Care for Hemorrhoids Postpartum

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Hemorrhoids, also referred to as piles, can form either inside or outside the rectum. Both types are caused by veins inside or at the entrance of the rectum ballooning out at a weakened area, which don't rupture but can leak blood. Hemorrhoids can cause pain and discomfort. Hemorrhoids are fairly common, especially after you have a baby. Fortunately, with some simple at home treatments and lifestyle choices, you can relieve the itching and pain associated with hemorrhoids.

Steps

Understanding Hemorrhoids

  1. Learn how hemorrhoids develop. Hemorrhoids are caused by an increased pressure on the veins in the anus or rectum. The pressure can make a weaker portion of the vein weaker, which causes it to balloon a little, either inside the rectum or outside the body near the anus.[1] It is common for pregnant women to develop hemorrhoids because of the extra weight and pressure from the baby.
    • Pregnancy also increases the risk of constipation, which is another risk factor of hemorrhoids.
    • Most women find that their hemorrhoids resolve after they give birth, but they require care and can recur weeks later.
  2. Notice the risk factors. The increased that causes hemorrhoids are typically caused from the pressure. Risk factors that contribute to the increased pressure on those areas are pregnancy, obesity, straining to have a bowel movement, constipation, anal intercourse, lifting heavy objects, weight lifting, and sitting on the toilet too long. Those who participate in these activities will likely experience a hemorrhoid. To reduce the likelihood of developing hemorrhoids or to alleviate the symptoms, reducing how much and often you do these activities.
    • Pay special attention to preventing constipation or standing for long periods in one place while pregnant. Do not gain more than the recommended amount of weight during your pregnancy as recommended by your obstetrician for your individual circumstances.
    • Do not lift heavy items at work or at home without help. Find someone to help or use mechanical assistance at work if possible.
    • Refrain from anal intercourse. It stretches the rectum past normal capacity and places additional stress on the veins in the anus and rectum.
  3. Recognize the symptoms. Hemorrhoids commonly form during pregnancy, but they are the same type that form during any other time. The only difference is the type of pressure that triggers the formation of the hemorrhoids. A hemorrhoid will be a lump around the anus, which is often sensitive or painful when touched. Symptoms of hemorrhoids include:[2]
    • Itching, irritation, and discomfort around the anus from the inflammation of the swollen vein.
    • Swelling as small as a pea
    • Pain with your bowel movements without bleeding and around the anus when you aren’t
    • Light bleeding from the pressure of the stool against the vein
    • Discomfort
    • Some leakage of stool into your underwear from the anus, which is not fully closed when the hemorrhoid is located near the entrance to the rectum
  4. Talk to your doctor. Taking any medications for hemorrhoids can affect your baby if you haven’t given birth yet. The medicine will also be passed through your milk if you are nursing, which can also affect the baby. Before using any over-the-counter treatment medication or natural herbal supplement, talk about the risks with your doctor and pharmacist.
    • Although pharmacists are not trained to prescribe medication, she has a vast knowledge of how medications interact, their side effects, and when it is appropriate to use them.

