Hemorrhoids are varicose veins in the rectum. It can appear both at the very beginning of pregnancy, and during gestation or after childbirth. It is widely believed that it is labor activity that provokes the development of hemorrhoids, but this is a myth, since even a caesarean section often causes an exacerbation. But still, there is a direct connection between the disease and pregnancy, since the bearing of a child is one of the provoking factors.
Causes of varicose expansion
During pregnancy, the uterus increases in size and begins to put pressure on the rectum and colon. In this regard, local stagnation of blood appears, the veins are stretched, hemorrhoids are formed, which protrude under the intestinal mucosa. In general, during the bearing of a child, the vascular system of a woman undergoes quite a lot of stress, since the volume increases by approximately 30%.blood that circulates in the body. As a result, problems such as hemorrhoids and enlarged veins in the legs appear.
Additionally, doctors identify several factors that provoke exacerbation or primary occurrence of hemorrhoids in pregnant women:
- constipation, especially chronic constipation, as the bowel walls are stretched excessively during bowel movements;
- lack of exercise, that is, the lack of movement and feasible physical exertion; if the pregnant woman moves a little, then stagnation forms in the pelvis, which provokes hemorrhoids;
- taking hormonal contraceptives before pregnancy, since most of them negatively affect the condition of the walls of the veins;
- increased intra-abdominal pressure, which is normal for pregnant women, but also causes hemorrhoids;
- extra pounds, especially when combined with lack of physical activity and other provoking factors;
- change in hormonal balance; progesterone causes smooth muscle relaxation, which causes constipation;
- decrease in intestinal tone during childbearing.
Stages of development of hemorrhoids in pregnant women
The risk of developing hemorrhoids is greatly increased in the third trimester and after childbirth, although some women may develop such a problem early in pregnancy. The enlargement of the uterus is physiologically determined, it is normal that by the time of delivery it occupies a large part of the abdominal cavity. Intestine whileis compressed, the rectum changes position, the vessels are pinched, the susceptibility of the muscles, which stimulates the digestive tract, is significantly reduced.
Doctors diagnose "stage I hemorrhoids" when the nodes protrude into the lumen of the rectum, but do not exit the anus. As the disease spreads, they begin to sag, increase. The second stage is characterized by protrusion of hemorrhoids from the anus, but they are set back when the position changes. In the third stage, the nodes no longer enter back into the rectum when changing position. The fourth stage of the development of the disease is complicated by heavy bleeding, thrombosis.
Hemorrhoids can be internal or external. It is not so easy to diagnose internal, because its signs are insignificant due to the small size of the nodes. Sometimes a woman may feel discomfort during emptying and see traces of blood on the toilet paper. As the nodes increase, a feeling of the presence of a foreign body in the intestine, pain during emptying, itching in the anus is added. At this stage, the treatment of hemorrhoids during pregnancy will be most effective.
In the future, the disease develops into an external form. At the same time, bumps appear around the anus, after each bowel movement, a woman may notice heavy bleeding, there is severe itching, burning in the anus, pain during defecation. Treatment of external hemorrhoids during pregnancy is difficult, requires the appointment of special drugs, and sometimes surgicalintervention.
Justification for the need to treat the disease
Hemorrhoids affect almost 8% of women who are not pregnant, about 25% of pregnant women and almost every second woman who has recently given birth to a child. But many pregnant women do not rush to the doctor, believing that this is a normal condition during the bearing of the baby. This is a fundamentally wrong approach that will only harm the he alth of a woman. Hemorrhoids that are not treated can cause a decrease in hemoglobin, diseases of the bones and joints, and the genitourinary system.
Often, the treatment of hemorrhoids during pregnancy is delayed until the woman recovers after childbirth. However, this approach is strongly criticized by many experts: with hemorrhoids, a successful pregnancy can be accompanied by very serious consequences. The combination of the disease and bearing a child leads to a deterioration in the woman's well-being. The more neglected the disease, the harder the expectant mother will endure pregnancy, which can adversely affect the normal development of the fetus.
The lack of treatment of hemorrhoids during pregnancy can lead to inflammation of the hemorrhoids and tissue death, which "opens" the way for all sorts of infections that are dangerous while expecting a baby. In some cases (if the infection enters the blood), even intrauterine infection can occur. Anemia and lack of hemoglobin are even more severe consequences that can cause fetal hypoxia and oxygen starvation. In addition, if not carried outtreatment of hemorrhoids during pregnancy, then immediately after childbirth, the woman's condition can worsen significantly. And this is regardless of the method of delivery.
