Hemorrhoids

Some pregnant women develop hemorrhoids — varicose veins in the rectum. Hemorrhoids are caused by increased blood volume and pressure from the uterus on the veins in your rectum. The veins may enlarge into firm, swollen pouches underneath the mucous membranes inside or outside the rectum. Hemorrhoids may occur for the first time during pregnancy or become more frequent or severe.

Constipation also can contribute to hemorrhoids because straining can enlarge the rectal veins. Constipation is common throughout pregnancy, especially during the later months, when your uterus may push against your large intestine. (See also Constipation.)

Hemorrhoids can be painful, and they may bleed, itch or sting, especially during or after a bowel movement. Usually, hemorrhoids recede or disappear after birth.

■ Prevention and self-care for hemorrhoids

The best way to deal with hemorrhoids is to avoid constipation. This is especially important if you've had them before getting pregnant. To prevent hemorrhoids and ease the discomfort, try the following:

• Avoid becoming constipated by eating high-fiber foods, fruits and vegetables and drinking plenty of fluids.

• Exercise regularly, which can help keep bowel movements regular.

• Avoid straining during bowel movements, as this puts pressure on the veins in your rectum and can aggravate or cause hemorrhoids. Put your feet on a stool to reduce straining, and avoid sitting on the toilet for long periods of time.

• Keep the area around your anus clean. Gently wash the area after each bowel movement. Pads of witch hazel may help relieve pain and itching. You can refrigerate the pads, which may be more soothing when applied cold. You may also want to try a warm sitz bath — a shallow basin that fits over the toilet and allows you to submerge your buttocks and hips.

• Use an ice pack to provide some relief.

• Try warm soaks in a tub or sitz bath to help shrink hemorrhoids and provide relief. Add an oatmeal bath formula or baking soda to the water to combat itching.

• Avoid sitting for long periods, especially on hard chairs.

■ Medical care for hemorrhoids

Stool softeners or bulk-producing laxatives may help, but consult your health care provider before using any over-the-counter remedy for hemorrhoids. If self-care measures don't work, your health care provider may prescribe a cream or an ointment that can shrink them.

Occasionally a hemorrhoid may become filled with blood clots (thrombosed). If this happens, the swollen vein won't shrink to its normal size. Minor surgery may be needed to remove the hemorrhoid.

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