Hemorrhoids During Pregnancy

What are hemorrhoids?

Hemorrhoids are swollen veins on or near your anus. Sometimes the veins are in your anus (external hemorrhoids). Other times, they’re inside your rectum, the section of large intestine that leads to your anus (internal hemorrhoids). No matter where they are, hemorrhoids are an unpleasant but common part of pregnancy. The good news is that they’re usually easy to manage with home treatments. They often go away after you’ve had your baby.

Is it normal to have hemorrhoids during pregnancy?

Yes. If you’re pregnant and have hemorrhoids, you’re not alone. Hemorrhoids during pregnancy are common, especially in the third trimester and up to one month after you’ve had your baby. About 30% to 40% of people who are pregnant get hemorrhoids.

What is the difference between hemorrhoids and anal fissures?

Hemorrhoids are swollen veins on your anus. Anal fissures are tears on your anus. They’re different conditions, but they’re both common during pregnancy. They share similar symptoms, too. Hemorrhoids and anal fissures can both feel itchy or painful. And they can both cause bleeding that shows up in your stools or on toilet paper after you wipe. The bleeding from an anal fissure or a hemorrhoid is usually harmless. Still, if you’re pregnant and notice blood in your stool, you should always contact your healthcare provider. They can let you know for sure that what’s causing your bleeding is a hemorrhoid or an anal fissure instead of something more serious.

Who gets hemorrhoids?

Anyone can get hemorrhoids, but your odds of getting them go up when you’re pregnant. The added weight of a growing fetus and the hormone changes that support pregnancy both increase your chances of having hemorrhoids.

What are the symptoms of hemorrhoids during pregnancy?

You can have hemorrhoids without having any symptoms at all. If you do have symptoms, they may include:

• Pain when you’re pooping.
• Itching in and around your anus.
• Intense pain from an internal hemorrhoid falling outside your anus (prolapsed hemorrhoid).
• Blood on the toilet, in your stool, or on the toilet paper where you wiped after a bowel movement (usually from an internal hemorrhoid).

It can be scary to see blood in your stool, but therectal bleeding from an internal hemorrhoid is usually harmless. Still, see your provider about any bleeding you notice if you’re pregnant.

What causes hemorrhoids during pregnancy?

Hemorrhoids appear when pressure bears down on your pelvic area and the lower part of your digestive tract (bowel). The pressure can be so heavy that even the veins in your anus absorb the impact, so much so that they swell. During pregnancy this pressure comes from:

• The fetus. A growing fetus puts pressure on your pelvic area and bowel. The added weight from the fetus presses the veins in your anus so that they aren’t able to move blood throughout your body as easily as they usually do. Instead, the slowed blood trickles and pools, swelling inside your veins.
• Increased blood volume. The amount of blood in your body increases during pregnancy to support the fetus. This means that your veins have to do the hard work of moving more blood than usual throughout your body.
• Constipation. You’re more likely to get hemorrhoids during pregnancy because you’re more likely to have constipation during pregnancy, too. Hormone changes in your body slow the digestion process that helps you have regular bowel movements. The extra weight from the waste stuck in your bowel can squeeze the veins in your anus so that it’s harder for them to move blood. Straining to poop adds even more pressure.

How are hemorrhoids during pregnancy diagnosed?

Hemorrhoids during pregnancy are common enough that your healthcare provider will likely know that you have hemorrhoids by how you talk about your symptoms. To be sure, your provider may:

• Take a closer look at your anus. Your provider can usually spot external hemorrhoids.
• Do a digital rectal exam. Your provider may insert a gloved finger inside your rectum to feel for any internal hemorrhoids.
• Do an anoscopy or sigmoidoscopy. Both procedures are simple and quick. They allow your provider to see inside your rectum.

None of the options sound pleasant, but getting a hemorrhoids diagnosis is more uncomfortable than painful. And don’t be embarrassed. This is a routine diagnosis for your provider.

How do you treat hemorrhoids during pregnancy?

Education is often the best treatment for hemorrhoids until they go away on their own. They usually go away after your baby arrives.

Relieve your constipation

Having regular bowel movements can ease the strain on your hemorrhoids. The less you’re straining on the toilet, the less stress you’re putting on these veins. Here’s how you do it:

• Eat 25 to 30 grams of fiber each day.
• Drink eight to 12 cups of water a day.
• Take a laxative — but only one that your provider has approved.

Try home remedies

Try some home remedies for hemorrhoids to relieve any discomfort you’re feeling.

• Apply pure aloe or coconut oil to ease minor pain or discomfort.
• Apply witch hazel to your hemorrhoids to reduce itching and pain.
• Apply either wet or dry baking soda to your hemorrhoids to ease itching.
• Try a sitz bath, or sit in a tub with about 2 to 3 inches of warm water. The water can improve your blood flow and relax the strained muscles around your anus.

Take the pressure off your hemorrhoids

There’s nothing you can do about the added pressure from the fetus that’s putting strain on your body, but you can change your habits so that you’re reducing the strain that you can control. Here are some tips:

• Don’t remain standing or sitting for too long. Instead, lay on your side to take pressure off your pelvic area and bowel.
• When you do sit, use a donut pillow.
• Don’t strain or linger too long on the toilet when you’re having trouble pooping. Instead, focus on relieving your constipation.

If at-home care isn’t working, your healthcare provider may recommend a procedure to remove your hemorrhoids that’s safe for you and your baby.

What medications are used to treat hemorrhoids during pregnancy?

If constipation is making your hemorrhoids unbearable, your healthcare provider may prescribe a laxative, hemorrhoid cream, or a fiber supplement. Always check with your provider before taking any over-the-counter medications. Your provider is your best resource for making sure you’re choosing options that are effective and safe.

How can I avoid getting hemorrhoids when I’m pregnant?

You can’t always prevent hemorrhoids, but you can put good habits in place to reduce your chances of getting constipated. Eat fiber-rich foods and drink the right amount of fluids each day. Work Kegel exercises into your daily routine to encourage healthy circulation in your anus and rectum.

What can I expect if I’m pregnant and have hemorrhoids?

You’ll likely experience some discomfort that you and your healthcare provider can work together to address. Your hemorrhoids may get worse before they get better. Sometimes the pushing during labor makes hemorrhoids worse immediately after delivery. Within a few weeks, though, your hemorrhoids should be getting better.

When should I see my healthcare provider?

Reach out to your provider if:

• You notice any bleeding during a bowel movement. Most causes of rectal bleeding during pregnancy, like hemorrhoids, are harmless. Some causes are serious, though. Be sure.
• You’re experiencing pain in your anal area that doesn’t get better with at-home treatments.
• You’re thinking of trying over-the-counter laxatives, stool softeners, creams, oils, or supplements. Your provider should approve any medications you take when you’re pregnant.

Should I be worried about hemorrhoids during pregnancy?

There’s no need to worry about hemorrhoids, especially when you know how to manage symptoms if you do get them. Hemorrhoids can be uncomfortable, but they’re harmless and usually go away eventually.

A note from Cleveland Clinic

Hemorrhoids can be an uncomfortable and even embarrassing part of pregnancy, but don’t worry if you have them. Relieving constipation and finding ways to soothe your symptoms can help make them more manageable. If your symptoms are bothering you and home treatments aren’t helping, reach out to your provider.