Treatment of hemorrhoids during pregnancy. Hemorrhoids during pregnancy - modern methods of treatment

08.08.2019

This form of drugs acts locally, which significantly reduces the risk of negative effects on the developing fetus. Modern proctology offers several safe and effective ointments for the treatment of hemorrhoids in pregnant women.

Why does hemorrhoids occur during pregnancy?

There are several factors provoking the appearance of a proctological disease in expectant mothers, and they affect the female body sequentially - depending on the trimester of pregnancy.

First trimester. In the first weeks, the threat of the development of the pathological process increases due to the hormonal substance progesterone. After fertilization of the egg, it is produced in large quantities and affects muscle tone, relaxing both the uterine walls and the smooth muscles of the intestines. As a result, the expectant mother suffers from constipation.
Second trimester. From about 13-14 weeks, for quite objective reasons, the mobility of the expectant mother is limited. Puffiness, toxicosis, dyspeptic symptoms, headache, high blood pressure - all this limits the activity of a woman and leads to frequent lying or sitting. As a result, stagnant processes begin in the pelvic veins, which causes the expansion of the existing cavernous formations.
Third trimester. By the end of pregnancy, the enlarged uterus begins to squeeze the venous vessels in the rectal canal, which disrupts blood flow in the pelvic and rectal zones. Also, by this time, the frequency of constipation increases significantly due to low mobility.

At any period of pregnancy, the development of hemorrhoidal disease is facilitated by congenital venous insufficiency.

Hereditary weakness of the vascular walls, coupled with predisposing factors, several times increases the threat of a pathological process.

Symptoms of hemorrhoids in pregnant women

The appearance of pronounced signs usually begins in the second half of pregnancy. The consequence of stagnation is the expansion and protrusion of varicose hemorrhoidal veins.

In addition, the muscle structures that support the cavernous "sacs" change pathologically, stretching and weakening. By the end of the third trimester, the vessels and muscles significantly lose their tone, which leads to protrusion and even loss of nodes.

At the beginning of the disease, hemorrhoids can be recognized by burning and itching sensations in the rectal canal. Soreness is usually mild. When you have a bowel movement, you may find blood on toilet paper.

As the disease intensifies, the symptoms increase. The presence of a foreign object in the rectum, bleeding, pain during and after a bowel movement is added to the previous signs.

If hemorrhoids are not treated, then soon the enlarged hemorrhoid will begin to come out of the anus. At first, it still independently returns to the rectum, but then it will be possible to correct it only with some effort.

Such nodules are painful, inflamed, and differ in dark red color. Their protrusion leads to discomfort and pain when using the restroom, moving around, resting and working.

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At the last stages of the disease, the nodes are no longer reset, significantly worsening the quality of life, well-being and health of the expectant mother. In such cases, emergency measures are required, since labor can only worsen the situation.

At an early stage of the pathological process, hemorrhoids during pregnancy can be slowed down with the help of ointments.

They effectively fight the manifestations of the disease, allowing the expectant mother to think not about pain, but about the upcoming motherhood.

Ointments against inflammation and infection

Ichthyol ointment

This preparation is made from processed peat containing fish remains. The active ingredient is ichtammol - a substance that contains sulfur.

The active ingredient gives the ichthyol ointment multiple useful functions, including anesthesia, relieving inflammation, disinfection, drying tissues and preventing suppuration, improving local blood circulation.

Ichthyol ointment prescribed at any gestational age helps:

from external hemorrhoids;
from rectal fissures;
from ulcers in the rectum.

Contraindications The medication is prohibited for use only if a pregnant woman has an intolerance to the active or auxiliary ingredients.

Application. A small amount of ointment is applied to the skin of the anus before falling asleep for 2 weeks. In the morning, the excess of the drug can be removed with a napkin, and the perineum can be washed with water. Hygiene procedures should be carried out before lubrication.

Relieves inflammation and accelerates healing, but is not able to get rid of the disease, therefore it is used as part of a complex treatment for hemorrhoids with other medicines.