That is why the treatment of hemorrhoids in pregnancy is necessary. There are, of course, cases where any intervention can harm the fetus, and you need to leave everything as it is. Here the decision should be made by the doctor based on the expected positive effect for the woman and the danger to the child.
Symptoms and diagnosis of hemorrhoids
Symptoms directly depend on the stage of development of the disease. With internal hemorrhoids, the signs are mild, with an internal external symptom, the hemorrhoids sag from the anus. This allows you to distinguish hemorrhoids from other diseases and start therapy. At this stage, many women experience discomfort during bowel movements, itching, burning, slight blood loss or traces of blood. In some cases, the nodes are pinched. The condition is accompanied by very severe pain in the anus and fever. In this case, it is urgent to go to a surgeon.
To clarify the diagnosis, the doctor performs palpation of the rectum. In this case, you can feel the internal nodes, evaluate their number, size and location. Such a study allows you to identify cracks - this condition often accompanies hemorrhoids, has similar symptoms, but is treated differently.
Treatment of hemorrhoids after pregnancy or during the period of bearing a baby is carried out in strict accordance with the severity of the disease. The disease develops slowly, but at the same timeWith the development of hemorrhoids, its therapy becomes more complicated. The initial stages can be successfully treated only by correcting the diet and a special hygiene regimen, while later ones require a combined medical course of therapy. Some cases can only be resolved with surgery.
Prevention of hemorrhoids in pregnant women
Asymptomatic period is rarely possible to determine, so it is advisable to prevent hemorrhoids throughout pregnancy. Preventive measures are very simple. They include the normalization of stools, a change in diet (you need to include more foods that contain fiber, these are cereals, cereals, prunes, vegetables and fruits, which have a beneficial effect on the digestive process and fermented milk products). You need to give up coffee and hot spices, a large amount of fat in food, and also limit the consumption of meat and other foods high in protein, as it predisposes to constipation.
An important preventive measure is hygiene care. It is recommended to wash the area of the anus and perineum after each emptying, once a day you can take baths with antiseptics (a solution of potassium permanganate or chamomile). You also need to give up work that involves a long stay in a sitting position, walk more in the fresh air. Two or three times a day, doctors recommend lying on your back for 15 minutes, raising your pelvis (for convenience, you can put a small pillow).
Treatment of disease during pregnancy
Hemorrhoids of the second degree of severity already require the appointment of special drugs. Treatment of hemorrhoids during pregnancy may include topical therapy and systemic treatment, with local (topical) being preferred over systemic. The fact is that the local effect of drugs reduces the risk of complications, side effects and reduces the adverse effects on the fetus. The final choice in favor of any drug is made by the doctor who observes the pregnant woman. In some cases, surgery is recommended.
Topical treatment of hemorrhoids during pregnancy
Medications intended for topical use include a vasoconstrictor, an anti-inflammatory component and a local anesthetic. As a rule, such preparations are produced in the form of suppositories or creams for local application. For the treatment of hemorrhoids during pregnancy, it is advisable to choose remedies based on natural ingredients. But even some types of natural substances are sometimes banned, so a doctor's consultation is required even in this case.
Candles for the treatment of hemorrhoids during pregnancy at home are suitable for sea buckthorn, Hepatrombin-G, Relief (hemostatic and disinfectant effects), Proctoglivenol, Neo-Anuzol (disinfectant and astringent properties), " Natalsid" (disinfects), "Posterizan" (local immunomodulator). "Anuzol" and "Bellataminal" are contraindicated, which include belladonna extract, which cancause spontaneous abortion. Ointments can be used as follows:
- homeopathic (eg Fleming's ointment);
- regenerating ("Posterizan");
- with analgesic effect ("Luan" or "Emla");
- heparin ointment reduces the inflammatory process and promotes the resorption of already formed nodes, in addition, it has a very mild effect;
- to reduce itching and swelling ("Troxevasin", "Troxerutin");
- "Misvengal" contains many natural ingredients, increases the speed of venous blood flow and reduces swelling, has a local disinfectant and analgesic effect.
Despite the absence of contraindications for pregnant women, find out the best way to treat hemorrhoids during pregnancy (in the 3rd trimester or earlier), preferably with a doctor.
Gymnastics against varicose expansion
Improving bowel function, reducing congestion and increasing muscle tone is facilitated by therapeutic exercises. Here are some useful exercises:
- Standing, you need to stretch your arms in front of you and put your feet shoulder-width apart. Then turn the body to the right (do not take your feet off the floor), take your right hand as far back as possible and take a breath. Then you need to return to the starting position and also make a turn to the right. Repeat five times on each side.
