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Prevention and Treatment of Hemorrhoids During Pregnancy

Michael XU, Surgeon

Hemorrhoids are the most common anorectal diseases, which can occur at any age and the incidence increases with the age. Folk also have “ten men nine hemorrhoids, ten females ten hemorrhoids”. Moreover, the incidence of hemorrhoids in pregnant women is more common and severe. Female friends can’t help asking why women so easily suffer from hemorrhoids during pregnancy and what harm do they cause?

This needs to start with the physiology of the pregnant period. In order to ensure the nutrition of the fetus during pregnancy, the blood flow in the pelvic cavity increases.

With the increasing of the uterus, the abdominal pressure of pregnant woman also increases. Also, the enlarged uterus can oppress the pelvic cavity, rectum, and block the hemorrhoid venous blood return, which is easy to form or/and worsen existing hemorrhoids.

In the later stages of pregnancy, pregnant women are prone to constipation. The straining during bowel movement will increase the abdominal pressure, leading to the expansion of the hemorrhoid vein and the formation of the hemorrhoid nucleus.

In addition, during pregnancy, the pelvic tissue relaxes due to hormones, which causes the occurrence and aggravation of hemorrhoids. Finally, during the natural labor process, the push pressure will make the abdominal pressure rise sharply, which can lead to hemorrhoids edema, incarceration and even strangulation.

Due to preceding factors, the incidence of hemorrhoids is far greater than that of the general population. Also, mild lesions can worsen and cause acute attacks, which can be extremely painful and dangerous both for the pregnant women themselves and fetus in the womb.

。It is because the pregnant women need adequate or more nutrition to keep the fetus growing. Hemorrhoids are often recurrent bleeding, which not only affects the health of pregnant women but also the normal development of the fetus, which can lead to growth retardation, low weight, and even premature birth or death.

Since the hemorrhoids during pregnancy and childbirth are so easily to happen and the harm is so big, how can we prevent and treat? First, a correct understanding of hemorrhoids during pregnancy is very important. Only by understanding the physiological and pathological causes of hemorrhoids, we can prevent and treat hemorrhoids scientifically. The most important of all is to prevent.

Women during pregnancy, in the absence of symptoms or early stages of hemorrhoids, should intentionally increase the intake of fibrous foods, including whole grains. Drink more water and avoid some spicy or stimulating food. Change bad bowel habits and develop a good habit of regular smooth bowel movement to prevent constipation and diarrhea.

Moderate activity also helps to prevent constipation. Avoid long standing and vigorous exercise. Be cautious about the use of drugs. It is suggested that any drug should be recommended by a professional hospital doctor.

Second, even if hemorrhoids occur, there are many ways to treat it. General treatments include sclerotherapy and rubber band ligation, usually with no sedation needed.

Sclerosant injection has a good short-term effect on hemorrhoids patients who have bleeding and are not suitable for surgery. And for some not so severe hemorrhoids, the rubber band ligation remains the simplest and effective method. Recently, the use of many kinds of minimally invasive equipment such as COOK has achieved good effect such as micropain and quick recovery.

Hemorrhoidectomy is a classic, durable option that has the best long-term results. Hemorrhoidectomy should be considered in patients who continued to have sever hemorrhoids or complicated with ulceration, fissure or fistula. Stapled hemorrhoidectomy is a technique that results in excision of a circumferential portion of the lower rectal and upper anal canal mucosa and submucosa with a circular stapling device. The procedure is completed by lifting the anal cushion and reducing the hemorrhoidal tissue. Compared with traditional hemorrhoidectomy, it has the advantages of safe minimally invasive, non-anal opening incision, and fast recovery.

In conclusion, due to various physiological and pathological factors, hemorrhoids are very common and harmful during pregnant period, and the clinical manifestations vary. The most important thing is to understand the disease itself so as to make a scientific prevention and treatment from all aspects. Wish all the mothers-to-be can have a happy pregnancy and have a healthy and beautiful baby.