Price. You can buy the product at any pharmacy for 70-90 rubles.

Heparin ointment

The main ingredient that determines the action of the drug is the anticoagulant heparin. It is thanks to this substance that it effectively and quickly relieves inflammation, prevents the formation of blood clots and dissolves already existing blood clots.

Other active ingredients - benzocaine and benzyl nicotinate - additionally anesthetize hemorrhoids and increase the penetration of heparin into tissues.

Heparin ointment for hemorrhoids is indicated for:

inflammatory processes;
enlarged external nodules;
high threat of thrombosis formation.

Contraindications Heparin ointment is prohibited for use if a pregnant woman has:

increased bleeding (the drug reduces blood clotting, which leads to bleeding);
rectal fissures;
erosive damage to the anus;
the risk of spontaneous abortion.

Application. Since the medication has limitations and side reactions, expectant mothers are allowed to use it only after consultation with the attending doctor. And in the first trimester it is generally better to refuse to use it.

The dosage and duration of treatment is determined by a specialist, usually the agent is applied to the external nodules twice a day for 10-14 days. With internal hemorrhoids, the drug is applied to a bath swab, which is injected into the rectum.

Price. The average cost of a medicine in Russian pharmacies is 50 rubles.

Hepatrombin G

This is a combination drug, which, in addition to heparin, also contains prednisolone and lauromacrogol 600. The combination of these ingredients allows you to dissolve and prevent the formation of blood clots in the veins, relieve swelling and stop inflammation.

In addition, the drug relieves painful sensations, glues blood vessels, which contributes to the collapse and reduction of cavernous veins.

In addition to external hemorrhoids during pregnancy, Hepatrombin G is indicated for the diagnosis of:

internal hemorrhoidal nodules;
thrombophlebitis of the anal veins;
itchy sensations;
eczematous lesions of the anus;
anal fissures.

Contraindications The drug is prohibited for use in case of intolerance to the main or additional ingredients.

It is also worth refusing to use the product if the skin or mucous membrane of the anorectal region is affected by bacteria, viruses or fungal organisms.

Due to the presence of heparin, the ointment is prohibited with a predisposition to bleeding and tumor formations of the skin.

Application. Hepatrombin G during pregnancy can be used only from the second trimester due to the content of the hormonal substance. It is very simple to use the product - you need to apply it to the affected area 2-4 times a day. With internal hemorrhoids, the drug is injected into the intestine using an applicator.

Price. The ointment can be purchased without a prescription for about 170-190 rubles at any pharmacy chain.

Vishnevsky ointment

The composition of the ointment, or rather the balsamic liniment, contains 3 main ingredients: xeroform, birch tar and castor oil.

It is their combination that determines the unique properties of the drug.

Disinfects, relieves inflammation, kills disease-causing organisms, and also enhances local immunity.

In addition, the ointment has an irritating effect on tissues, activating blood circulation in the damaged areas and, thereby, accelerating regeneration.

Balsamic liniment is a universal remedy against many pathologies of the skin, purulent processes in the deep layers of tissues.

Pregnant women can be prescribed it for:

acute external hemorrhoids;
inflammation of the anorectal region;
anal fissures.

Contraindications The drug has a very short list of contraindications - it cannot be used only in case of hypersensitivity to one or more ingredients.

Application. For expectant mothers, the drug can be used in any trimester, it is also allowed during breastfeeding. The agent should be applied to the nodules and surrounding tissues with a thin layer, the procedure is carried out 2-3 times a day.

Price. Another advantage of balsamic liniment is its low cost. The ointment is sold in pharmacies for 30-40 rubles per pack.

Levomekol

This is a combination drug, which is also called "the surgeon's favorite drug."

It received this name for its pronounced antibacterial, anti-inflammatory and wound healing qualities.

The combination of active substances (chloramphenicol and methyluracil) ensures rapid penetration of the agent into the affected tissues and accelerates the recovery processes in the deep layers.

