Hemorrhoids are varicose veins in the rectum. It can appear both at the very beginning of pregnancy, and during the gestation period 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 cesarean section often causes exacerbation. But nevertheless, there is a direct connection between the disease and pregnancy, since bearing a child is one of the provoking factors.
Causes of varicose development
During pregnancy, the uterus increases in size and begins to put pressure on the rectum and colon. In this regard, local blood stasis appears, veins are stretched, hemorrhoidal nodes are formed, which protrude under the intestinal mucosa. In general, during the bearing of a child, the vascular system of a woman undergoes quite large loads, since the volume of blood that circulates in the body increases by approximately 30%. As a result, such problems as hemorrhoids and leg veins appear.
In addition, doctors identify several factors that provoke an exacerbation or primary occurrence of hemorrhoids in pregnant women:
- constipation, especially chronic, since the walls of the intestine are overly stretched during bowel movements;
- lack of exercise, that is, the lack of movement and feasible physical activity; if the pregnant woman does not move much, 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 in combination with a lack of motor activity and other provoking factors;
- change in hormonal balance; progesterone provokes relaxation of smooth muscles, and this causes constipation;
- decrease in bowel tone during gestation.
Stages of hemorrhoids in pregnant women
The risk of developing hemorrhoids increases greatly in the third trimester and after childbirth, although in some women this problem may appear at the beginning of pregnancy. The increase in the uterus is physiologically determined, it is normal that by the time of delivery it occupies a large part of the abdominal cavity. At the same time, the intestines are compressed, the rectum changes position, blood vessels are compressed, the sensitivity of muscles is significantly reduced, which stimulates the digestive tract.
Doctors make a diagnosis of "hemorrhoids of the first stage" in the case when the nodes protrude into the lumen of the rectum, but do not come out of the back opening. As the disease spreads, they begin to sag, increase. The second stage is characterized by protrusion of hemorrhoidal nodes from the anus, however, they are set back when the position changes. At the third stage, the nodes no longer enter the rectum when the position is changed. The fourth stage of the development of the disease is complicated by heavy bleeding, thrombosis.
Hemorrhoids can be internal or external. Internal diagnosis is not so simple, because its signs are insignificant due to the small size of the nodes. Sometimes a woman can feel discomfort during emptying and see traces of blood on toilet paper. As the nodes grow, the sensation 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 bowel movements. Treatment of external hemorrhoids during pregnancy is difficult, requires the appointment of special drugs, and sometimes surgical intervention.
The rationale for the treatment of the disease
Hemorrhoids affect almost 8% of women who are not in a position, about 25% of pregnant women, and almost every second child who has recently given birth. But many pregnant women are not in a hurry to see a doctor, believing that this is a normal condition while carrying a baby. This is fundamentally the wrong approach, which will only harm the health of women. Hemorrhoids that are not treated can cause a decrease in hemoglobin, diseases of bones and joints, and the genitourinary system.
Often, treatment of hemorrhoids during pregnancy is delayed until the woman recovers after childbirth. However, many experts strongly criticize this approach: 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 well-being of a woman. The more neglected the disease, the harder the expectant mother will endure and pregnancy, which can adversely affect the normal development of the fetus.
The lack of treatment for hemorrhoids during pregnancy can lead to inflammation of the hemorrhoids and tissue death, which will “open” the path to all kinds of infections that are dangerous while waiting for the baby. In some cases (if the infection enters the bloodstream), even intrauterine infection can occur. Anemia and a lack of hemoglobin are even more serious consequences that can cause fetal hypoxia and oxygen starvation. In addition, if hemorrhoids were not treated during pregnancy, then immediately after childbirth the condition of a woman can significantly worsen. And this is regardless of the method of delivery.
That is why the treatment of hemorrhoids in pregnancy is necessary. Of course, there are cases when 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, while with an internal external symptom, sagging hemorrhoidal nodes from the anus are. 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 an increase in body temperature. In this case, it is urgent to go to the surgeon.
To clarify the diagnosis, the doctor performs a rectal palpation. In this case, you can probe 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 gestation is carried out in strict dependence on the severity of the disease. The disease develops slowly, but simultaneously with the development of hemorrhoids, its therapy is complicated. The initial stages can be successfully treated only by correcting the diet and a special hygiene regimen, and later stages require a combined medical course of therapy. Some cases can only be resolved through surgery.
Prevention of hemorrhoids in pregnant women
The asymptomatic period is rarely possible to determine, so it is advisable to carry out the prevention of hemorrhoids throughout pregnancy. Preventive measures are very simple. They include normalization of stool, change in diet (you need to include more foods that contain fiber, these are cereals, cereals, prunes, vegetables and fruits, have a beneficial effect on the digestive process and sour-milk products). It is necessary to abandon 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 the development of constipation.
An important preventive measure is hygiene. It is recommended to wash the area of the anal opening and perineum after each emptying, once a day you can carry out baths with antiseptics (a solution of potassium permanganate or chamomile). You also need to abandon work, which involves a long stay in a sitting position, walk more in the fresh air. Two or three times a day, doctors recommend lying on their back for 15 minutes, lifting their pelvis (for convenience, you can put a small pillow).