Using Home Remedies

  1. Use an ice pack. The swollen veins on your rectum from the hemorrhoids can shrink if you apply cold, which helps reduce the swelling and pain. Apply an ice pack covered in a thin washcloth or towel to your anus. Don't use it more than 10 to 15 minutes at a time to prevent over-chilling, but you can do it several times a day. [3]
    • This may also reduce pain and swelling from stitches if you had an episiotomy while giving birth.
  2. Try a sitz bath. A sitz bath it is a small, shallow tub that fits over the toilet, which you fill up and sit in. It can be bought at your local pharmacy. To use, fill the sitz bath with a few inches of warm water and sit on the toilet for about 20 minutes after each bowel movement. You can so this two to four times a day to help soothe the pain and discomfort of hemorrhoids. This method helps relieve irritation, muscle spasms, and itching.
    • Pat the area dry with a soft towel, but do not rub or wipe hard. If the hemorrhoids are painful, try using a hair dryer on the lowest warm setting to dry the sensitive skin.
    • If you don't have a sitz bath, fill the tub with a couple of inches of warm water and soak in that for 20 minutes instead.[4]
    • If you had an episiotomy, talk to your doctor about how appropriate sitz baths are for you. The extra moisture can affect your stitches, and how often you can take sitz baths will vary based on the type of stitches your doctor used.
  3. Keep yourself clean and dry. Keeping irritants and wetness from your hemorrhoids can help make them feel better. Keep the skin around your hemorrhoid as clean and dry as possible. Bathe every day to clean the skin with warm water. Avoid using too much soap or soap with alcohol or perfumes on that area, because it can aggravate the issues affected with hemorrhoids. This can cause itching, swelling, and irritation. After you cleanse it, gently pat the area dry.[5]
    • This care is also useful for caring for stitches after an episiotomy.
  4. Use moist wipes. To keep yourself clean between baths, use moist wipes after each bowel movement to clean yourself. You can buy baby or adult moist wipes, but make sure they do not have alcohol or perfumes in them.[6]
    • Don’t use dry toilet paper. If you don't have moist wipes, moisten your toilet paper. Use white toilet paper because the printing cause irritation to the area.[7]
  5. Make bathroom visits quick. In order to help ease the pain of hemorrhoids, do not sit on the toilet for long periods of time. This increases the pressure placed on the veins in your rectum.[8] Unless you need to finish going to the restroom, get up from the toiler as soon as you can. Don't read the paper, check your phone, or take a break from the baby.
  6. Try witch hazel. To help soothe the irritated skin and discomfort associated with hemorrhoids, use witch hazel on cotton pads. Soak a cotton pad or round with witch hazel and lay it against the hemorrhoid. Some people find that refrigerating the witch hazel prior to use increases the efficiency of the product. [9]
    • Witch hazel is an astringent from deciduous trees that is commonly used for skin conditions, but is also being evaluated for antioxidant and anti-tumor behavior.[10]
  7. Try oral pain relievers. There is pain and discomfort associated with hemorrhoids and over the counter medication can help. Acetaminophen (Tylenol) and ibuprofen (Advil) can temporarily relieve some of the discomfort and pain from your hemorrhoids.[11]
    • Do not take these medications for more than one or two days to relieve the discomfort. They are meant to be a temporary solution. Try using more natural remedies, such as cold packs, sitz baths, and cleansing routines, to help reduce the pain and swelling over longer periods of time.
  8. Use hemorrhoid creams. Before using an over the counter hemorrhoid cream, which also come in suppository form, check with your obstetrician for side effects or other problems that might arise. These can help reduce the itching and discomfort. Most of the over-the-counter suppositories and creams contain 1% hydrocortisone cream, which helps reduce the inflammation, itching, and pain associated with hemorrhoids.[12]
    • Always follow manufacturer's instructions to get the correct dosage of cream within the right amount of time.
    • Talk with your doctor about using these products while pregnant or if you are breastfeeding.

Avoiding Constipation Naturally

  1. Learn about the effects of constipation. Constipation is extremely bad for hemorrhoids. It is one of the leading causes of hemorrhoids, which means that being constipated just makes your hemorrhoids worse. The straining increases the pressure against the veins, which causes them to grow, become irritated, and potentially bleed.[13]
  2. Exercise. Keeping your body moving will also help keep your digestion moving. To prevent constipation, exercise daily. Exercise will move the food through your intestines in a timely and natural way. Find something fun like to do, such as yoga, Pilates, or jogging, to make it easier to work out every day.
    • Talk to your doctor about how strenuous your physical activities can be so soon after your pregnancy.[14]
  3. Go when you have to go. When you feel the urge for a bowel movement, go the bathroom as soon as can. Don’t suppress the urge. The longer the stool is in your large intestine and colon, the more water is removed. This makes it harder to pass and increases the strain on you.
    • Even if you feel uncomfortable doing this while you are out shopping or at work, it is a natural process and waiting can be bad for your health.[15]
  4. Hydrate yourself. The more water your system has, the looser your stools will be. Drink enough water every day that your urine is light yellow in color. This will vary person to person. If your urine is nearly clear, you are over hydrated. If it is dark yellow, you need to hydrate much more. Dehydrated causes your body to take water from your waste products and stool to increase the amount available to your heart and brain.[16]
  5. Eat high fiber foods. Foods rich in fiber help your stool retain more moisture. This will make them easier to pass, which will help you avoid constipation. Avoid processed foods, which are low in fiber and can cause constipation, such as French fries, donuts, white breads, foods made with white flour, and potato chips. Eat foods high in fiber such as:[17][18][19]
    • Vegetables
    • Fruits
    • Dried fruits, such as figs and raisins
    • Beans
    • Nuts
    • Seeds
  6. Take probiotics. Probiotic supplements can help ease constipation. The probiotic re-populates your stomach with good bacteria necessary for digestion and proper stool formation. Probiotics should be taken with meals and most often are recommended to be taken with breakfast.
    • Although some yogurt contains probiotics, there is typically so much sugar that it encourages bad bacteria growth instead. Check the label of your yogurt brand for sugar levels. Even plain Greek yogurt can be high in sugar.
    • Probiotic supplements are not regulated by the FDA. Ensure your supplement comes from a company you trust and which advertises their testing procedures. Always ask your doctor before using these, especially when pregnant or nursing.[20]