The drug is indicated for use when detecting:

rectal fissures;
external hemorrhoids;
erosive and ulcerative damage to the anorectal region;
inflammation of the anus.

Contraindications Levomekol has a minimum of contraindications. The product is prohibited for use only in case of hypersensitivity to its ingredients.

Application. During the period of childbearing, the drug is allowed, but it must be agreed with the gynecologist, since the ointment contains a local antibacterial ingredient.

With hemorrhoids, a small amount of ointment is applied to the affected areas in the evening after hygiene procedures.

Price . You can buy Levomekol at any pharmacy at a very reasonable price - 100-110 rubles.

Fleming's ointment

This is a homeopathic medicine, which contains extracts of medicinal plants such as calendula, witch hazel, horse chestnut. The preparation also contains zinc compounds and menthol.

The natural components of Fleming's ointment can quickly and effectively relieve inflammation, destroy pathogenic bacteria, numb, dry damaged areas, and strengthen the walls of blood vessels.

The drug is used for mild external hemorrhoids, which is accompanied by inflammatory processes and the release of venous exudate (the so-called weeping hemorrhoids).

Contraindications Due to its naturalness, the drug has practically no contraindications, with the exception of hypersensitivity to the components of the drug. Expectant mothers are prescribed this ointment in any trimester of pregnancy.

Application. The tool is used in a short course - up to 7 days.

If symptoms persist, the doctor may prolong treatment or prescribe another drug. Apply the ointment 1-3 times a day, applying a thin layer to the inflamed areas.

Price. The price for a 25-gram tube is approximately 300-320 rubles. The drug is dispensed without a prescription.

Posterisan

The drug, which is based on inactivated bacterial cells, has pronounced anti-inflammatory properties. Its use allows you to remove puffiness, restore damaged tissues, accelerate the healing of cracks, and increase local immunity.

In addition, the ointment has a positive effect on the condition of the veins and capillaries, increasing their tone, eliminating congestion, as a result of which itching and burning sensations in the perianal region disappear.

Hemorrhoid cream can also be used for problems such as:

eczematous lesions of the anus;
rectal fissures;
itching in the anal area;
perianal dermatitis.

Contraindications The main contraindication for use is the intolerance of the phenolic compound present in the composition. In other situations, the drug is allowed for all categories of patients, including pregnant women.

Application. The drug should be applied to the affected area of the skin or mucous membrane in a thin layer in the morning or in the evening. With internal hemorrhoids, the agent is introduced into the rectal canal using the applicator attached to the package.

Price. Prices for the drug vary, but the average cost of a 25-gram tube is 480 rubles.

Ointments with vasoconstrictor and venotonic properties

It is prescribed to improve blood circulation in cavernous formations. Venotonic drugs are designed to restore the elasticity of the vessel walls and improve venous blood flow.

Also, agents with a vasoconstrictor effect are used, which are designed to stop bleeding and relieve swelling of hemorrhoidal nodules.

Troxevasin

The drug related to venotonics and angioprotectors increases the tone of the venous walls, increases their elasticity and reduces fragility, relieves inflammation and swelling.

In addition, Troxevasin reduces the severity of painful sensations, prevents the formation of blood clots in the venous ducts. At the initial stages, the gel is able to completely restore blood circulation in the veins.

The drug not only relieves hemorrhoids during pregnancy, but also effectively fights conditions such as:

venous insufficiency;
varicose veins;
rectal valve spasms.

Contraindications The gel is prohibited for use in case of intolerance to the active or additional ingredients. Also, you can not apply the agent for deep wound injuries and infectious processes in the anorectal region.

Application. Venotonic is allowed to be used at any gestational age with the permission of the attending doctor. The drug is applied to the damaged area or a compress soaked in the agent is applied to the external hemorrhoidal nodules.

Price. The drug can be purchased without a medical prescription for 180-210 rubles.

