Piles in pregnancy – and beyond

Let’s talk about one of pregnancy’s least glamorous side effects – haemorrhoids. If you’re dealing with them, you’re not alone! Up to 50% of pregnant women experience these swollen veins in and around the anus or rectum, thanks to the extra pressure on the pelvic area and those ever-changing hormones.

According to Dr Maré du Plessis, a specialist surgeon at Mediclinic Milnerton in Cape Town, most pregnancy-related haemorrhoids improve after birth, often requiring no further intervention. So while they might be a pain (literally!), there’s hope.

Why are haemorrhoids so common in pregnancy?

Several factors to consider.

• Increased uterine pressure: As the uterus grows, it restricts blood flow in the pelvic veins, leading to swelling.
• Hormonal changes: Progesterone relaxes blood vessels, making them more prone to enlargement.
• Constipation: A common pregnancy symptom that causes straining, worsening the issue.
• Increased blood volume: This can cause veins to dilate, especially in the rectal area.
• Delivery strain: The pushing phase of labour can trigger or worsen haemorrhoids.

Symptoms to look out for

• Itching or pain around the anus
• Painful lumps or swelling near the anus
• Painful bowel movements
• Blood on toilet paper after wiping
• A feeling of fullness or discomfort in the rectal area

Managing haemorrhoids at home

Dr Du Plessis suggests these at-home remedies for relief:

• Warm baths: A 10–15-minute sitz bath can reduce pain and inflammation.
• Cold compresses: Helps reduce swelling and numb discomfort.
• Fibre supplements: Increasing dietary fibre helps prevent constipation and straining.
• Topical treatments: Over-the-counter creams can ease itching and inflammation (check with your doctor before use).
• Good hygiene: Gently clean the area with warm water and avoid rough toilet paper.
• Hydration: Drinking enough water helps keep stools soft.

When to see a doctor

If home remedies don’t help, there are medical treatments available. “A Rubber Band Ligation procedure involves placing a small rubber band around the haemorrhoid to cut off its blood supply, causing it to shrink. We usually wait until after the baby is born to do this,” explains Dr Du Plessis.

In rare cases, surgical interventions like haemorrhoidectomy or stapled haemorrhoidopexy may be considered, but they’re not often necessary.

Preventing haemorrhoids in pregnancy

Dr Du Plessis advises: “Avoid straining during bowel movements, increase fibre intake, drink plenty of water, and stay active. Elevating your feet slightly when sitting can also help reduce pressure on the pelvic veins.”

For most women, haemorrhoids can be managed with simple lifestyle changes and home treatments. If symptoms persist, consult your doctor to discuss further options.