of hemorrhoids during pregnancy

Causes of hemorrhoids in pregnant women

The main cause of hemorrhoids in pregnant women remains poor nutrition and lack of physical activity. As a rule, these conditions provoke weakening of the vascular walls even in absolutely healthy people. A number of changes occur in the body of pregnant women, which include:

increase in circulating blood volume;
a decrease in the contractility of all abdominal organs under the influence of progesterone (this is a kind of protective reaction that prevents premature birth);
change in the position of the rectum;
compression of organs and blood vessels by the enlarging uterus.

Such processes lead to poor circulation and congestion. In addition, defecation is also difficult - when going to the toilet, a woman has to push hard to empty her bowels.

The changes listed above in 50% of cases initiate pathological dilatation of the veins in the rectum. To completely get rid of this phenomenon, treatment of hemorrhoids during pregnancy should begin in the early stages.

How to treat hemorrhoids during pregnancy 3rd trimester, surgical methods

In advanced stages of hemorrhoids, drug treatment does not make any sense, so surgical intervention is performed. Also, modern clinics use minimally invasive procedures that do not require long-term rehabilitation in a hospital setting.

Symptoms of hemorrhoids during pregnancy by stage

In the first trimester of pregnancy, hemorrhoids in most cases do not bother a woman, but from the 20th week there is a sharp increase in symptoms. This is due to limited mobility and significant weight gain. At the first stage of the disease, a woman may feel slight discomfort in the rectum, as well as pain during bowel movements. If constipation occurs or the stool is too hard, drops of blood are released from the rectum. Such symptoms sometimes subside for several days or even weeks and then return.

When moving to the next stage, hemorrhoids, the treatment of which during pregnancy requires special safety measures, are characterized by an expansion of symptoms due to itching and mucus discharge from the anus. A similar picture is observed with inflammation of the nodes. In addition, after defecation, a woman may notice prolapsed nodules that quickly fall into place without repositioning.

The third stage of hemorrhoids in pregnant women differs from the previous ones in the exacerbation and intensification of symptoms that were observed previously. Thus, pain occurs not only during bowel movements, but also while sitting, standing up abruptly, or when walking. Hemorrhoids that fall out during bowel movements do not return to their original position - manual reduction is required. Bleeding appears more often and becomes more profuse.

The fourth stage of hemorrhoids becomes the most difficult for a woman. If the symptoms characteristic of the previous stage of the disease persist, the woman feels significant discomfort, since the nodes protruding out of the rectum can no longer be adjusted manually. In addition, blood clots begin to form. This process is accompanied by nagging or bursting pain, severe burning and intense bleeding. Often, at stage 4, treatment of hemorrhoids during pregnancy is only possible through thrombectomy.

Treatment methods for hemorrhoids during pregnancy

During pregnancy, hemorrhoid treatment methods are selected taking into account the fact that drugs and procedures can affect the fetus a woman is carrying. First of all, the emphasis is on safety for the child and the absence of a significant effect on the course of pregnancy.

It is possible to achieve positive dynamics in hemorrhoids using the following methods:

Dieting.
Performing exercise therapy exercises selected taking into account the fact that the woman is pregnant.
Drug therapy.
Minimally invasive and surgical treatment methods are used only in the presence of strangulation of prolapsed nodes, heavy bleeding or acute inflammation of hemorrhoids.

Drug treatment - what drugs can be used by pregnant women

Drug treatment of hemorrhoids during pregnancy is used mainly from the second stage of the disease. A prerequisite is an integrated approach to therapy. Medicines are used both topically and orally.

The main groups of medications used, approved for use during pregnancy:

suppositories and ointments with anesthetics;
laxatives in the form of suspensions or suppositories;
anti-inflammatory ointments and suppositories;
venotonics in the form of tablets, ointments and suppositories;
preparations for topical use with heparin.

The most effective drugs that combine anti-inflammatory and analgesic properties that reduce the risk of blood clots are Hepatrombin G, Relief Advance and Detralex, Phlebodia 600. They are recommended to be taken from the second trimester of pregnancy and only with the approval of the attending physician. Among laxatives, preference should be given to Duphalac, Regulax or Forlax.

For hemorrhoids in pregnant women, you cannot use suppositories and ointments with belladonna extract - Anuzol and Bellatamine.

Exercises for hemorrhoids in pregnant women

Physical exercises for hemorrhoids in pregnant women are designed to significantly improve blood flow in the pelvic area and improve intestinal motility. All this will eliminate or reduce congestion.

Basic exercises:

Swing your legs forward and backward and left and right. It is performed in a standing position, with mandatory support, especially in the last trimester of pregnancy.
Walking with high knees.
Tilts the body to the sides.
The Kegl complex is a rhythmic contraction of the anus with a delay of several seconds in a tense state.

The duration of each exercise is no more than 5 minutes, the entire complex is about 20 minutes. In the last trimester, it is allowed to reduce the time to 3 minutes for one exercise and 15 minutes for the entire complex.

