— A problem in the anal canal, in particular, anal fissure, external thrombosed hemorrhoids and an increase in internal hemorrhoids are a common reason for pregnant women to consult a proctologist. What contributes to the exacerbation of these diseases during pregnancy? A significant increase in blood flow to the pelvic region, an increase in pressure in the abdominal cavity and stagnation in the veins of the pelvis, including in the hemorrhoidal venous plexus, leads to an increase in blood filling of hemorrhoids.The fetus grows, the uterus presses on the intestines, impairing its motility, and chronic constipation forms. These are the two main factors that increase the risk of hemorrhoid exacerbation in pregnant women.
To resolve these problems, first of all, it is necessary to pay more attention to bowel movement, to ensure that it occurs regularly and comfortably, without strain.Therefore, the leading therapeutic measure is to follow a diet that includes a large amount of vegetables, fruits, dietary fiber and mandatory adherence to the drinking regime recommended by a gynecologist.
The next point to avoid these problems is hygiene. It is necessary to abandon the use of toilet paper, which does not purify enough and significantly damages the delicate skin in the anal canal area. It is necessary to use a bidet or shower with cool or warm water, special means for intimate hygiene, or, as a last resort, wet wipes if it is impossible to carry out water procedures.
A common reason for pregnant patients seeking emergency proctological care is thrombosed external hemorrhoids, which cause significant discomfort due to pain. If such symptoms appear (blood droplets, pain, burning, itching, a feeling of heaviness in the anal canal, etc.), depending on the severity of the symptoms and the size of the nodes, we can remove the blood clot (thrombectomy), or prescribe local medication. There are medications for hemorrhoids that can be prescribed during pregnancy and lactation, however, they should be used on the recommendation and under the supervision of a proctologist.
A visit to a proctologist should not be postponed "for later", because the symptoms may change every day, worsening the well-being of the expectant mother. Thoughts about visiting a proctologist sometimes cause fear and great excitement, because so far this specialist is not as "popular" as a gynecologist or urologist, and it can be difficult for both men and women to decide on a visit to a proctologist. At the initial appointment, only a visual examination and a finger examination of the rectum are performed. Instrumental studies are prescribed according to indications and require preparation, if necessary, the doctor will tell you in detail about this at the reception.
If you do not start treatment for hemorrhoids during pregnancy, childbirth can provoke a sharp exacerbation of this disease. Childbirth is a long and complex process involving the tension of all the muscles of the perineum and pelvis. In addition, the stagnation of blood in the venous plexuses is also affected by the progress of the fetus through the birth canal. All this can lead to a significant increase in pre-existing nodules, provoke node prolapse and, as a complication— injury and thrombosis. These complications, especially in combination with postpartum perineal injuries, adversely affect the course of the postpartum period.
That is why a woman should pay special attention to her health during pregnancy and, if hemorrhoids are suspected, do not postpone a visit to a doctor.
