Your pregnant body

• Your body goes through major changes during pregnancy.
• Weight gain, breast changes and aches and pains are common.
• There are ways to deal with common discomforts and changes.

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Many pregnant women get hemorrhoids (also called "piles") while pregnant, especially during the third trimester. Hemorrhoids are more common if the woman is constipated.

Causes of hemorrhoids during pregnancy
Hemorrhoids are varicose veins (swollen veins) that appear in the rectal area. They can sometimes protrude from the anus. They are often itchy or painful and can sometimes rupture and bleed.

Hemorrhoids occur when straining or pressure causes the veins in your rectum to swell and enlarge. Three common causes of hemorrhoids are:

1. Straining during bowel movements
2. The strain of excess weight
3. The pressure of sitting or standing for long periods of time

During pregnancy:

• Your growing uterus can increase the pressure on the veins in the lower body. This can lead to hemorrhoids.
• Pregnancy hormones can also cause the walls of your veins to relax. This allows them to swell more easily.
• Straining, especially during hard bowel movements, traps more blood in the swollen veins. This can make hemorrhoids very painful.
• Straining can also cause hemorrhoids to protrude from the rectum.

If you have had hemorrhoids before pregnancy, you're more likely to get them again while pregnant. They may also develop or flare up with the straining of labor.

What you can do
You can help prevent hemorrhoids by making simple lifestyle changes that keep you from getting constipation:

Drink plenty of liquids.

• Drink at least 8-10 glasses of water each day.
• One to two glasses of fruit juices, such as prune juice, can help.

Eat foods high in fiber.

• Eat raw fruits, vegetables, bran cereals and other sources of fiber.
• If you are also suffering from increased gas, start eating foods that are high in fiber.
• Wheat bran is a good fiber supplement. It causes less gas than other fiber-rich foods.

Exercise regularly.

• With your health provider's OK, walking and engaging in other safe activities for at least 2 1/2 hours of aerobic exercise every week can help the digestive system do its work. This means that most pregnant women should try to get 30 minutes of aerobic exercise on most, if not all, days.
• Always be sure to find out from your health care provider what exercises are safe for you and how long you can maintain your exercise program.

When you gotta go, you gotta go.

• Always go to the bathroom as soon as you feel the urge.
• When you delay, it becomes harder to pass stool.

Don't gain too much weight.

• Gain a sensible amount of weight.
• Stay within the guidelines your health care provider sets.
• Excess pounds put extra pressure on your abdomen. This increases your chances of getting hemorrhoids.

Avoid long periods of standing or sitting.

• If you must sit for long periods, get up and move around for a few minutes every hour or so.
• When lying down, lie on your left side to help take the pressure off.

Most hemorrhoids improve on their own. But you can do several things to help you relieve the pain, swelling and itching of hemorrhoids:

• Soak your rectal area in warm water for 10 to 20 minutes at a time for several times a day.  At most drug stores, you can get a sitz bath that you can use for this. A sitz bath is a small basin that fits over the seat of the toilet.
• Ask your health care provider about which over-the-counter hemorrhoid creams are safe to use.
• Use unscented, white brands of toilet paper. Some women find it helpful to wipe the anal area with moist towelettes, wet toilet paper, or medicated pads instead of toilet paper.
• Keep the anal area clean. Soap isn't necessary and may aggravate the problem. Be careful to gently dry the area after bathing, since moisture can cause irritation.
• Apply ice packs or cold compresses for 10 minutes up to four times a day.
• If a hemorrhoid begins to stick out, gently push it back into the rectal canal.

When to talk to your health care provider
Most hemorrhoids go away on their own, but some require a medical procedure. Talk to your health care provider if:

• You don't get relief using the suggestions above 
• You notice bleeding

August 2009