Question: I have just had a baby and developed haemorrhoids during pregnancy. They are really painful, especially when I sit to breastfeed.
Haemorrhoids are basically varicose veins that occur in the rectal area. There are two main types of haemorrhoids. Internal haemorrhoids occur in the lower rectum (part of the large intestine leading to anus) and are often painless but cause bleeding. External haemorrhoids occur under the skin around the anus and often feel like a small hard lump. Additionally, internal haemorrhoids can also prolapse (fall down) and protrude outside the anus, particularly following a bowel movement. Prolapsed haemorrhoids can be very painful.
Women often develop haemorrhoids during pregnancy due to the added pressure of the baby on the veins in pelvis. In addition, during pregnancy the hormone progesterone causes the walls of the veins to relax, which allows them to swell more easily. Haemorrhoids can also develop when a woman pushes during the second stage of labour, particularly if this second stage is prolonged.
Symptoms of haemorrhoids include itching, pain, burning sensation, bright red bleeding during a bowel movement (often seen in the toilet or on toilet paper) and a feeling that the bowel movement is incomplete. The size of the haemorrhoid does not always indicate the amount of pain and discomfort felt with some small haemorrhoids being extremely painful. Symptoms are often exacerbated by prolonged periods of standing and/or sitting (such as you are experiencing while breastfeeding).
Haemorrhoids are often just dismissed as an inconvenience of pregnancy and birthing. They should, however, be taken more seriously as the pain, discomfort and worry they cause can interfere with women's enjoyment of their new baby.
Treatment for haemorrhoids includes reducing any further strain on the area which will exacerbate symptoms. Avoiding constipation by drinking lots of water and eating enough fibre is an important step. You can take a fibre supplement if you think your fibre intake maybe inadequate. Using a correct toileting position (see our Urinary Incontinence factsheet for more details) is also important to reduce any strain. Stay off your feet as much as possible and try feeding your baby while lying down to take the pressure off the area.
To relieve the pain see your pharmacy about haemorrhoid creams and ointments. A pharmacist can properly advise which creams and ointments are suitable to use while breastfeeding. If the pain and discomfort persists though see your GP about other treatment options. In addition, some symptoms of haemorrhoids such as bleeding are also symptoms of bowel cancer and so should be investigated if they persist.
Last updated December 2014.
©Women's Health Queensland Wide Inc. This article was reviewed by the Women's Health Queensland Wide editorial committee. It was published in Health Journey 2014 Issue 3/4.