Hemorrhoids in Pregnancy & Conditions That Can Cause or Contribute to Hemorrhoids
Hemorrhoids develop due to increased pressure on rectal veins, impaired venous return, or weakened connective tissues. Below are key diseases and conditions linked to their development:
1. Gastrointestinal Disorders
- Chronic Constipation/Diarrhea:
Straining during bowel movements (common in IBS or IBD) increases rectal pressure, damaging veins. - Inflammatory Bowel Disease (IBD):
Crohn’s disease or ulcerative colitis cause chronic inflammation, frequent diarrhea, and rectal urgency. - Colorectal Obstruction:
Tumors or strictures (e.g., colorectal cancer) lead to straining to pass stool.
2. Metabolic and Cardiovascular Conditions
- Portal Hypertension:
Liver cirrhosis or portal vein thrombosis elevates rectal venous pressure, promoting hemorrhoids (less common than esophageal varices). - Obesity/Metabolic Syndrome:
Excess abdominal fat increases intra-abdominal pressure and impairs pelvic circulation.
3. Pelvic and Structural Issues
- Pelvic Floor Dysfunction:
Weak pelvic muscles or dyssynergic defecation (improper muscle coordination) cause chronic straining. - Hemorrhoids in Pregnancy:
Hormonal changes and uterine pressure compress rectal veins (not a disease but a significant risk factor).
4. Vascular and Connective Tissue Disorders
- Chronic Venous Insufficiency:
Poor venous return from prolonged sitting/standing exacerbates rectal vein engorgement. - Genetic Connective Tissue Disorders:
Ehlers-Danlos syndrome or Marfan syndrome weaken rectal supportive tissues.
5. Respiratory and Circulatory Diseases
- Chronic Cough (e.g., COPD):
Persistent coughing raises intra-abdominal pressure. - Heart Failure:
Systemic fluid retention increases venous pressure.
Key Takeaways
Hemorrhoids often arise secondary to conditions that increase abdominal/rectal pressure or weaken tissues. Addressing underlying diseases (e.g., managing IBD, treating constipation, or weight loss) can reduce risk.
Navigating Hemorrhoids in Pregnancy
The First Trimester Glow
Emma, 28, had always dreamed of motherhood. When she saw the two pink lines on her pregnancy test, she was overjoyed. The first trimester brought nausea and fatigue, but she powered through, fueled by excitement. By week 20, her baby bump blossomed, and she proudly flaunted maternity dresses. But as her due date neared, an unexpected challenge arose.
The Uninvited Guest
At 32 weeks, Emma noticed a dull ache after sitting through back-to-back work meetings. A few days later, she saw bright red streaks on the toilet paper. Panic set in—Was this a miscarriage? Her OB-GYN examined and reassured her: “It’s hemorrhoids. Hemorrhoids are common in pregnancy.”
Emma was stunned. Hemorrhoids? She’d heard friends joke about them but never imagined the burning, itching, or the tender lump near her anus. “Your growing uterus is pressing on pelvic veins, and progesterone relaxes blood vessels, making them swell,” her doctor explained. Chronic constipation from prenatal iron supplements hadn’t helped.
The Emotional Toll
Embarrassment kept Emma silent at first. She canceled yoga classes, dreading downward dog. Even simple joys—like her nightly ice cream—felt risky. “What if straining makes it worse?” she confided in her sister, a nurse. “You’re not alone,” her sister said. “Nearly 35% of pregnant women get hemorrhoids. Let’s tackle this.”
A Plan of Action
Emma’s OB-GYN prescribed a three-pronged approach:
- Diet: Fiber-rich meals (oatmeal, chia seeds) and prunes to soften stools.
- Hydration: A giant water bottle became her constant companion.
- Topical Relief: Witch hazel pads and pregnancy-safe hydrocortisone cream.
For immediate comfort, she soaked in warm sitz baths and swapped tight leggings for loose cotton skirts. “Avoid prolonged sitting,” her doctor warned. Emma set hourly phone alarms to pace her home office.
The Silver Lining
By week 36, the flare-ups lessened. Emma even joked about her “pregnancy badge of honor” at her baby shower. When her son, Liam, arrived via uncomplicated delivery, she felt empowered—not just by childbirth, but by overcoming a struggle so many hide.
Key Takeaways for Expectant Mothers
- Prevention: Prioritize fiber, water, and gentle exercise (e.g., prenatal yoga).
- Timely Care: Don’t ignore symptoms; hemorrhoids can worsen postpartum if untreated.
- Community: Share your experience—vulnerability often sparks support, not judgment.
“Pregnancy is beautiful, but it’s okay to admit it’s hard too,”
References
- World Journal of Gastrointestinal Surgery (2019). Hemorrhoid classification and pathophysiology.
- Diseases of the Colon & Rectum (2019). Portal hypertension and anorectal varices.
- Techniques in Coloproctology (2014). Pelvic floor dysfunction and hemorrhoids.
- Journal of Gastroenterology and Hepatology (2017). Metabolic syndrome and colorectal health.
- American Pregnancy Association. (2023). Hemorrhoids During Pregnancy.
- Journal of Maternal-Fetal & Neonatal Medicine. (2021). Anorectal Disorders in Pregnancy.
- International Journal of Women’s Health. (2020). Managing Hemorrhoids in the Third Trimester.
See article on Hemorrhoids click here.
