Pregnant women are a high-risk population of hemorrhoids. Hemorrhoids are a group of veins formed by the expansion, bending, and bulging of the hemorrhoid venous plexus on the lower rectal mucosa and the deep surface of the anal skin. During pregnancy, in order to ensure the nutritional supply of the fetus, the arterial blood flow in the pelvic cavity of pregnant women increases; with the development of the fetus, the uterus becomes larger and larger, which will compress the pelvic cavity and hinder the blood return in the hemorrhoids; and pregnant women often have bowel movements. Effort or constipation can cause blood stasis in the hemorrhoid venous plexus in the lower rectum and anus, which can induce or aggravate hemorrhoids. Among the most risk factors for hemorrhoids, stool is the most influential factor, and stool abnormalities include diarrhea and constipation.
1. Prevention and treatment of anorectal diseases during pregnancy
1) Prevention first. Women who are preparing or starting pregnancy, especially in the middle and late stages of pregnancy and a period of time after childbirth, should do a good job of health care and prevention of the anal area from diet, defecation, and daily life. On the one hand, you should eat more fresh vegetables and fruits that are light and rich in fiber in your diet, which will help keep your stool smooth. Don't eat spicy and irritating foods to avoid dry stools. On the other hand, develop the habit of regular defecation in daily life. The defecation method should choose the sitting defecation method and minimize the defecation time. It is best not to squat to defecate. Wash the anus with warm water after defecation or before going to bed. In addition, avoid sedentary, standing, squatting and other postures, often do levator anus exercises and change postures appropriately to reduce the pressure on the anal area.
2) The basic principle of treatment is conservative treatment. In pregnancy, when anal disease causes obvious systemic symptoms and needs treatment, local conservative treatments are generally taken first, such as liquid fumigation, bathing, and ointment external application, etc., to reduce or eliminate symptoms. Influential topical medicines such as musk hemorrhoid cream and suppositories should also be banned. If conservative treatment is not effective and surgical treatment is necessary, it should be done in the third trimester of pregnancy, preferably after delivery. Pregnancy surgery must be fully prepared with an obstetrician and gynecologist before surgery. Local anesthesia or lumbar shu should be selected for anesthesia. For anesthesia, choose a comfortable lateral position, and choose a surgical procedure that is mildly injured and can quickly eliminate symptoms. If symptoms such as abdominal pain and vaginal bleeding occur during or after surgery, please consult the obstetrics and gynecology department for timely treatment.
2. Contraindications of medication during pregnancy
According to the toxicity of medicinal materials, the strength of their effects, and the degree of their effects on the mother and fetus, they are often divided into three categories: banned, contraindicated and used with caution. Prohibition means that the use must be strictly prohibited; avoidance means to avoid or preferably not use; use with caution means that under certain conditions, it can be used with caution, but the changes in the condition and the reaction after medication must be observed. In the Chinese Pharmacopoeia, there are a total of 99 kinds of medicinal materials and decoction pieces that are prohibited, contraindicated and used with caution in pregnancy. Chinese patent medicines containing corresponding ingredients are accordingly regarded as contraindicated, contraindicated and used with caution in pregnancy. Chinese patent medicines related to the treatment of anorectal diseases: prohibited ingredients (papaverine, musk, artificial musk, realgar, etc.); ingredients (rhubarb, aloe, notoginseng, borneol, etc.) should be used with caution.
Because hemorrhoids are often aggravated after pregnancy, it is recommended that women should treat hemorrhoids before pregnancy, especially those who often have prolapse after defecation should be psychologically prepared. For mild hemorrhoids before pregnancy and women who have no history of prolapse, they can adjust their diet during pregnancy. Appropriate amount of activity, work and rest, regular bowel movements, and a good mood to reduce the chance of hemorrhoids.