Taking Medications for Constipation

  1. Talk to your doctor about medications. You should only use over-the-counter medications for constipation after consulting with your physician. He will suggest the other methods first to avoid taking medication. Medications to help with constipation work in different ways. Each of these medications come in different strengths and the dosage will depend upon your circumstances. Read the directions on the box to ensure you take the prescribed amount and over the prescribed interval.
    • Always talk with your doctor if you have not yet delivered your baby or if you are breastfeeding. [21]
  2. Try bulk forming agents. These medications help to hold more water in the stool and make it easier to pass. Always take these with water or they can cause a blockage in your intestines. Common over-the-counter brands include Citrucel, Fibercon, and Metamucil.
    • Bowel or esophageal obstructions can occur when you don't add enough water to the powder. It can then stick in your esophagus or bowels and obstructs anything else from passing.
    • You might experience a change in bowel habits or some minor bloating while using these products.[22]
  3. Try osmotic agents or stool softeners. These products help keep the fluid in the stool. Side effects from osmotic agents include dehydration and mineral imbalances. These agents include Milk of Magnesia and Miralax.[23]
    • Stool softeners, which can be over the counter or prescription, include Colace and Docusate. Side effects from these products can include gastrointestinal bloating and cramping, skin rashes, and a dangerous reduction in magnesium levels when used chronically to treat constipation during pregnancy.[24][25]
  4. Try lubricant laxatives. Lubricants are medications that coat the outside of the stool already in the colon. This helps to soften the stool and makes it pass easier. These include brands such as Fleets Enemas and Zymenol.
  5. Consider topical painkillers. Try a cream that combines lidocaine and hydrocortisone, which can be applied topically to hemorrhoids and may numb the pain and relieve itching.[26] You can apply these creams twice a day for no longer than seven to 10 days.

Getting Medical Help

  1. Look for blood. After giving birth, your hemorrhoids often resolve using home care treatments; however, if you experience severe pain or notice more than just a few drops of blood from the area, see your physician immediately. You may believe that your hemorrhoid is bleeding, but the blood may originate from bleeding inside the colon, which is a symptom of another, more serious condition such as colon cancer.
    • It is also necessary to figure out if the blood might be coming from the uterus after delivering your baby. If you are having difficulty distinguishing this, place a maternity pad against your vagina and a towelette at the anus. If there is more than just a few drops of blood from the hemorrhoid, talk to your physician. [27]
  2. Check for anemia. A complication that arises from having hemorrhoids that chronically bleeds is anemia. Although rare, chronic blood loss will cause not enough blood to transport oxygen to the cells. You will then develop fatigue and a strain on the heart muscle. If you experience chronic fatigue not related to lack of sleep, talk to your doctor about blood testing to check the oxygen carrying capacity of your blood.
    • You may also experience some mild anemia following the birth of your baby. This is due to the discharges of the blood and tissue from the uterus.[28]
  3. Watch out for a strangulated hemorrhoid. A strangulated hemorrhoid is formed when the blood supply to the hemorrhoid has been cut off. It can cause extreme pain, ulceration, tissue death, or gangrene. This is a medical emergency and requires immediate medical care. You doctor will have to re-establish the blood supply to the area to prevent infection in the dead tissue. [29]
  4. Look for a clot. A hemorrhoid can also develop a clot inside the vein. This causes extreme pain and is typically excruciating. When this happens, you have a thrombosed hemorrhoid. See you doctor immediately for treatment of the clot. It may need to be surgically removed or withdrawn from the vein in an out-patient procedure.
    • Your physician can also help you control the pain and prevent of further complications.[30]

