What are haemorrhoids?

Haemorrhoids (also known as ‘piles’) are swollen varicose veins located in the rectum and anus (back passage). Haemorrhoids are a common condition in pregnancy, affecting around 1 in 3 pregnancies.

There are two main types of haemorrhoids:

• Internal haemorrhoids are not visible from the outside. Your doctor may see them while performing a visual or digital rectal examination (where the doctor examines your anus with a gloved finger).
• With external haemorrhoids, the veins swell and become visible from the outside.

Some people have both types of haemorrhoids at the same time.

What are the symptoms of haemorrhoids?

Haemorrhoids can cause symptoms including:

• bleeding from the rectum or anus
• pain or burning when having a bowel motion
• itching

External haemorrhoids are more likely to cause symptoms. Internal haemorrhoids generally don’t cause pain, but at times can cause minor bleeding.

When should I see my doctor?

If you have pain when passing stools or see blood on the toilet paper or on your faeces (stool or poo), you should see your doctor. It might be the result of haemorrhoids, but it could be a sign of a more serious condition.

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What causes haemorrhoids during pregnancy?

During pregnancy, haemorrhoids can be triggered by an increase in pressure on your rectal veins. This can result from your growing uterus and pressure from your growing baby, and increased blood flow in the area.

Straining on the toilet because of constipation can also trigger or worsen haemorrhoids.

Haemorrhoids are generally more common in females during their reproductive years.

Sometimes pregnancy can trigger symptoms from internal haemorrhoids, even if they previously did not cause symptoms.

When am I more likely to experience haemorrhoids during my pregnancy?

Pressure on the veins around your anus may get worse as your pregnancy progresses. This is due to your growing uterus and your baby’s increased size. This is why haemorrhoids are more common in the second and third trimesters of pregnancy.

Am I more likely to experience haemorrhoids if I had them before pregnancy?

Not everyone with haemorrhoids has symptoms. If you first experience haemorrhoids during pregnancy, you might not be able to tell if this is new, or if you have had haemorrhoids in the past that did not cause symptoms.

If you know you had haemorrhoids before your pregnancy, take extra care, as they may get worse during pregnancy.

How are haemorrhoids managed during pregnancy?

Because constipation worsens haemorrhoids, treatment options centre around preventing or managing constipation. Another goal of treatment is to reduce the pain associated with haemorrhoids.

Treatment options include the following:

• Lifestyle changes — including a diet high in fibre and drinking lots of water will help ensure you don’t need to strain on the toilet. External haemorrhoids can be treated by placing an icepack on the affected area to reduce swelling. Taking a warm bath may also help to reduce the pain.
• Laxatives — help ease any straining associated with constipation. They help you pass bowel movements (poo) more easily.
• Pain relief medicines — paracetamol can help reduce pain associated with sore, swollen veins, and can be taken during pregnancy. Be sure to follow the directions for use.
• Haemorrhoid creams — help reduce itchiness, pain or inflammation, and contain active ingredients such as corticosteroids or local anaesthetics.

Check with your doctor or pharmacist before using medicines or creams while pregnant.

Could haemorrhoids be a sign of something more serious?

If you think you might have haemorrhoids, it is important to tell your doctor.

This is because symptoms such as bleeding from your bowel or anus can be a sign of more serious conditions.

Will haemorrhoids affect my baby?

Some people are concerned that haemorrhoids might affect their pregnancy or their baby. There is no evidence to support this.

However, there is some concern that the pushing stage of labour and birth can worsen your haemorrhoids. Speak to your midwife if you are concerned about haemorrhoids during your pregnancy or birth.

Will haemorrhoids continue after I’ve had my baby?

In most cases, haemorrhoids go away within a few days after your baby is born.

Minimising constipation by drinking plenty of water and eating a diet high in fibre will help your haemorrhoids improve.

If you find your haemorrhoids do not get better, even a short time after giving birth, speak to your doctor about further treatment.

Can haemorrhoids be prevented?

Avoiding constipation is the best way to reduce your chance of haemorrhoids. A healthy gut will prevent the need to strain during a bowel movement. Eat a diet high in fruit, vegetables and wholegrains, and drink plenty of water.

Resources and support

If you have more questions about haemorrhoids during your pregnancy, you can consult with:

• your doctor or midwife
• an obstetrician
• an accredited dietitian