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Hemorrhoids issues, constipation during pregnancy. How is its treated?

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General & Family Physician
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I believe I am suffering from some XXXXXXX hemorrhoids issues, I wanted to get some advice. I am a 38 year old women. When I became pregnant with my first child, constipation and hemorrhoids were my worst pregnancy issues. I had some issues with hemorrhoids before getting pregnant-rarely- both XXXXXXX (2x) and external. XXXXXXX hemorrhoids symptoms included bright red blood in the toilet and some bright red blood on the tissue paper. I was given a digital exam by my obgyn who did not order any further testing. She is currently aware of the situation I am describing here. After giving birth to my son, my external hemorrhoids were extremely aggravated but went away with time, however, the constipation and XXXXXXX hemorrhoids have persisted. It has been roughly five months. The constipation and XXXXXXX hemorrhoids started to go away but came back when I became extremely stressed and overwhelmed. Lately I have become concerned that the hemorrhoids are a sign of a more serious problem. I am wondering how concerned I should be?
Posted Thu, 24 May 2012 in Digestion and Bowels
Answered by Dr. Pavan Kumar Gupta 1 hour later
Hello and thanks for the query.
You should definitely be concerned about it as it is not going to go of it's own and you have to take some measures to cure it because if left untreated,it will keep on causing problem to you.

Hemorrhoids are relatively common during pregnancy and the postpartum period. Some women get them for the first time while they're pregnant – and if you had them before you conceived, you're likely to get them again. Luckily, they often go away on their own soon after you give birth or with some simple measures but in many cases they progress as in you.

Pregnancy makes you more prone to hemorrhoids.
Your growing uterus puts pressure on the pelvic veins and This pressure can slow the return of blood from the lower half of your body, which increases the pressure on the veins below your uterus and causes them to become enlarged.
In addition, pregnancy brings an increase in the hormone progesterone, which causes the walls of your veins to relax, allowing them to swell more easily. Progesterone also contributes to constipation by slowing down your intestinal tract. Constipation often leads to straining, which can cause or aggravate hemorrhoids.
You may also have developed hemorrhoids while you were pushing during the second stage of labor.
Conservative treatment typically consists of increasing dietary fiber, oral fluids to maintain hydration, non-steroidal anti-inflammatory drugs (NSAID)s, sitz baths, and rest. Increased fiber intake has been shown to improve outcomes,and may be achieved by dietary alterations or the consumption of fiber supplements.
While many topical agents and suppositories are available for the treatment of hemorrhoids, there is little evidence to support their use.Steroid containing agents should not be used for more than 14 days as they may cause thinning of the skin. Skin protectants such as petroleum jelly or zinc oxide cream may potentially reduce injury and itching.
A number of surgical techniques may be used if conservative medical management fails. 
Hemorrhoidectomy is a surgical excision of the hemorrhoid used primarily only in severe cases. 
Doppler-guided, transanal hemorrhoidal dearterialization is a minimally invasive treatment using an ultrasound doppler to accurately locate the arterial blood inflow. These arteries are then "tied off" and the prolapsed tissue is sutured back to its normal position. 
Stapled hemorrhoidectomy, or, more properly, stapled hemorrhoidopexy, is a procedure that involves the resection (removal) of much of the abnormally enlarged hemorrhoidal tissue.It is generally less painful than complete removal of hemorrhoids, and is associated with faster healing compared to a hemorrhoidectomy.
You must consult your doctor and try to cure it by conservative treatment but if this treatment fails,then you have to resort for the surgery which can be decided by your doctor in consultation with.
I hope to have answered your query however you can revert to me for any other query.
Thanks and best of luck
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