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As your uterus expands and hormone levels change, your bowel movements often slow down, leading to constipation. Add in the pressure from the growing baby and a softer, more relaxed network of veins and muscles in your pelvis, and you’ve got the perfect storm. The result? Swollen veins (haemorrhoids) or small tears in the anal lining (fissures) that make each toilet trip stressful. But there are ways to manage the discomfort and reduce the risk.
What Are Haemorrhoids and Anal Fissures?
Let’s break down the difference first:- Haemorrhoids are swollen blood vessels in the rectum. They may appear as internal (inside the rectum) or external (around the anus). They can itch, bleed, ache, or feel like a lump.
- Anal fissures are small tears in the thin tissue that lines the anus. They usually occur after passing a hard or large stool and can cause intense pain or a burning sensation.
Why They Matter in Pregnancy
These conditions may seem minor, but they can significantly affect daily life. Here's how they interfere with pregnancy comfort and health:- Pain leads to fear of passing stools, which can worsen constipation.
- Bleeding may mimic vaginal spotting, causing anxiety.
- Discomfort while sitting or walking can affect mobility and rest.
- Sleep and intimacy may be disrupted due to ongoing pain.
- Postpartum worsening, especially after a vaginal delivery or episiotomy, can make recovery harder.
Common Causes and Risk Factors
Several pregnancy-related changes contribute to haemorrhoids and fissures:- Constipation – Hard stools cause both straining and tearing.
- Increased blood volume and pressure – This enlarges the veins in the rectum.
- Progesterone – This hormone relaxes smooth muscles, slowing bowel movement and weakening vein walls.
- Weight gain and uterine pressure – The growing uterus presses on pelvic veins and the rectum.
- Labour pushing – This can aggravate or trigger haemorrhoids or fissures postpartum.
- Low-fibre diet and poor hydration – These dietary patterns make stools drier and harder to pass.
How Are They Diagnosed?
Most cases are diagnosed clinically based on symptoms and a simple visual exam. Your healthcare provider may:- Examine the anal area for swelling or visible tears.
- Ask about bleeding patterns (streaks on tissue vs. mixed with stool).
- Rule out other causes like fissures due to infection or piles due to unrelated bowel disease.
Management and Treatment Options
The good news? Most pregnancy-related haemorrhoids and fissures resolve with simple changes and conservative care. Here’s what can help:- Dietary fibre – Increase fibre intake via vegetables, fruits, whole grains, or psyllium husk. This softens stools and reduces strain.
- Hydration – Aim for 2–3 litres of water per day unless otherwise advised. Fluids help bulk and soften stool.
- Warm Sitz baths – Soaking in warm water for 10–15 minutes, especially after bowel movements, can soothe inflammation and ease muscle tension.
- Topical treatments – Doctor-approved creams with hydrocortisone (for haemorrhoids) or lidocaine (for fissures) can relieve itching and pain. Always check before use in pregnancy.
- Cold compresses – Applying ice packs can reduce swelling and numb pain in haemorrhoids.
- Avoid straining or prolonged sitting on the toilet – Use a footstool to elevate your feet and help align the rectum for easier passage.
- Pelvic floor physiotherapy – For chronic discomfort or muscle tightness, trained specialists can teach safer ways to eliminate and strengthen control.
- Stool softeners – If diet changes aren’t enough, your doctor may recommend pregnancy-safe options like docusate sodium.
Emotional and Practical Support
Pain in private areas can feel isolating, but it’s nothing to be embarrassed about.- Talk to your doctor without hesitation. These are very common pregnancy issues.
- Adjust your daily habits. Carry wipes, keep extra underwear, and prioritise gentle fabrics to reduce irritation.
- If the pain is affecting your sleep, work, or mental well-being, a short-term treatment plan can help ease the load.
FAQs on Haemorrhoids and Anal Fissures During Pregnancy: Painful But Common—Here’s What Helps
- Can they go away on their own during pregnancy?
Mild cases often resolve with diet and hygiene changes. However, untreated cases may persist or worsen postpartum. - Is bleeding always a cause for alarm?
Not always. Bright red blood on tissue or in the toilet bowl is common with haemorrhoids or fissures. But any new bleeding should still be evaluated by your doctor to rule out other causes. - Will I have to deal with haemorrhoids and fissures postpartum, too?
Possibly, especially after vaginal delivery. But early management during pregnancy often reduces the risk of worsening later.