1. What is hemorrhoids? Why are pregnant women prone to constipation and hemorrhoids?
Hemorrhoids are soft venous clusters formed by the expansion and flexion of the submucosa of the lower rectum and the subcutaneous venous plexus of the anal canal. It is a chronic disease.
Pregnant women are a high incidence of hemorrhoids. The main reasons are as follows: ⑴The general activity of pregnant women is relatively reduced, which causes weakening of gastrointestinal function, and the feces stay in the intestinal cavity for a long time, and the absorption of water causes dry stool and constipation; ⑵ The pressure of the enlarged uterus on the rectum can aggravate constipation; (3) The enlarged uterus compresses the blood vessels in the pelvic cavity, so that the venous blood in the legs, perineum and rectum cannot flow back smoothly, which makes the lower rectum and around the anus. Venous stasis swells to form hemorrhoids; (4) The effects of progesterone, estrogen, and aldosterone in the body cause water and sodium retention during pregnancy, aggravating tissue edema, and progesterone and oxytocin act on the pelvic floor fascia and the internal and external rectal sphincter to relax, which is easy to induce inflammation Prolapse and bleeding of external and internal hemorrhoids.
2. What are the manifestations of hemorrhoids? What is the harm to pregnant women and fetuses?
Hemorrhoids are divided into internal hemorrhoids and external hemorrhoids. Internal hemorrhoids are divided into grades I to IV. Because of their different severity, the clinical manifestations are also different. Degree I internal hemorrhoids are manifested as bloody, dripping or jet-like bleeding in the stool. The bleeding can stop on its own. Second-degree internal hemorrhoids are manifested as blood, dripping or jet-like bleeding in the stool, accompanied by prolapse of internal hemorrhoids, which can be repaid by themselves after the stool. III-degree internal hemorrhoids are manifested as bloody and dripping in the stool, accompanied by prolapse of internal hemorrhoids or standing for a long time, coughing, fatigue, and prolapse of internal hemorrhoids during weight bearing, which need to be repaid by hand. IV degree internal hemorrhoids manifested as internal hemorrhoids prolapsed and could not be received. Internal hemorrhoids can be accompanied by incarceration, strangulation and pain. External hemorrhoids manifest as anal discomfort, dampness and uncleanness, and may be accompanied by thrombosis and pain.
The main hazards of hemorrhoids to pregnant women are: ① blood in the stool, which can cause anemia in severe cases; ② internal hemorrhoids with incarceration, strangulation or thrombotic external hemorrhoids can cause pain and affect work and rest.
The main hazards of hemorrhoids to the fetus are: pregnant women's anemia affects the normal development of the fetus, easily causing fetal growth retardation and low weight; severe cases may cause premature delivery or death of the fetus.
3. How to treat and condition during pregnancy?
Hemorrhoids during pregnancy are mostly treated conservatively, and the child’s condition can be relieved to varying degrees after birth. After the child is born, it is determined whether further treatment is needed according to the condition. The level of progesterone in the body in the early stage of pregnancy is low, and various stimuli in the perineum can reflexively cause uterine and vaginal contractions, causing miscarriage, and invasive treatment is not suitable; the placenta can produce enough progesterone in 4-7 months of pregnancy. The general injury of the perineum stimulates the uterus and vagina lightly, and can treat thrombotic external hemorrhoids and hemorrhoid hemorrhage in stages I and II with less damage; and invasive treatment in the late pregnancy may cause premature delivery.
It is recommended that patients eat a high-fiber diet, drink plenty of water, defecate regularly, maintain local hygiene, and hot water PP bath. Use drugs under the guidance of a doctor. Some drugs can cause teratogenesis or cause miscarriage and should be avoided. For example, musk has a significant excitatory effect on the uterus, and miscarriage or premature delivery can easily occur after the use of medicine containing musk; in addition, strong laxatives (rhubarb, senna, etc.) can also induce miscarriage or premature delivery. When pregnant women suffer from hemorrhoids and have bleeding symptoms, a suppository containing compound carrageenin can be used directly into the anus. Appropriate oral laxatives (such as lactulose, honey, etc.). When hemorrhoids are prolapsed, incarcerated, swollen and painful, wash them with hot water first, then apply 33% magnesium sulfate solution to hot and wet the affected area, and then locally apply hemorrhoid cream (9 Hua paste or carrageenan etc.).
4. How to prevent constipation and hemorrhoids during pregnancy?
① Eat a reasonable diet, avoid spicy and irritating food, and eat small and frequent meals.
② Pregnant women should drink plenty of water, drink a glass of light salt water or honey water after getting up in the morning to avoid dryness in the intestines.
③ Eat more cellulose-rich vegetables and fruits, such as celery, leeks, cabbage, fungus, dried white bamboo shoots, bananas, apples, etc.
④ Pay attention to local cleanliness, and take a warm water bath every day to speed up blood circulation.
⑤Appropriate exercise, do not sit on the sofa for a long time during pregnancy, and do not sit in front of the computer or TV for a long time.
⑥Develop the habit of defecation regularly, try to shorten the time of each defecation, and do not sit on the toilet and read the newspaper.
⑦ During pregnancy, sleep in a lateral position to relieve or eliminate the compression of the pregnancy uterus on the inferior vena cava and avoid blood stasis.
⑧Lifting anus exercise: 3 times a day, 30 times each time, to improve local blood circulation, strengthen the muscles of the bottom of the pelvis, and help defecate and prevent hemorrhoids.
5. Will hemorrhoids affect delivery? What should I do after delivery?
Hemorrhoids generally do not affect childbirth. After delivery, continue to eat a reasonable diet, drink more water, eat more fiber-rich foods, and exercise properly. For severe hemorrhoids, it is best to have surgery after childbirth or after the baby is weaned.