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Dr. Laura Pipher

That postpartum symptom no one told you about…

Okay, I’m going to say it mama, postpartum hemorrhoids are real pain in the ***.

When they told you about pregnancy, they DIDN’T tell you that even if you didn’t have constipation, pregnancy & postpartum hemorrhoids will [probably] happen, and once they do, well definitely won’t be going away on their own ! 

DID YOU KNOW – about 40% of women are diagnosed with hemorrhoids following childbirth (1). 

Hemorrhoids occur due to increased pressure in the veins of the anorectal area. This pressure may result from pregnancy, frequent heavy lifting, or repeated straining during defecation (eg, due to constipation) (2) . 

Postpartum constipation, can be a cause of hemorrhoids with straining and hard stool causing pressure in the anorectal area. Consequently, haemorrhoids, pain at the episiotomy site, and effects of pregnancy hormones can increase the risk of postpartum constipation, leading to the appearance of hemorrhoids (3).

here are some treatment options to ease your suffering: 

Fibre 
  • Seven randomized trials found fibre had a beneficial effect in the treatment of symptomatic hemorrhoids (4).
  • Fibre supplementation showed reductions in: 
    • Prolapse
    • Pain
    • Itching
    • Bleeding
Pycnogenol 

Women with hemorrhoids after their second pregnancy were dosed with pycnogenol for 6 months. Results concluded that pycnogenol appears to positively affect hemorrhoid signs and symptoms in the months after pregnancy (5). 

Probiotics 

In the group of women consuming probiotics, no one had haemorrhoids on most days by week 5-6. In the placebo group, on average four subjects had haemorrhoids from the beginning, and no obvious change was observed by week 6. 

Sitz Bath

Women in the sitz bath group had a salt sitz baths three times per day (7). The second protocol consisted of topical cream twice daily. Both protocols included the supportive treatments of 2g glycerin suppositories per rectum 20min before defecation as lubricant and Metamucil once daily after breakfast for constipation (7). Complete healing was achieved in all patients 284 (100%) in the Sitz bath group, compared to 179 (84.8%) in the cream group.

Flavonoids 

One study found the use of a flavonoids mixture (diosmin, troxerutin, rutin, hesperidin, quercetin) was found to be a safe and effective mean of managing bleeding from hemorrhoidal disease and minimal adverse events are reported (8).

Reducing constipation 
  • Water intake
    • set a goal of drinking atleast 2-3 litres of water per day (for every cup of coffee or caffeinated beverage, add a cup of water)
  • Food sensitivities 
    • these can be investigated through elimination diets or food sensitivity testing
  • Stomach acid 
    • low stomach acid can be a cause of constipation, evaluating your stomach acid will be an important first step for improving your digestion

Want to chat about your options? CLICK HERE to book your 15 minute discovery call 

References 

  1. doi: 10.1111/1471-0528.12838.
  2. https://www.merckmanuals.com/en-ca/professional/gastrointestinal-disorders/anorectal-disorders/hemorrhoids 
  3. doi: 10.1002/14651858.CD011625.pub2
  4. https://pubmed.ncbi.nlm.nih.gov/16235372/?from_term=postpartum+hemorrhoid&from_filter=subject.cam&from_pos=10
  5. doi: 10.1002/14651858.CD011625.pub2.
  6. DOI: 10.3920/BM2014.0076
  7. https://pubmed.ncbi.nlm.nih.gov/29055673/?from_term=hemorrhoids&from_filter=subject.cam&from_pos=8
  8. https://pubmed.ncbi.nlm.nih.gov/29934701/?from_term=hemorrhoid+treatment&from_filter=subject.cam&from_pos=7

 

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