There are also some not-so-joyous moments in pregnancy, the morning sickness, the swelling and inflammation, and the potentially long hours spent in labour. Additionally, pregnancy can cause you to become more prone to constipation, and by extension, hemorrhoids.
This condition affects approximately 25-35% of the population while in some regions, up to 85% of woman experience hemorrhoids in the third trimester. In this article, we plan to explore the causes and treatments as we get to the bottom of the situation.
Gastrointestinal tract
The gastrointestinal tract is responsible for the transition of food to waste as we absorb the available nutrients from the food we’ve ingested. The GI tract begins with our mouth, ends with the anus, and includes all the structures between. In order to move things along, the smooth muscles of the tract contract in a slow wave-like motion known as peristalsis. To help visualize the process, imagine a log falls into a lake. Eventually, that log will drift to shore because the regular crests and troughs of the waves move it forward through the body of water. When this process becomes impaired, the fecal matter has the potential to build up and the peristalsis is no longer strong enough to move the mass.
Constipation
This condition is known as constipation, a common condition amongst pregnant women due to the higher circulating levels of the hormone known as progesterone. This hormone inhibits GI contraction while promoting relaxation, which has the overall effect of slowing down the passage of fecal matter. This has the benefit of ensuring that all possible nutrients are absorbed from the food to nurture the growing baby, but with the potential to become backed up as the water is absorbed from the stool. When we pull the water out, the fecal matter becomes very dry and cannot move as smooth as it can when hydrated. When we feel a need to have a bowel movement, the dry matter often causes individuals to strain their rectal muscles. This brings a greater amount of blood to the veins that supply the anus and rectum, causing the area the to swell like a tiny balloon.
Hemorrhoids in pregnancy
These hemorrhoids could occur internally, within the rectum, or externally, on the anus itself. Often times, an itch may be felt around the anus indicating the development of a hemorrhoid, but the most obvious sign that something is abnormal is when you notice blood on the stool. As the dry matter passes the hemorrhoid, it may impact the swollen vessel and cause it to bleed. Unfortunately, this issue is exasperated during pregnancy by the growth of the uterus. The baby begins to take up a lot of real estate within the mother’s abdomen, which displaces structures and puts additional pressure on the intestines and rectum. The risk of developing hemorrhoids is also high during labour because of the intense contractions meant to bring new life into the world that direct blood to the pelvic region.
Many treatment options exist for hemorrhoids
Try a few of the following to ensure your bowel movements are regular and smooth to minimize any risk of developing the condition:
- Quench your thirst. As mentioned, when our intestinal transit time slows down, the stool can become dry and hard which could tear tissue during a bowel movement. Consuming lots of water ensures the body stays hydrated and therefore, does not try and absorb so much water from the stool passing through the intestines.
- Probiotic yogurt. With all the flavours out there now, yogurt is a great way to encourage a happy and healthy gut. Many helpful bacteria in the form of probiotics can be found in todays yogurt, and studies have shown that consuming up to 300g/day can improve symptoms of constipation, and potentially prevent hemorrhoids from developing. It is worth your time to research the different kinds of yogurt as many have added sugars and few probiotics.
- Symptomatic relief. Horse chestnut seeds (Aesculus hippocastanum) have historically been used to treat circulatory issues. The seeds have been shown to tonify veins, and exhibit anti-inflammatory and vascular protective properties. Products like Venaforce Extra are an easy way to consume the herb. Consult a healthcare practitioner prior to use.
- Bulk laxatives are your friend. Psyllium husk (Plantago ovata) is a plant where the seeds produce a thick mucilage when they react with water. This fiber bulks up your stool by soaking up water in the gut and encourages regular, smooth bowel movements. This plant has also been shown to decrease pro-inflammatory reactions from the bacteria in the gut. The downside to bulk laxatives is that they can reduce the absorption of vitamins as the mucilage can engulf the multivitamin or cover the intestinal lining where the vitamins are absorbed. Take your vitamins with food approximately 2 hours before consuming psyllium husk to ensure they are properly absorbed.
- See your primary care provider. Rectal bleeding cannot be attributed to hemorrhoids 100% of the time and may suggest a more serious condition. Often times, bright red blood indicates an issue further along the GI tract towards the anus, usually coating the stool, but dark blood mixed with stool suggests something earlier in the tract. The best rule of thumb is to visit your doctor to receive the proper information if you notice any blood.
References:
http://www.altmedrev.com.ccnm.idm.oclc.org/publications/6/2/126.pdf
http://www.mayoclinic.org/diseases-conditions/hemorrhoids/symptoms-causes/dxc-20249175
https://www.ncbi.nlm.nih.gov/pubmed/12004215
https://www.ncbi.nlm.nih.gov/pubmed/12865195
https://www.ncbi.nlm.nih.gov/pubmed/16433160
https://www.ncbi.nlm.nih.gov/pubmed/20501437
https://www.ncbi.nlm.nih.gov/pubmed/28333654
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5294450/