Why does it occur after childbirth?
During pregnancy, an enlarged uterus impedes venous outflow from the pelvis, and progesterone relaxes the vascular wall and slows down bowel function. Constipation, taking iron supplements, and decreased physical activity are added. By the end of pregnancy, the nodes in many women are already enlarged, although they do not bother them. During childbirth, when pushing, the pressure in the veins increases sharply, and the nodes can swell, fall out, or thrombose. After childbirth, the situation is aggravated by fear of pain during bowel movements, lack of water and fiber in the diet, and prolonged sitting during feeding.
- Compression of veins by the growing uterus
- Hormonal relaxation of the vascular wall
- Constipation during pregnancy
- Iron supplements
- Pushing in the second stage of labor
- Fear of pain and holding in bowel movements after childbirth
Symptoms
Most often, women note discomfort, itching and a feeling of a foreign body in the anus, as well as scarlet blood on paper or on top of the stool. The pain is characteristic of thrombosis of the external node: then a dense, painful bluish formation appears, which makes it difficult to sit and walk. It is important to remember that anal fissure gives similar complaints, in which the pain is sharp, burning, occurs during bowel movements and continues after it. Only a doctor can distinguish the conditions during examination, so self-diagnosis is often erroneous.
- Itching and foreign body sensation
- Scarlet blood on paper or on top of stool
- Loss of knots when straining
- Dense painful node due to thrombosis
- Discomfort when sitting
- Feeling of incomplete emptying
The main thing is to adjust the chair
No ointment will help as long as constipation persists and every bowel movement injures the nodes. The basis of treatment is soft stool without straining. To do this, you need a sufficient amount of liquid, vegetables, fruits, cereals, and, if necessary, a mild laxative, which is selected by the doctor taking into account breastfeeding. It is important not to sit on the toilet for a long time with the phone and not to push, and also not to restrain the urge. Warm sitz baths reduce spasms and pain. Women taking iron supplements often require adjustments to their regimen because iron increases constipation.
- Drinking enough throughout the day
- Fiber: vegetables, fruits, grains
- Mild laxative as prescribed by your doctor
- Do not push or sit on the toilet for a long time
- Warm sitz baths
- Washing with cool water instead of hard paper
- Correction of iron supplementation with a doctor
Treatment while breastfeeding
Many women endure for months, fearing harm to the child. In fact, there are local remedies - suppositories, creams and ointments - which the proctologist or obstetrician-gynecologist selects taking into account feeding. You should not buy drugs on your own on the advice of friends: some of them contain components that are undesirable during lactation. If conservative treatment does not help, minimally invasive methods are used, such as ligation of nodes with latex rings, which are performed on an outpatient basis. Surgical removal of the nodes is discussed later, when the condition has stabilized, and usually not in the first weeks after birth.
- Local remedies selected by a doctor taking into account lactation
- Pain relief with approved drugs
- Ligation of nodes with latex rings
- Other minimally invasive methods
- Hemorrhoidectomy for severe forms
- Refusal to independently select medications
Prevention and lifestyle
After giving birth, it is important to start moving as soon as possible in the amount allowed by your doctor: walking improves intestinal function and venous outflow. Gymnastics for the pelvic floor muscles is useful, but you should start it after a consultation, especially if there were tears or stitches. You should not lift weights beyond what is recommended, and when feeding, it is better to change your position and not sit in one position for hours. A diet with enough fiber and water is the best long-term prevention. If you become pregnant again, you should discuss measures with your doctor in advance.
- Early physical activity and walking
- Exercises for the pelvic floor muscles after your doctor's permission
- Changing feeding position
- Limiting heavy lifting
- Diet with fiber and sufficient fluids
- Regular bowel movements without rushing
