Piles during pregnancy

Piles is a condition where there are collections of inflamed tissues in the anal area. Piles are otherwise known as haemorrhoids. The tissue collection normally contains blood vessels, support tissue, muscle, and elastic fibres. These swollen tissues can be present in different sizes and they may be found internal or external of the anal canal. Internal piles are normally located above the opening of the anus, and they are the more common type. External piles occur on the outside edge of the anus and when the tissue swelling aggravates, they may hang out of the anus after passing a stool. Piles are being a common occurrence during pregnancy. 25% to 35% of pregnant women develop piles during their third trimester. Chennai laser gastro, being the best piles hospital in the city, takes ultimate care on treating piles for pregnant people by having the best lady doctor for piles in the city.

There are 3 factors that may contribute towards developing piles during pregnancy:-

1. The body produces high levels of the hormone progesterone which makes the walls of the blood vessels relax for better blood circulation required during pregnancy. This can make the blood vessels swell.
2. The pressure of the growing baby in the uterus makes the veins under to swell and stretch. This adds to the pressure on the vessels surrounding the rectum and anus to get inflamed as well.
3. As the foetus grows, the pressure over the rectum and anus slows down the bowel movement leading to constipation. The continuous strain while passing stools due to constipation may result in piles.

Symptoms of pregnancy - time piles :

• Itching, aching, soreness or swelling around the anus
• Pain when passing a stool with a mucus discharge afterwards
• A lump hanging outside the anus, which may need to be pushed back in after passing stools
• Painless bleeding after passing a stool
• Feeling of fullness in the rectum even after defecation

Home remedies for piles in pregnancy :

• Warm baths help ease the itching and pain. Resist scratching the anal area as it can worsen the condition.
• Use a cold compress, such as an ice pack, to relieve the pain around the anal region.
• Clean the affected area gently and thoroughly after using the toilet
• Using chemical-free moist toilet wipes to clean the area can be more comfortable than using toilet tissue. Avoiding scented soaps, talcum powders and even scented toilet wipes is better as the chemicals causing the scent can aggravate piles and thus cause more trouble than relief.
• Patting the anal area with a clean soft towel rather than rubbing dry is best.
• Piles that hang outside the anus should be gently pushed back into the rectum with a clean finger. A lubricating jelly can be used to make it easier.
• Sleeping on the left side may ease the pressure on the abdomen thus giving relief from pain due to piles.
• Putting the feet up on a stool when using the toilet may make opening your bowels easier.
• Sitting on a pillow or waffle cushion to relieve pressure on the rectum or sitting in a rocking chair or recliner may also be more comfortable than sitting in a straight chair.
• Loose-fitting cotton clothes are suggested for easy breathing of the rectum area and pain relief from piles while pregnant.

How to avoid piles during pregnancy?

• Waiting to pass motions can make faeces harder and drier. It is advisable to pass stools as early as the urge arises.
• Ensure to have loads of fluids like soups, broth and juices apart from plain water to keep the bowel movements smooth and easy.
• Have a balanced diet with fruits, green vegetables and other foods rich in fibre such as wholemeal bread, brown rice and cereals again for an easy and smooth bowel moment.
• Constipation is one of the key factors of piles during pregnancy, avoid constipation by staying hydrated and eating a healthy diet. Avoiding oily and spicy food can help prevent constipation.
• Exercise as simple as a daily walk is a must in pregnancy to digest what is eaten so as to allow an easy bowel movement.
• Guided pelvic floor exercises to strengthen pelvic muscles help in preventing constipation as well as having a normal delivery.
• Sitting for too long on the toilet seat or straining much on the toilet seat can cause undue pressure on the rectal and anal tissues. If the pressure to pass stools in the first 10 minutes is not felt, then to try later on the feel of the slightest pressure would be right.

How To Treat Piles During Pregnancy?

Piles commonly appear during the last trimester of pregnancy and may disappear completely after pregnancy and delivery without any treatment as hormone levels, blood volume, and intra-abdominal pressure decrease after delivery. Hence, weighing the risks of medical intervention during pregnancy, some prominent conservative piles treatment options that can be considered under medical advice from the gynaecologist to provide immediate relief from symptoms of piles are :

• Soaking in a bath with witch hazel or Epsom salts will ease discomfort.
• Medicated pads can bring some relief from symptoms of piles.
• Stool softeners which are a type of laxatives can also help in giving smooth bowel movements, as constipation is one of the major factors of piles.
• Topical medications such as creams and ointments which include safe pain-relieving or anti-inflammatory ingredients can be effective.
• Prescription oral treatments may be useful but have to be taken with caution.

Inflamed tissues of the piles can be shrunk without invasive treatments or manage symptoms until delivery, but certain invasive procedures may be necessary in some cases. Piles are often at their worst during the third trimester. If the problem does not emerge until after week 27 or 28, it is better to determine if it can wait until after birth. This decision is dependent on the specific details of the case.

Painful haemorrhoids that do not respond to other, more conservative treatments and cases that present with uncontrolled bleeding leading to complications such as anaemia during pregnancy may require such interventions. A proper evaluation of such cases is the foremost to decide on the right choice of treatments. In case of any surgical intervention, there may be a need for a c-section or other changes in the birth plan.