- While standing, raise your hands in front of you, clasp your fingers in the lock. Next, you need to turn the body to the left and right, moving your hands as far back as possible.The exercise should be repeated five times in each direction.
- Sitting on the floor, rest your hands behind you. Then you need to bend your knees and slowly stretch them. At the same time, the heels cannot be torn off the floor. Repeat (as the previous exercises) five times.
- In a sitting position, spread your legs as much as possible, pressing them tightly to the floor, it is advisable not to bend your knees. Bend over and try to touch the left foot with the fingers of the right hand, and the right foot with the fingers of the left hand. You need to repeat the slopes five to seven times. This exercise can only be done in the first and second trimesters if it does not cause discomfort to the expectant mother.
- From the same starting position as in the previous exercise, you need to perform side bends. The opposite hand should be kept on the belt. You need to repeat five times in each direction. Recommended for use only in the first and second trimesters.
Folk remedies for the treatment of hemorrhoids
Treatment of hemorrhoids during pregnancy at home may involve the use of folk remedies. Many methods have no contraindications, but it is still necessary to consult a supervising doctor. Treatment of hemorrhoids during pregnancy with folk remedies involves the use of homemade candles. Potato will do. You need to cut them out of peeled and washed raw potatoes. In size and shape, they should resemble rectal suppositories, which are sold in pharmacies. Such suppositories are inserted into the anus before going to bed.
Natural ointment can be obtained by mixing sea buckthorn oil and honey. This compositionyou can lubricate the nodes that have come out, introduce it into the rectum. Another good remedy is an ointment based on propolis. It is mixed in crushed form with vegetable oil (one to ten) and boiled for about an hour. It is necessary to use the ointment in a chilled form, several times during the day. You can store a natural remedy only in the refrigerator.
Treatment of hemorrhoids during pregnancy with folk remedies can be carried out using sea buckthorn lotions. A bandage or soft cloth should be rolled up in five layers, soaked in sea buckthorn oil and applied to the anus. You can also use sitz baths with garlic or onion peel, which are also effective in the treatment of hemorrhoids during late pregnancy.
Systemic treatment of hemorrhoids in pregnant women
Treatment for hemorrhoids during pregnancy in the 3rd trimester or earlier may involve oral medication. Modern drugs allow not only to quickly cope with the disease, but also to minimize the adverse effect of their use. If it is necessary to carry out general drug therapy, it is better to entrust the specialist with the selection of drugs for the treatment of hemorrhoids during pregnancy. Reviews confirm that no amateur performance is allowed here and can only aggravate the situation.
Diet and lifestyle for varicose veins
Treatment of hemorrhoids during pregnancy at home involves the correction of diet and lifestyle. The daily ration should be divided into three to five meals.in small portions. A he althy diet should contain a sufficient amount of fiber, a minimum of fatty, fried and spicy foods. It is necessary to exclude fast food, soda and canned food, semi-finished products. Dairy products are very useful. Also, drink at least 1.5-2 liters of fluid throughout the day.
We must not forget to do therapeutic exercises, to observe hygiene. After each emptying, you need to carry out an external toilet (cool, but not completely cold water), and with severe hemorrhoids, it is better to abandon toilet paper. You can apply swabs with a cool infusion of oak bark or chamomile. You need to walk more often, while working in a sitting position for a long time, regularly take breaks and change the position of the body.
Surgery and minimally invasive techniques
The operation is performed in the late stages of hemorrhoids and in cases where a pregnant woman has prolapsed nodes that do not retract into the lumen of the rectum. Indications for surgical intervention are complications of hemorrhoids, for example, pinching of the node or an acute inflammatory process. Then this is the only way to eliminate the disease. If possible, doctors still use conservative methods, but such therapy will not cure the disease completely, but only slow its course.
In some cases, it is possible to use minimally invasive methods - these are bloodless or small operations. These include sclerotherapy, which involves the introduction of special preparations that adhere to its walls. Also sometimes carried outligation, in which the knot is pinched with a ring, which causes it to be rejected after seven to ten days. Laser coagulation and infrared photocoagulation are used. In this case, the node is exposed to a laser or high temperature, a burn occurs, which provokes death, the node disappears seven to ten days after the operation.
If the condition of a pregnant woman allows, doctors often postpone all interventions to the postpartum period.
Carrying a child is a wonderful, but quite dangerous and very responsible period in the life of every woman. That is why expectant mothers need to be much more attentive to their own he alth than before. This is now necessary not only for the woman herself, but also for the baby. At the first symptoms of hemorrhoids or other ailments, you should immediately seek medical help. Then the disease can be cured quickly, and complications can be avoided.