Articles

Key takeaways

• Piles are swollen blood vessels inside or around your bottom.
• They are common in pregnancy due to hormones and constipation.
• Symptoms can include itching, pain, and bright red bleeding of your back passage.
• Always check with a healthcare professional before using any treatments.

What are piles and why do they happen in pregnancy?

Piles, also known as haemorrhoids, are swellings. These swellings contain enlarged blood vessels. They are found inside or around your bottom/back passage.

Piles are common during pregnancy. Hormones can make your veins relax, which contributes to them.

Constipation is also common in pregnancy. It can trigger piles or make them worse. They are most common in later pregnancy, from the second trimester onwards.

Symptoms of piles

Symptoms of piles can include:

• Itching
• Aching
• Soreness
• Swelling around your bottom/back passage

You might feel pain when having a bowel movement. A mucus discharge can also happen afterwards.

Some people notice a lump outside their bottom/back passage. This lump can often be gently pushed back into place after you've had a poo.

Bleeding after doing a poo is another symptom. The blood is usually bright red and is often noticed on wiping your back passage.

Tips for prevention and at-home management

Simple lifestyle adjustments and home remedies can help prevent and manage piles during pregnancy, easing discomfort and preventing them from worsening.

Diet and hydration

A cornerstone of prevention is maintaining soft, regular bowel movements to avoid straining.

Increase your daily intake of fiber-rich foods. Examples include:

• Fresh fruits
• Vegetables
• Whole grains (like oats, brown rice, and whole-wheat bread)
• Legumes

Aim for at least 25-30 grams of fiber per day.

Alongside this, ensure you drink plenty of water throughout the day – at least 8-10 glasses – to keep your stools soft and easy to pass. Dehydration can lead to harder stools, making constipation worse.

Regular, gentle exercise

Incorporating gentle, regular physical activity into your routine can help stimulate bowel movements and improve overall circulation. This reduces pressure in the veins. Activities like walking, swimming, or prenatal yoga are excellent choices. Avoid prolonged periods of standing or sitting. If your job requires this, take frequent short breaks to move around.

Mindful toilet habits

When you feel the urge to have a bowel movement, don't delay. Holding it in can make stools harder and more difficult to pass.

Try not to strain or push forcefully when on the toilet. This increases pressure on the rectal veins and can worsen piles. Instead, allow your body to work naturally.

Using a small footstool to elevate your knees while sitting on the toilet can help achieve a more natural squatting position. This straightens the rectum and makes bowel movements easier and less strenuous.

Sitz baths

Soak your bottom in a warm sitz bath for 15-20 minutes a few times a day. This can relieve pain, itching, and discomfort. The warm water helps to relax the anal sphincter, improve blood flow, and soothe irritated tissues.

You can purchase a sitz bath kit that fits over your toilet, or simply use a clean bathtub with a few inches of warm water. Gently pat the area dry with a soft towel afterwards.

Cold compresses

Applying a cold pack can help reduce swelling, inflammation, and pain. Wrap ice in a soft cloth and apply it for 10-15 minutes at a time. This can be particularly helpful after a bowel movement or when you experience more discomfort.

Proper hygiene

Keep the area of your back passage clean and dry. After a bowel movement, gently wipe the area. Use soft, unscented toilet paper or moist, alcohol-free wipes. Avoid harsh scrubbing or perfumed products, which can cause further irritation.

Sleeping position

Lying on your side can help reduce pressure on your rectal veins. Lying on your left side is particularly effective. This can potentially ease discomfort.

Over-the-counter remedies

Some over-the-counter creams or suppositories designed for piles can offer temporary relief. However, it is crucial to check with a professional before using any medication during pregnancy. Speak to your doctor, midwife, or pharmacist first. This ensures it is safe for you and your baby.

When to seek help from your doctor or midwife

If you think you may have piles, it is important to talk to a healthcare professional. You can speak to your midwife, doctor, or pharmacist. They can suggest a suitable treatment to help soothe the area and ensure it is indeed piles and not another condition.

Do not use any cream or medicine without checking with them first, as some products may not be safe during pregnancy. Always get advice from a healthcare professional before starting any treatment.

Alert symptoms

You should seek medical advice promptly if you experience any of the following alert symptoms:

• Severe pain – Piles that are extremely painful require attention, especially if the pain is constant or worsening. This could indicate a thrombosed pile (where a blood clot forms inside).
• Heavy or continuous bleeding – Heavy or continuous bleeding requires immediate medical attention. This is especially true if the blood is dark red or mixed with your stool.
• A hard, painful lump – If you notice a hard, painful lump around your back passage that cannot be gently pushed back inside, this could be a thrombosed external pile. This may require specific medical intervention.
• Signs of infection – Signs of infection include fever and chills. Also look for increased redness, swelling, or pus discharge from the affected area.
• Symptoms that don't improve – Seek help if your symptoms persist, worsen, or significantly impact your quality of life despite trying home remedies and lifestyle changes.
• Any uncertainty – Talk to your midwife or doctor if you are unsure about your symptoms or if they are accompanied by other concerning signs.