Treatment of the disease during pregnancy
Hemorrhoids of the second degree of severity already require the appointment of special drugs. Treatment of hemorrhoids during pregnancy may include local therapy and systemic treatment, and local (topical) is preferred to systemic. The fact is that local exposure to medications 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 a doctor who observes a pregnant woman. In some cases, surgical intervention is recommended.
Local treatment of hemorrhoids during pregnancy
The composition of drugs intended for topical use includes a vasoconstrictor, an anti-inflammatory component, and local anesthetic. As a rule, such preparations are available in the form of suppositories or creams for local application. For the treatment of hemorrhoids during pregnancy, it is advisable to choose funds based on natural ingredients. But even some types of natural substances are sometimes banned, so a doctor’s consultation is mandatory even in this case.
Suppositories for the treatment of hemorrhoids during pregnancy at home are suitable for sea buckthorn, “Hepatrombin-G”, “Relif” (hemostatic and disinfectant effects), “Proctoglivenol”, “Neo-Anuzol” (disinfecting and astringent properties), “Natalsid” (disinfects) , "Posterisan" (local immunomodulator). "Anuzol" and "Bellataminal" are contraindicated, which include extract of beladonna, which can provoke spontaneous abortion. Ointments can be used as follows:
- homeopathic (e.g. Fleming ointment);
- regenerating ("Posterisan");
- with anesthetic effect ("Luan" or "Emla");
- heparin ointment reduces the inflammatory process and promotes resorption of already formed nodes, in addition, it has a very mild effect;
- to reduce itching and swelling ("Troxevasin", "Troxerutin");
- Miswengal contains many natural ingredients, increases the speed of venous blood flow and reduces edema, has a local disinfectant and analgesic effect.
Despite the absence of contraindications for women in the situation, it is advisable to find out from the doctor the best way to treat hemorrhoids during pregnancy (in the 3rd trimester or earlier).
Gymnastics against varicose veins
Improving bowel function, reducing stagnation and increasing muscle tone contributes to therapeutic exercises. Here are some useful exercises:
- Standing, you need to extend your arms in front of you and put your feet shoulder width apart. Then turn the body to the right (do not tear off the feet from the floor), take your right hand as far back as possible and take a breath. Then you need to return to its original position and also make a right turn. Repeat five times in each direction.
- Standing raise your hands in front of you, clasp your fingers into the lock. Next, you need to perform body turns left and right, taking your hands as far back as possible. The exercise must be repeated five times in each direction.
- Sitting on the floor rest your hands behind. Then you need to bend your knees and slowly stretch them. Heels should not be torn off the floor. Repeat (like previous exercises) five times.
- In the sitting position, spread your legs as much as possible, firmly pressing them to the floor, it is advisable not to bend your knees. Bend over and try to touch the fingers of the right hand of the left foot, and the fingers of the left hand - the right foot. 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 tilts to the sides. The opposite hand should be kept on the belt. Repeat five times in each direction. Recommended for execution 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 with an observing physician. Treatment of hemorrhoids during pregnancy with folk remedies involves the use of homemade candles. Potato will do. They need to be cut from peeled and washed raw potatoes. In size and shape, they should resemble rectal suppositories, which are sold in pharmacies. Such candles are introduced into the anus before bedtime.
Natural ointment can be obtained by mixing sea buckthorn oil and honey. With this composition, you can lubricate the nodes that come out, enter it into the rectum. Another good remedy is propolis ointment. It is mixed in a crushed form with vegetable oil (one to ten) and boiled for about an hour. You need to use the ointment chilled several times during the day. You can only store a natural product in the refrigerator.
Treatment of hemorrhoids during pregnancy with folk remedies can be carried out with the help of sea buckthorn lotions. A bandage or soft tissue should be folded in five layers, moistened in sea buckthorn oil and applied to the anus. You can also use sedentary baths with garlic or with onion husks, which are also effective in treating hemorrhoids during pregnancy in later stages.
Systemic treatment of hemorrhoids in pregnant women
Treatment of hemorrhoids during pregnancy in the 3rd trimester or earlier may involve taking medications for internal use. Modern drugs can not only quickly cope with the disease, but also minimize the adverse effect of their use. If it is necessary to carry out general drug therapy, it is better to entrust a specialist with the selection of medications for the treatment of hemorrhoids during pregnancy. Reviews confirm that no initiative here is unacceptable 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 diet should be divided into three to five meals in small portions. A healthy diet should contain enough fiber, a minimum of fatty, fried and spicy. It is necessary to exclude fast food, soda and canned foods, convenience foods. Sour-milk products are very useful. In addition, during the day should drink at least 1.5-2 liters of fluid.
We must not forget to perform therapeutic exercises, observe hygiene. After each emptying, you need to carry out an external toilet (cool, but not quite cold water), and with severe hemorrhoids it is better to refuse toilet paper. You can apply tampons with cool infusion of oak bark or chamomile. You need to walk more often, with prolonged work in the sitting position 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 prolapse of nodes that do not set into the lumen of the rectum. Indications for surgical intervention are complications of hemorrhoids, for example, pinching of a node or 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 completely cure the disease, but only slow down its course.
In some cases, minimally invasive methods can be used - these are bloodless or small operations. , , . , , — . . , , , — .
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