What are haemorrhoids?

Haemorrhoids (also known as ‘piles’) are swollen varicose veins located around the anus. Haemorrhoids are a common condition in pregnancy, with up to 1 in every 4 pregnant women affected.

Haemorrhoids can be internal, which generally don’t cause pain, but at times can cause minor bleeding. Haemorrhoids can also be external if the veins swell and become visible from the outside. Signs of external haemorrhoids include bleeding, pain when using the toilet and itchiness. If you see blood on your toilet paper or on your faeces (poo), it is important to speak to a doctor. It might be the result of haemorrhoids, but it could also signal a more serious condition

What causes haemorrhoids during pregnancy?

Haemorrhoids are caused by a reduction in the tone of anal canal cushions, which control your bowel movements.

During pregnancy, haemorrhoids can be triggered by an increase in pressure on your rectal veins. This can result from your uterus enlarging, pressure from your growing baby, and increased blood flow. All of these occurrences increase the pressure on the veins around your anus as pregnancy progresses. Further, straining on the toilet because of constipation can trigger or worsen haemorrhoids.

Straining on the toilet because of constipation can trigger or worsen haemorrhoids.

When am I more likely to experience haemorrhoids during my pregnancy?

Haemorrhoids are most likely to occur during the second and third trimesters of pregnancy. As your pregnancy progresses, haemorrhoids are triggered by a growing uterus, hormonal changes, constipation or blood flow changes.

Am I more likely to experience haemorrhoids if I had them before pregnancy?

Not everyone with haemorrhoids has symptoms, so if you first experience haemorrhoids during pregnancy, you may not know whether this is the first time you’ve experienced haemorrhoids.

How are haemorrhoids treated during pregnancy?

Because constipation worsens haemorrhoids, treatment options centre around preventing or managing constipation, or reducing pain associated with haemorrhoids.

Treatment options include the following:

• Lifestyle changes — having a diet high in fibre and drinking lots of water will help ensure you don’t need to strain on the toilet. External haemorrhoids can be treated by placing an icepack on the affected area to reduce swelling. Taking a warm bath may also help to reduce the pain.
• Laxatives — these help ease any straining associated with constipation. They help you pass bowel movements more easily.
• Pain relief medicine — paracetamol can help address pain associated with sore, swollen veins, and can be taken during pregnancy. Be sure to follow the directions for use.
• Haemorrhoid creams — help address itchiness, pain or inflammation, and contain active ingredients such as corticosteroids or local anaesthetics.

Speak with a health professional such as pharmacist before using medicines or creams while pregnant.

Avoiding constipation is the best way you can reduce your chance of haemorrhoids. A healthy gut helps stop you from straining during a bowel movement. Eat a diet high in fruit, vegetables and wholegrains, and drink plenty of water.

Could haemorrhoids be a sign of something more serious?

If you think you might have haemorrhoids, it is important to tell your doctor. This is because symptoms such as bleeding from your bowel or anus can be a sign of more serious conditions such as bowel cancer.

Will haemorrhoids affect my baby?

Some women are concerned that haemorrhoids might affect their pregnancy or their baby, but there is no evidence to support this. However, there is some concern that the pushing process during labour and birth can worsen your haemorrhoids. Speak to your midwife if you are concerned about haemorrhoids during your pregnancy or birth.

Will haemorrhoids continue after I’ve had my baby?

In most cases, haemorrhoids go away after your baby is born. While regular treatment of haemorrhoids is encouraged during breastfeeding, it is especially important to drink plenty of water at this time to prevent constipation. If you find that your haemorrhoids do not get better even a short time after giving birth, speak to your doctor about further treatment.

Where to get help

If you have more questions about haemorrhoids during your pregnancy, you can consult with:

• your doctor or midwife
• an obstetrician
• an accredited dietitian