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Piles in pregnancy

Dr Karen Martin
Reviewed by Dr Karen MartinReviewed on 19.10.2023 | 3 minutes read
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Pregnancy can bring on unexpected changes, and unfortunately, piles – or hemorrhoids, as doctors call them – are one of these surprises. Piles occur when swelling forms in the blood vessels (veins) around the rectum. These can become engorged with blood and look and feel like little pink cushions.

Piles are ubiquitous in the general population, affecting both men and women. Still, pregnancy makes them more likely, due to the pressure from your growing baby, increased hormones such as progesterone that cause veins to relax, and straining for a bowel movement, as you’re more likely to be constipated in pregnancy.

Doctor’s advice

What symptoms do piles cause?

Most people notice a bit of fresh red bleeding in the toilet bowl, on toilet tissue, or around the rectum. You may find the rectum a bit itchy or sore, making it uncomfortable to pass poop. You may notice a soft lump just outside the anus, and you may need to push it back in after passing a poop. And some people pass a bit of mucus.

How can I make my piles better?

Constipation is one of the leading causes of piles.

  • This can be helped with staying hydrated and maintaining a healthy diet.
  • You should drink plenty of water (around 8 glasses per day), especially during pregnancy.
  • Seek out a good amount of fiber-rich food every day - you can find it in fruits, vegetables, whole grains, lentils, and beans.

These steps will soften your stool, making it pass more easily, and also improve gut health.

Exercise is another important way to ensure that your circulation is optimized and your bowel is moving. In the late stages of pregnancy, you may not feel like continuing any demanding exercise, but you should try to stay active by walking or swimming.

A simple remedy to soothe pain and itching around the rectum is to apply ice wrapped in a towel.

This may also help reduce the size of the pile. You can also use simple painkillers such as acetaminophen or ibuprofen. If you have a pile that sticks out, use a lubricating gel to push the pile back in gently.

If you are unable to push your hemorrhoid back in, or it's suddenly excruciating, you should seek urgent medical help.

When should I see my pharmacist or doctor?

If these simple measures have not sufficiently helped, it’s worth a trip to your pharmacy. Creams and suppositories, such as Anusol, are available over-the-counter. Anusol has a mild anesthetic, which numbs the area to ease bothersome symptoms. Make sure you let the pharmacist or any doctor know that you are pregnant so that they can offer the safest treatment.

Stool softeners or laxatives can help relieve constipation if increasing dietary fiber and water intake hasn’t helped.

If these don’t work well enough, it’s best to speak to your doctor, who can consider your symptoms, examine you, and prescribe other medications to help. If there’s any doubt about your diagnosis, you should also book an appointment.

Am I stuck with piles forever?

The short and comforting answer is no. Piles do usually disappear after you deliver your baby. This occurs as the pressure eases on your bowels and the high progesterone levels gradually reduce.

Piles sometimes become more pronounced during delivery, as the pressure of pushing your baby out of the vagina can cause further vein engorgement, but in most cases this is short-lived, and you recover. If it doesn’t go away after several days, it’s best to speak with your doctor.

Be mindful that you can become dehydrated after birth, especially if you're breastfeeding, which can worsen constipation. So, remember to stay hydrated, take a look at your diet again, and start from the beginning with these methods to ease your symptoms if they worsen or recur.

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This article has been written by UK-based doctors and pharmacists, so some advice may not apply to US users and some suggested treatments may not be available. For more information, please see our T&Cs.
Dr Karen Martin
Reviewed by Dr Karen Martin
Reviewed on 19.10.2023
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