Troxerutin

The drug acts similarly to Troxevasin, since it contains the same active ingredients. This venotonic helps to normalize blood circulation, prevent the formation of blood clots, eliminate congestion in the anal veins and relieve inflammation and swelling.

Among the indications of a medical device are:

external hemorrhoids;
edema of the anorectal region after hemorrhoidectomy;
venous insufficiency.

Contraindications The list of contraindications coincides with the limitations of the previous venotonic agent.

Application. But on this point there are some discrepancies. Troxerutin is prohibited in the first 12 weeks of gestation; you can start using it only from the third trimester. Apply the gel to the damaged external nodules in the morning and evening.

Price. The expectant mother may be pleasantly surprised by the price of the medication. In pharmacy chains, it costs about 35-40 rubles for a 40-gram tube.

Relief

The product contains a unique ingredient - shark liver oil, which helps to stop blood, accelerate tissue regeneration, relieve inflammation and itching sensations.

The second active ingredient - phenylephrine - is a pronounced vasoconstrictor that prevents bleeding and relieves tissue swelling.

In addition to external hemorrhoids, the drug is used to treat:

internal hemorrhoids;
rectal fissures;
itching in the anus.

Contraindications The ointment is prohibited for use in case of intolerance of the constituent elements of the product, blockage of blood vessels with blood clots, blood disease in which the number of granulocytes is reduced. Due to the vasoconstrictor effect, the drug is prescribed with caution to hypertensive patients.

Application. The tool is approved for use during the period of bearing a child, but only on strict indications. Apply the ointment twice a day to the affected areas or inject it into the rectum using an applicator.

Price. The medication can be purchased for 390 rubles per tube.

Anesthetic ointments

Ointments for hemorrhoids during pregnancy with an analgesic effect are usually prescribed in case of exacerbation of hemorrhoidal disease or with severe pain syndrome that accompanies bowel movement.

Bezornil

Combined medicine made according to the prescriptions of healers from China. The ointment fights with almost all the main symptoms of hemorrhoids, but most often it is prescribed for pain in the last stages of the disease.

Pearls and bezoar contained in the ointment have a pronounced analgesic effect.

Other ingredients help relieve inflammation and heal damaged areas.

The drug is used for the complex therapy of hemorrhoidal disease, anal fissures and eczematous lesions of the anorectal region.

Contraindications Bezornil should be discarded by women with an intolerance to one or more of the ingredients. In addition, some pregnant patients find it difficult to tolerate the not entirely pleasant smell of the drug.

Application. Prescribe a remedy during pregnancy after a balance of risk and benefit to the fetus. The drug is applied twice a day and after each bowel movement.

With rectal nodes, the ointment is injected using a tip.

Price. The ointment is sold in pharmacy chains without a prescription at a price of 350 rubles for a 10-gram tube.

Procto-Glivenol

The drug acts in a complex way, relieving pain, relieving inflammation and reducing bleeding. In addition, the cream has a venotonic effect, that is, it allows you to restore blood circulation in the affected areas and restore the elasticity of blood vessels.

The cream is intended for the treatment of chronic and acute varicose enlargement of hemorrhoidal veins of external or internal form.

Contraindications A medication is prohibited in the presence of intolerance to the ingredients, as well as in severe liver failure.

Application. Procto-Glivenol is allowed to be used only from the 2nd trimester for strict medical reasons. The cream is applied in a thin layer to the external nodules; for rectal hemorrhoids, the drug is injected into the rectal canal using a tip.

Price. The drug can be purchased at any pharmacy for 370-390 rubles.

Relief Advance

In addition to shark liver oil, the preparation contains benzocaine anesthetic, which causes analgesic properties. Also, the ointment will help get rid of itching sensations, inflammation, bleeding, and also accelerate the healing of the affected tissues.

The drug for hemorrhoids can also be used to treat:

erosive damage to the anus;
anal itching;
ulcerative lesions of the rectal mucosa.

