Treatment For Piles in Pregnancy

home remedies for piles after pregnancyPiles, also called hemorrhoids is a clinical condition characterized by dilatation and engorgement of the veins at the lower part of the rectum and around the anus. It is commonly seen in patients who suffer from constipation and occurs due to excessive straining during defecation.

In women, pregnancy and vaginal delivery predisposes them to developing piles, primarily because of raised intra-abdominal pressure and an alteration in the body’s hormones. Studies have shown that it can occur in about 85% of the cases in third trimester(1), with up to 35% of pregnant women being affected by this condition.(2)

Treatment for piles in pregnancy is essential in pregnancy, especially if the patient is experiencing symptoms, given the effect it has on the quality of life. It commonly presents with itching or pain around the anal orifice, along with occasional bleeding.

If left untreated, complications such as thrombosis of piles or prolapsed can occur.

However, in majority of cases, the piles regress after delivery of the baby.

The various option on treatment for piles have been discussed below.

Treatment For Piles

There are a number of ways that treatment for piles can be administered. These have been discussed in brief below:[list style=”arrow”]

  • Increase dietary fiber intake – This is probably the most important measure to take. Constipation is a common factor in all patients with piles, and treating this effectively by increasing dietary fiber can help reduce the amount of straining required during defecation. Certainly, this has been shown in clinical studies.(3)
  • Increase fluid intake – This helps maintain a healthy bowel function, and particularly maintains a normal stool consistency when combined with increased dietary fiber intake.

The above two measures are generic measures, and are applicable to both pregnant and non-pregnant patients. Other treatment for piles below are also generic, though some of them are contraindicated in pregnant women.

  • Warm water baths – These help reduce ano-rectal pain.(4)
  • Topical treatments – These provide effective short term relief, and are useful as they bear a good degree of safety given the amount that is actually used. However, there is a paucity of studies analyzing its safety in pregnant women.
  • Botulinum toxin – There is some evidence that this is useful in treatment for piles, but it is not safe to use in pregnant and lactating women and hence must be avoided.
  • Oral hydroxyethylrutosides – A recent Cochrane review showed this group of drugs to be relatively safe in treating piles in pregnant women, but more studies need to be conducted to assess the full degree of safety.(5)
  • Other advanced techniques include sclerotherapy and surgery, which are often reserved for severely symptomatic cases.[/list]

Conclusion

Piles is a common condition that can occur in pregnancy. Treatment for piles involves a variety of conservative measures, but unfortunately there is not a significant body of evidence that supports this.

Further clinical studies need to be conducted to assess specific application of these methods in treating this rather distressing condition, bearing in mind the side effects that treatment may have on the fetus.

 References

1.  Gojnic M, Dugalic V, Papic M, Vidakovic S, Milicevic S, Pervulov M. The significance of detailed examination of hemorrhoids during pregnancy. Clin Exp Obstet Gynecol. 2005;32(2):183–4

2. Abramowitz L, Batallan A. Epidemiology of anal lesions (fissure and thrombosed external hemorroid) during pregnancy and post-partum. Gynecol Obstet Fertil. 2003;31(6):546–9

3. Alonso-Coello P, Mills E, Heels-Ansdell D, López-Yarto M, Zhou Q, Johanson JF, et al. Fiber for the treatment of hemorrhoids complication: a systematic review and meta-analysis. Am J Gastroenterol. 2006;101(1):181–8.

4. Shafik A. Role of warm-water bath in anorectal conditions. The “thermo-sphincteric reflex. J Clin Gastroenterol. 1993;16(4):304–8

5. Quijano CE, Abalos E. Conservative management of symptomatic and/or complicated haemorrhoids in pregnancy and the puerperium (Cochrane Review) Cochrane Database Syst Rev. 2005;(3):CD004077.

 

Photo Credit (Top): Peggy Reimchen

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