Treatment Options for Pregnancy Hemorrhoids

By C.Stone Mitchell, MD, FACS

As a surgeon who specializes in hemorrhoid treatment, I see many women who suffer from pregnancy-related hemorrhoids. Hemorrhoids are blood vessels in the rectal area that have become swollen. They may be inside or outside the anus and range from the size from a pea to the size of a cluster of grapes. Hemorrhoids can be simply itchy and mildly uncomfortable, or quite painful. An estimated 20 to 50 percent of pregnant women experience hemorrhoids. The pressure of an enlarged uterus and increased blood flow to the pelvic area, plus constipation, may cause the condition during gestation, especially during the third trimester. Straining and pressure during labor can also aggravate existing hemorrhoids, causing extra discomfort and pain for new mothers.

Unfortunately, because of embarrassment or a belief that hemorrhoids are just an unpleasant byproduct of pregnancy, many women may be hesitant to discuss the condition with their physician during or after pregnancy. Some women, concerned about a possible painful surgery and long recovery period never seek treatment. I have encountered numerous female patients who have been living with painful pregnancy hemorrhoids for years and years, unaware that gentle relief and treatment are readily available.

Physicians should discuss the occurrence of hemorrhoids with female patients and encourage them to seek treatment, if needed. During pregnancy, general hemorrhoid therapy includes soaking in warm (not hot) water several times a day, and propping up the legs as much as possible.

If a hemorrhoid has become painfully thrombosed, with the blood pooling and clotting, it can be gently drained. The patient will feel immediate pain relief. For the comfort of the patient, the expertise of an experienced hemorrhoid specialist is invaluable in identifying and treating a thrombosed hemorrhoid. During pregnancy, an evaluation with a hemorrhoid specialist can provide immediate relief or a plan of treatment after delivery can be discussed, when their venous pressure has returned to a normal state.

In most people, 95% of hemorrhoids do not require surgery. Infrared coagulation is a painless, non-surgical treatment for hemorrhoids. It involves using a small probe that exposes the vein above the hemorrhoid to short bursts of warm light, causing the hemorrhoid to shrink and recede. This treatment can be performed quickly, with no anesthesia, incisions, or stitches.

Women should understand that they do not have to live with the pain of pregnancy hemorrhoids. Gentle treatment can provide welcome, lasting relief to this common condition.

C. Stone Mitchell, MD, FACS, is a physician with the Premier Hemorrhoid Treatment Center in Knoxville, a division of Premier Surgical Associates. Dr. Mitchell is board certified in general surgery by the American Board of Surgery and is a fellow of the American College of Surgeons.

Premier Surgical Associates is the Knoxville area’s largest surgical group, performing general, vascular, bariatric, breast, and laparoscopic procedures. Premier has offices in Knoxville, Dandridge, Maryville, Lenoir City, Sevierville, and Seymour.