Diet as a method of preventing hemorrhoids during pregnancy

Following a diet is the first recommendation that doctors give to a pregnant woman if hemorrhoids already exist or are threatening to develop. A diet that provides the body of mother and child with the necessary vitamins and microelements, without causing constipation and diarrhea, greatly increases the chance of bearing a child without complications such as hemorrhoids - treatment during pregnancy and after it may not be required at all.

It is recommended to include more foods containing coarse plant fibers (fiber) in your diet. The richest sources of it are considered to be cereals, vegetables and fruits, various cereals and prunes. Dairy products are also beneficial for the expectant mother and her baby, especially kefir, cottage cheese and other fermented milk products. To meet protein needs, it is recommended to use lean meat, legumes, and fish.

It is worth excluding from the menu foods and dishes that irritate and weaken peristalsis: hot seasonings, coffee, fats (especially animal fats), fatty meats and baked goods.

Folk remedies for hemorrhoids in pregnant women

To reduce symptoms and if it is impossible to use medications, a woman can use folk remedies. Most likely, it will not be possible to achieve effective treatment of hemorrhoids during pregnancy with their help, but they will help reduce painful manifestations.

Applications of sea buckthorn oil to the perianal area and directly to prolapsed nodes are considered the safest and at the same time useful. They will help reduce inflammation. Homemade ointments and suppositories with honey have a similar effect.

It is not advisable for pregnant women to use sitz baths with herbal decoctions, as this risks introducing microorganisms into the genitals.

Treatment

1. Lifestyle changes:

Following a diet rich in fiber, fruits and vegetables:
Foods rich in fiber are recommended: wholemeal bread (it is advisable to replace white bread with wholemeal baked goods;
It’s better to start the day with whole grain porridge or bread);
fruits and vegetables: these should be included in the diet at least four times a day, as well as dried fruits (dried apricots, prunes, figs and dates).

Increasing physical activity, including physical therapy.

Compliance with the rules of sanitary hygiene (use of wet toilet paper and napkins, washing after stool, etc.).

2. Drug therapy:

In most cases, hemorrhoids are diagnosed not independently, but by specialists. It is the doctor who makes the diagnosis: “hemorrhoids” in pregnant women; How to treat this disease is also determined by a specialist. First of all, treatment should be aimed at stopping bleeding, eliminating thrombosis of hemorrhoids, relieving pain and eliminating the inflammatory process. Complex drug treatment is carried out using suppositories, ointments and tablets, it begins with solving the main problem: how to choose the optimal effective remedy for hemorrhoids for pregnant and lactating women.

Systemic drugs:

To eliminate inflammation, the following are used: non-steroidal anti-inflammatory drugs (Diclofenac, Xefocam, etc.), glucocorticosteroids (in the form of ointments), phlebotropic drugs that increase the tone of the veins and improve microcirculation (Detralex, Glivenol, Venoruton).

Why do you need to see a doctor for hemorrhoids in pregnant women?

A pregnant woman must take care not only of herself, but also of her unborn child. Hemorrhoids, even at the first stage of the disease, can harm both the mother and the fetus. Thus, even minor bleeding, which occurs already at the first stage of the disease, can provoke iron deficiency anemia. This condition, if left untreated, can affect fetal development and future health.

In addition, hemorrhoids are a source of inflammation, which, in the absence of therapy or if the treatment is incorrectly prescribed, can spread to neighboring tissues and organs. This poses a direct threat to the condition of the fetus, because the uterus is almost close to the rectum.

To avoid the risk of pathologies in the fetus, a woman is recommended to inform either the gynecologist managing the pregnancy about the problem of hemorrhoids, or contact a proctologist.

Therapy for hemorrhoids in pregnant women

When choosing a drug for the treatment of a pregnant or lactating woman, its safety should be taken into account both for the patient herself and for the fetus and newborn. In the first trimester of pregnancy, primarily NSAIDs and glucocorticoids are contraindicated, both in systemic therapy (for oral administration) and for local use, as well as systemic drugs for the treatment of hemorrhoids. In the II-III trimester, postpartum period, during breastfeeding, limited use of drugs is possible, both in the form of tablets and locally: in this case, suppositories or ointment for hemorrhoids are prescribed for pregnant women, taking into account the risk/benefit ratio.

Local therapy

: Local treatment is prescribed to relieve pain and inflammation. Among the many drugs existing on the pharmacological market, the drug Procto-Glivenol® currently deserves special attention. The drug contains tribenozide and lidocaine: tribenozide relieves inflammation, improves microcirculation and increases vascular tone, lidocaine reduces pain, eliminates itching and burning. Procto-Glyvenol® is available in the form of rectal suppositories and rectal cream. With the use of the drug, especially with complex treatment, when both cream and suppositories for hemorrhoids for pregnant women are simultaneously used, on the 7th day the main symptoms of the disease, such as bleeding, pain, itching, decrease, and on the 15th day of treatment symptoms of the disease disappear in 92.9–97.6% of cases.

Procto-Glyvenol

® is the drug of choice for the conservative treatment of hemorrhoids and the prevention of its complications during pregnancy and the postpartum period.