Hemorrhoids after childbirth

Causes of hemorrhoids after childbirth

By itself, hemorrhoids are varicose veins of the rectum. Most often, women face such a problem during pregnancy, as well as after childbirth. Firstly, during pregnancy, a woman’s hormonal background changes greatly, which can lead to a decrease in the tone of the pelvic vessels, and the enlarged uterus compresses them. Due to the increased pressure, the walls of the vessels begin to thin, blood flow is disturbed, cracks and protrusions form. During the birth itself, intra-abdominal pressure greatly increases, due to which the veins of the rectum increase sharply in volume, the walls thicken, forming a hemorrhoid (bump). The problem is exacerbated if during pregnancy the woman led a largely sedentary lifestyle, did not move much, her weight increased greatly, or the woman had frequent constipation, which she did not pay attention to and did not treat them.

It is necessary to distinguish between hemorrhoids in pregnant and postpartum hemorrhoids. In the first case, the woman practically does not experience any unpleasant symptoms, or there are complaints, but they are minor. Most often, hemorrhoids go away after childbirth, but the problem can get worse. Postpartum hemorrhoids occur precisely because of labor pains and strong intra-abdominal pressure, therefore, they need treatment and can greatly affect the quality of life if left untreated.

Symptoms of hemorrhoids after childbirth

Symptoms of hemorrhoids after childbirth directly depend on the form of the disease (internal, external or combined) and its stage.

In the first stage, during a bowel movement, slight bleeding or mucous discharge may occur. A woman may notice itching and discomfort in the anus, but the hemorrhoids themselves do not fall out.

In the second stage, prolapse of hemorrhoids joins with itching, discomfort and bleeding when a woman strains during a bowel movement. At the same time, at the end of the process, the nodes are set back on their own.

In the third stage, hemorrhoids fall out not only during bowel movements, but also during sneezing, severe coughing or during physical exertion, and it is already necessary to set them back manually.

In the fourth stage, hemorrhoids fall out even at the slightest load, and severe bleeding occurs, accompanied by pain. Blood clots form in hemorrhoidal cones, which disrupts blood flow, and gradually the process affects the entire anal area, including the subcutaneous tissue of the anus.

Treatment of hemorrhoids after childbirth

Very often, a young mother is too busy with her baby, so she does not pay due attention to her health and ignores dangerous symptoms, which is why hemorrhoids progress rapidly and require surgical treatment.

Diagnostics

Diagnosis of postpartum hemorrhoids begins with the fact that the proctologist collects an anamnesis, clarifying such risk factors as a sedentary lifestyle, obesity, the presence of hemorrhoids in close relatives, and also asks about the course of pregnancy and childbirth. After that, the doctor finds out what exactly worries the patient, how long ago the pain and itching appeared, whether there is bleeding during defecation, whether hemorrhoids fall out and whether they return on their own, etc.

After the doctor proceeds to the examination: with the help of palpation, he feels the rectum, assesses the condition of the hemorrhoids and determines the form and stage of the disease.

To clarify the diagnosis and exclude other diseases, such as colorectal cancer, the doctor may prescribe an additional examination. It includes colonoscopy (with the help of a special apparatus-colonoscope, the doctor examines the inner surface of the colon) and anoscopy (with the help of an anoscope, the doctor assesses the condition of the anus and rectum). Also, if necessary, a consultation with a gynecologist is appointed.

Modern treatments

– How to treat postpartum hemorrhoids depends on what we find during the examination. Accurate and high-quality examination is the basis of proper treatment. In most cases, this is a conservative treatment, which, however, does not exclude the possibility that the patient will have to be operated on in the future. In a small number of cases, with severe pain, we operate immediately. This allows you to quickly relieve pain. In addition, now everyone is talking about lasers as a kind of panacea, but in reality this is not so. We always select the equipment that is needed, and not the one that is trumpeted by advertising. Since the so-called “postpartum hemorrhoids” are most often thrombosis of external nodes, most often we remove the painful node either with a radio wave scalpel, or with a laser, or with an electric knife, although now world proctology is gradually returning to a conventional scalpel, as the most careful tool, lists proctologist of the highest category, head of the department of proctology of the Medical Center “Family” Artem Bely.

– The anatomical and physiological picture of exacerbation of hemorrhoids after childbirth, in fact, is no different from other hemorrhoids. The clinical manifestations are also identical. But the approaches to treatment are different. This is due primarily to the limitations caused by the consequences of pregnancy, childbirth, as well as the presence of lactation. Not all drugs are approved for use in parturients and nursing mothers. The approach to surgical methods of treatment has recently changed. If earlier the management of this group of patients was as conservative as possible, then recently there have been more and more publications on the use of modern surgical techniques, such as laser technologies, dearterialization, etc. In my opinion, in deciding on the choice of a treatment method, an individual approach plays a decisive role, a thorough assessment of the patient’s condition and the severity of the process, taking into account all risk factors, a competent choice of a method or a combination of them, attentive, thoughtful subsequent management, – explains Eldar Sadretdinov, Ph.D., Surgeon, Proctologist.

Prevention of hemorrhoids after childbirth at home

In general, the prevention of hemorrhoids should be dealt with during pregnancy, and even better – all the time. Pregnant women need to move more often – walk, do simple gymnastic exercises, and also monitor their diet – exclude spicy and salty foods, eat more foods rich in fiber – vegetables and fruits. You also need to be sure to monitor your weight, and if you have constipation, be sure to inform your doctor about it.

– First of all, it is necessary to monitor the stool and prevent constipation, and if they occur, then treat them. The second is to monitor body weight and ensure sufficient physical activity. There is currently no known medical prophylaxis. Only a change in lifestyle, – explains the proctologist of the highest category Artem Bely.

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