The incidence of hemorrhoids among the adult population according to various reports is 10-20%. While pregnant women hemorrhoids occurs much more often.
Hemorrhoids is a pathological increase in venous plexus of rectum. Venous plexus of the rectum are called hemorrhoidal (the name of the disease that occurs when they lose). This type of structure of the vascular network is highly characteristic to the finite divisions of blood supply of our body. Hemorrhoids veins included in the hemorrhoidal plexus dilate and lose their elasticity – this leads to hemorrhoids.
Physiological features of the rectum are as follows: during the act of defecation or in the accumulation of faeces, the rectum undergoes significant stretching, which can lead to irreversible damage to blood vessels of this organ. Also due to the nature of the location in the blood vessels of the rectum constantly collects venous blood (blood stasis). A particularly strong stagnation of blood in the rectum occurs in the sitting position or when stationary.
Causes of hemorrhoids in pregnant women
- Chronic constipation. In chronic constipation increases the tension and stress of the walls of the rectum during defecation, which in turn leads to the formation of hemorrhoids.
- In pregnant women the frequency of constipation is much higher, mainly due to the decrease of the tonus of the intestine during pregnancy.
- Sedentary lifestyle. Physical inactivity (sedentary lifestyle) contributes to the stagnation of blood in the venous plexus of the rectum, which eventually leads to thrombosis and formation of hemorrhoids. Pregnant women, because of their condition, forced to more or less sedentary lifestyle and therefore the risk of development of hemorrhoids is much higher than other people.
- Violation of blood circulation in the lower half of the body is quite common for pregnant women. During pregnancy, the growing uterus compresses the inferior Vena cava, which leads to stagnation of blood in the veins of the legs and rectum. During childbirth intra-abdominal pressure in women increases very much – this may be a cause of hemorrhoids after giving birth.
Stages of hemorrhoids in pregnant women
The risk of developing hemorrhoids increases as pregnancy progresses. Especially hemorrhoids often occurs in the third trimester of pregnancy or after childbirth, however, the occurrence of hemorrhoids in the I or II trimester of pregnancy is not excluded.
Development of hemorrhoids is as follows: under the influence of the factors described above, there is a gradual dilation of blood vessels hemorrhoidal (cavernous) plexus of the rectum. The stretching of the veins higher in the period of pregnancy. Expanding the walls of the veins of the rectum lose elasticity over time, this leads to the formation of bulging veins under the mucous membrane.
Hemorrhoids 1 stage: when hemorrhoids protrude only into the lumen of the rectum and out of anal hole. With the development of the disease hemorrhoids grow and begin to SAG from the anus.
Hemorrhoids stage 2: is characterized by the sagging of hemorrhoids from the anus, which, however, reduce back to your rectum when you change body positions.
Hemorrhoids stage 3: in pregnant women hemorrhoids SAG out of the anus and not reduce into the rectum when changing body positions.
Symptoms of hemorrhoids in pregnant women
Hemorrhoid symptoms depend on the stage of the disease. The above-described stage can be divided into internal (first stage) and external hemorrhoids (the second and third stages). When internal hemorrhoids symptoms expressed little, and the main symptom is sagging hemorrhoids from the anus is missing. At this stage of the hemorrhoids in pregnant women may have pain during defecation, bleeding, or small traces of fresh blood in the stool, itching and discomfort in the anal area.
When external hemorrhoids are the main symptom of the disease is considered to be sagging out of the anus of crimson red nodes. Can SAG only one node, can multiple nodes. This characteristic allows to distinguish hemorrhoids from other diseases, the initial symptoms of which can resemble hemorrhoids (for example, the crack of the anus). Because of sagging hemorrhoids walking and sitting become extremely painful, severe pain occur during defecation.
Particularly severe symptoms of hemorrhoids in pregnant women occur during the infringement hemorrhoids: severe pain in the anal area, fever. In such cases, strictly necessary access to a doctor surgeon.
Diagnosis of hemorrhoids in pregnant women
Pain, itching, discomfort and slight bleeding from the rectum during pregnancy gives the doctor the right to suspect hemorrhoids. Hemorrhoids in pregnant women most often develop in the third trimester of pregnancy or after childbirth (postpartum hemorrhoids).
The appearance of hemorrhoids that SAG out of the anus, enables accurate diagnosis of hemorrhoids, however, even in this case, an additional examination of a pregnant woman – it allows you to set the stage hemorrhoids and to distinguish it from other diseases (or the presence of other diseases with similar symptoms).
To clarify the diagnosis is carried out digital examination of the rectum. The doctor may feel internal hemorrhoids, to assess their location, size, quantity. Digital examination of the rectum to determine the presence of cracks rectum (the disease often accompanies hemorrhoids, has similar symptoms, but treated otherwise).
Accurate diagnosis hemorrhoids in pregnant women is important in the correct treatment assignment, which, as we show below, is in strict dependence on forms (stages of hemorrhoids). Hemorrhoid treatment pregnant Hemorrhoids develops slowly. Simultaneously with the progression of the disease is complicated and its treatment.
If the initial asymptomatic stage of hemorrhoids can only be treated through correction of diet and special hygienic regime, the later stages of the disease require combined medication and severe cases of hemorrhoids can be solved only through surgical operations. Below we describe methods of treatment of hemorrhoids depending on the severity of the disease.
Treatment and prevention of hemorrhoids in pregnant women
Unfortunately, diagnosis asymptomatic hemorrhoids is rare. Due to the fact that all pregnant women are at greater risk of developing hemorrhoids, prevention is advantageously carried out throughout pregnancy without waiting for the appearance of disease symptoms.
Prevention of hemorrhoids is quite simple: normalization of stool (elimination of constipation). Pregnant women often suffer from constipation, and constipation are known to be one of the main factors in the development of hemorrhoids.
For the prevention and treatment of constipation need to adjust the diet: food is added to more foods containing crude fiber (vegetables, fruits, grains, cereals, prunes). In the process of digestion and beneficial lactic-acid products. Meat and other food with rich protein content on the contrary predisposes to the development of constipation. You should also abandon the excess fats, coffee, hot spices.
Hygiene hemorrhoids – this is an important measure of prevention of hemorrhoids in pregnant women. To prevent hemorrhoids, it is recommended to wash the perineum and anus after each defecation once a day can be performed sitz baths with antiseptics (camomile tea, weak solution of potassium permanganate, etc.)
Treatment of hemorrhoids the second stage in pregnant women include prescription medicines. Can be used two types of drug treatment: local and systemic. In the case of pregnant women, local (topical treatment) system is preferred.
Local application of drugs reduces the risk of side effects, increases treatment efficiency and reduces the negative impact of treatment on the fetus. Today, there are a large number of various drugs for local treatment of hemorrhoids. The final choice of drug and method of its application and tactics of treatment prescribed by the attending physician, watching a pregnant woman.
Usually ant hemorrhoid drugs are available in the form of suppositories or creams. The composition of these drugs (Gepatrombin G) includes the following components: a vasoconstrictor, local anesthetic medication and anti-inflammatory component.
Surgical treatment of hemorrhoids treatment is carried out at late stages and is appointed in cases when a pregnant woman is already a prolapsed hemorrhoid that cannot be reduced in the lumen of the rectum. Another indication for surgery is the presence of acute complications of haemorrhoids: haemorrhoid infringement, the node necrosis, acute inflammation. Surgical treatment of hemorrhoids is performed using various surgical techniques.
In the case of hemorrhoids pregnant surgery can be postponed for the period after childbirth and during pregnancy to undergo conservative treatment.