Tips

  • Prevention is the best medicine for hemorrhoids. Recognize the triggers which develop hemorrhoids during pregnancy and try to avoid these.
  • Use home care treatments for your hemorrhoids to reduce the pain and discomfort of the hemorrhoid. If your homecare is not effective after several days you may want to consult a physician and consider a minor surgical procedure which can reduce the symptoms and control bleeding.

Related Articles

Sources and Citations

  1. http://familydoctor.org/familydoctor/en/diseases-conditions/hemorrhoids/causes-risk-factors.html
  2. http://www.mayoclinic.org/diseases-conditions/hemorrhoids/basics/symptoms/con-20029852
  3. http://www.mayoclinic.org/diseases-conditions/hemorrhoids/basics/lifestyle-home-remedies/con-20029852
  4. http://www.health.harvard.edu/diseases-and-conditions/hemorrhoids_and_what_to_do_about_them
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  6. http://familydoctor.org/familydoctor/en/diseases-conditions/hemorrhoids/treatment.html
  7. http://www.babycenter.com/0_hemorrhoids-during-pregnancy_244.bc
  8. http://www.umassmemorialhealthcare.org/sites/umass-memorial-hospital/files/Documents/Services/Surgery/Hemorrhoids%20Patient%20Information.pdf
  9. http://www.mayoclinic.org/diseases-conditions/hemorrhoids/basics/lifestyle-home-remedies/con-20029852
  10. http://www.drugs.com/npc/witch-hazel.html
  11. http://www.mayoclinic.org/diseases-conditions/hemorrhoids/basics/lifestyle-home-remedies/con-20029852
  12. http://www.mayoclinic.org/diseases-conditions/hemorrhoids/basics/lifestyle-home-remedies/con-20029852
  13. http://www.niddk.nih.gov/health-information/health-topics/digestive-diseases/hemorrhoids/Pages/facts.aspx
  14. http://www.niddk.nih.gov/health-information/health-topics/digestive-diseases/constipation/Pages/treatment.aspx
  15. http://www.niddk.nih.gov/health-information/health-topics/digestive-diseases/constipation/Pages/treatment.aspx
  16. http://www.niddk.nih.gov/health-information/health-topics/digestive-diseases/constipation/Pages/treatment.aspx
  17. http://www.niddk.nih.gov/health-information/health-topics/digestive-diseases/constipation/Pages/treatment.aspx
  18. http://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/in-depth/high-fiber-foods/art-20050948
  19. https://www.nlm.nih.gov/medlineplus/ency/patientinstructions/000120.htm
  20. http://www.health.harvard.edu/blog/probiotics-may-ease-constipation-201408217377
  21. http://www.niddk.nih.gov/health-information/health-topics/digestive-diseases/constipation/Pages/treatment.aspx
  22. http://www.drugs.com/monograph/bulk-forming-laxatives.html
  23. http://emedicine.medscape.com/article/184704-medication#8
  24. http://www.drugs.com/sfx/dulcolax-stool-softener-side-effects.html
  25. http://emedicine.medscape.com/article/184704-medication#3
  26. http://www.mayoclinic.org/drugs-supplements/lidocaine-and-hydrocortisone-topical-application-route-rectal-route/description/drg-20072751
  27. http://familydoctor.org/familydoctor/en/diseases-conditions/hemorrhoids/diagnosis-tests.html
  28. http://www.mayoclinic.org/diseases-conditions/hemorrhoids/basics/complications/con-20029852
  29. http://www.merckmanuals.com/professional/gastrointestinal-disorders/anorectal-disorders/hemorrhoids
  30. http://www.mayoclinic.org/diseases-conditions/hemorrhoids/basics/complications/con-20029852