The ointment is used as an anesthetic for diagnostic measures - for example, with sigmoidoscopy.

Contraindications Relief Advance is prohibited for use if the patient is hypersensitive to its components. Also, the drug is abandoned for thromboembolic conditions.

Application. The remedy is prescribed to expectant mothers with caution and only according to strict indications. Ointment with severe pain syndrome is applied up to 4 times a day, if necessary, you can use a special applicator.

Price. The drug is not cheap - the price for a small tube starts at 400 rubles.

Table of antihemorrhoidal ointments allowed during pregnancy

For the convenience of women in position, all the ointments presented above are summarized in a table that will help to understand in which trimester of pregnancy one or another medication is allowed.

Means	Trimesters
Means	I	II	III
Ichthyol ointment	+	+	+
Heparin ointment	-	+	+/-
Hepatrombin G	-	+	+
Vishnevsky ointment	+	+	+
Levomekol	+	+	+
Fleming's ointment	+	+	+
Posterisan	+	+	+
Troxevasin	+	+	+
Troxerutin	-	+	+
Relief	By agreement with the doctor
Bezornil	According to strict indications
Procto-Glivenol	-	+	+
Relief Advance	By agreement with the doctor

Homemade hemorrhoid ointments for pregnant women

If a woman in a position is afraid to use pharmaceuticals or wants to enhance the effect of medications, the doctor may suggest homemade anti-hemorrhoidal ointments.

Most often, homemade preparations include active ingredients such as:

tincture of calendula;
propolis;
vegetable raw materials.

Preparing funds is quite simple, it is only important to find the necessary components. As a basis, butter or vegetable oil, interior fat are used. Traditional healers offer the following recipes for ointments.

With calendula. The tool fights inflammation and pathogenic bacteria, and also promotes the early healing of wound surfaces. To prepare the drug, 5 parts of butter are mixed with 1 part of the pharmacy's tincture of calendula. After cooling, it is applied to the external nodules.
With propolis. The waste product of bees promotes rapid regeneration, removal of puffiness. The crushed product is mixed with vegetable oil in a ratio of 1 to 10 and placed in a water bath until dissolved. The ointment is applied to the affected areas, you can also make candles from propolis from hemorrhoids during pregnancy.
With herbs. Take in equal parts the crushed powder of St. John's wort, kidney grass, toadflax and oak bark. Vegetable raw materials are added to the interior fat and melted in a water bath. After a few hours, the preparation will be ready to be applied to the inflamed areas.
With onion. The peeled vegetable is boiled with vegetable oil, then the onion is removed, and beeswax and potato pulp are added to the broth. After thorough mixing and cooling, the product is ready for application to external hemorrhoids.

The listed non-traditional methods of treatment have proven their effectiveness. However, using only them for the treatment of hemorrhoids is a wrong decision.

Expectant mothers should consult a doctor who will prescribe local or systemic pharmaceuticals, tell about important hygiene procedures and proper diet.

Despite the local, independent use by expectant mothers is excluded. Only with a reasonable approach to therapy can the risks for oneself and the child be eliminated.

The literal translation of the disease of the civilized age is bleeding, because the main symptom of hemorrhoids is spotting from the anus. The vessels of the rectum have weak and extensible walls. When filled, it stretches, the veins lose elasticity, provoking the formation of hemorrhoids.

The most severe congestion provides a prolonged stay in a sitting or standing position (motionless). Pregnant women are also at risk.

Treatment options determine the stage of the disease and the trimester of pregnancy. In particular, sigmoidoscopy (the study of internal nodes with an optical apparatus inserted into the intestine) is contraindicated for pregnant women, the examination is carried out with fingers.

The risk of hemorrhoids increases during the 2nd trimester of pregnancy. The enlarged uterus occupies a significant volume of the abdominal cavity. The constricted intestines are displaced, the veins are pinched, causing blood congestion.

