Hemorrhoids are a common occurence for those in their third trimester and after childbirth. One study found it affects ~40% of the pregnant/postpartum population! That A LOT of people!
But what are hemorrhoids, what causes them, and how can we help treat it??
Hemorrhoids
A Hemorrhoids is an inflamed and swollen vein that is around the anus (external) and/or lower rectum (internal). They can be painless or extremely uncomfortable!
Cause
Extra pressure on the the veins is what cause hemorrhoids. This can be due to an inter-abdominal pressure mismanagement. If we are not managing the pressure in our abdomen when doing things, such as lifting, this is increasing the amount of pressure that is on the pelvic area, increasing the chance for hemorrhoids or pelvic floor dysfunction to happen.
Common causes are:
- Straining with bowel movements (constipation)
- Sitting on the toilet for long periods of time
- Family History
- Constipation or Diarrhea Frequently
- Pregnancy
- Over 50 years old
- Heavy Lifting
During pregnancy the extra pressure is due to the growing belly from baby and then pushing creates lots of extra pressure on the pelvic area.
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Symptoms of Hemorrhoids
The type of symptoms you have can be person dependent and type of Hemorrhoids dependent (internal vs external)
Common Symptoms:
- Anal Itching
- Anal Ache/Pain (Especially when sitting)
- Bulge felt at anus
- Bleeding after having a bowel movement
Since these symptoms could also be a sing of something else more serious, it is always advised to be seen by a medical professional to rule anything else out!
Most of the time symptoms will resolve on their own without too much treatment as the inflammation reduces.
Treatment Options
Treatment options can depend on the severity of the hemorrhoid and the type of hemorrhoid (internal vs external)
Conservative Treatment:
Non-invasive treatment options are a great first-line option to help manage the symptoms and decrease inflammation. These can be used before seeing a doctor, but if the symptoms do not get better after 1 week of use, seeking medical help is advised!
- Medication creams and suppositories (dibucaine/anusol)
- Ice packs
- Sitz bath
- AVOID ITCHING OR RUBBING THE HEMORRHOIDS!! Especially after going to the bathroom, this can just prolong the healing process and increase the risk of infection
Surgical Options:
Surgery is sometimes necessary depending on the severity of the hemorrhoid, Most of the outcomes are a removal of the hemorrhoid entirely. Some common surgery options:
- Hemorroidectomy: surgical removal of the Hemorrhoids, permanent solution
- Rubber Band Litigation: Rubber Band is tied around the base of the hemorrhoid causing it to shrink and disappear due to the loss of blood flow
There are other surgical options, but would be beneficial to have the discussion with your provider if this route seems may be for you!
Beneficial to see a Pelvic Floor PT to be assessed after having hemorrhoids! It could have been caused by the mismanagement of intra-abdominal pressure and a pelvic floor PT can give you tools to prevent it from happening in the future.
Diagnosis
How they will diagnose a Hemorrhoids is different based on where it is located.
If it is external, all they will need to do is look at the anus. They will be able to see the swollen veins.
If the hemorrhoids are internal, it is usually necessary to have a digital rectal exam for them to assess the internal hemorrhoid. Sometimes it may be necessary to have imaging with a colonoscopy, anoscopy, or proctosigmoidoscopy. These all look at the lining of either your colon, rectum, or anus.
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Prevention
Once you have had a Hemorrhoids, it is a lot easier for one to come back. Some refer to it as “flaring up” when symptoms return.
Things that be helpful to prevent them in the future
- Pelvic Floor PT
- Diaphragmatic breathing
- Ensuring adequate water and fiber intake to avoid constipation/diarrhea which can lead to straining on the toilet/prolonged sitting on the toilet
- Squatty Potty** is a GREAT tool to have if you have any difficulty with bowel movements.
- Taking stool softeners can be helpful until diet can be changed
- Good Body mechanics and pressure management when lifting heavy objects
Hemorrhoids...common but treatable!
Hemorrhoids are so common during life in general, but particularly those of us in the childbearing population!
There are tools to help prevent them from happening, but if it happens to you. You are not alone and it can be treated!