At the same time, the intestinal muscles lose sensitivity to nerve impulses and stimulants. The functions of the intestines and uterus are regulated by one nerve plexus, a protective reaction that preserves pregnancy, contributes to the difficulty of emptying the intestines. A pregnant woman experiences discomfort from constipation, which causes tension during bowel movements.

Labor activity sharply increases the pressure during contractions, the fetus, pressed against the small pelvis, compresses the veins. The nodes swell and darken. The longer the labor is, the more likely you are to get hemorrhoids..

- a common phenomenon: 25.7% of pregnant women and 49.8% of women in labor receive such a diagnosis. Many women consider the disease to be the norm and do not go to the doctor. The consequences of an untreated chronic disease are serious: it can cause diseases of the joints and spine, inflammation of the urogenital area.

Can such a “delicate problem” be avoided?

A pregnant woman must constantly monitor her condition. Therapies shown for ordinary people, for pregnant women, can have a negative effect on the fetus. Each visit to the pharmacy is discussed with the doctor. At the first stage of hemorrhoids, the proctologist gives general recommendations:

Avoid stress when using the toilet.
Avoid sedentary or standing work. As a last resort, increase the breaks for changing body positions.
A balanced diet should include more plant foods and less meat and flour dishes. It is important to take food in fractional parts: 200-300 g 5-6 times a day. The rate of water for pregnant women is up to 2 l / day.
In addition to kefir and yoghurts, vegetables are useful (watermelons, pumpkin, prunes, beets, carrots, cabbage).
Limit constipation-causing black bread, legumes, and fruits. Avoid spicy and salty foods that increase blood flow. Provokes constipation and fatty foods.
Hygiene procedures are carried out with water at room temperature after each trip to the toilet. It is better not to use paper and napkins. A shower and tampons with herbal decoction are useful (calamus, oak bark - 1 tbsp. L. Per glass of boiling water).
Lift your pelvis with a roller and lie on your back for up to 15 minutes.

In addition to special treatment with drugs for hemorrhoids, during pregnancy, sitz baths in warm water with a solution of manganese or a decoction of calamus root are recommended. Heavy physical activity, including hand washing, cleaning, is prohibited.

The fourth stage of the disease, characterized by profuse bleeding of pinched prolapsing cones, requires urgent hospitalization. Surgical treatment consists in and:

, which holds the walls of blood vessels;
- pinching the knot with a latex ring, causing it to die off;
and - laser therapy and warming up.

If time suffers, the operation is postponed for a month or two after childbirth. The cost of the service is about 30 thousand rubles. In addition to the operation, this amount includes hospitalization in the clinic, pain relief, research, and the purchase of disposable instruments.

Special means

In the treatment of hemorrhoids during pregnancy, drugs are used of two types: for local and systemic effects. The first option (ointments, creams and suppositories) is more effective during pregnancy.

Local treatment reduces the side effect that is harmful to the child. Such drugs quickly relieve pain, swelling and inflammation, restore blood flow in the intestine, prevent the development of blood clots, relax the sphincter, improve bowel function, and liquefy feces.

increase the muscle tone of the abdominal region, improve bowel function, reduce blood stasis. It is advisable to do gymnastics at least in the morning and in the evening.

Walking with legs raised high, bent at the knees;
Swing legs alternately: back and forth and to the sides - you can hold onto a chair;
Torso bends;
Tension of the buttocks with parallel retraction of the anus;
Toe squats (knees wide apart).

Medicines for hemorrhoids for pregnant women are conveniently placed in a table.

Name	Indications	Restrictions	Mode of application
Suppositories with, lanolin and anesthetics	Pain relieves, soothes.	Individual intolerance to the components	Administer after emptying the intestines, lying on its side.
Prednisolone	Reduces inflammation, itching, burning, allergies.	Viral and fungal infections of the intestine. In the first trimester, they are not prescribed.	The ointment is applied in a thin layer 3-4 times a day, after hygiene.
Medicines with heparin	They prevent the appearance of blood clots, relieve swelling, and enhance tissue regeneration.	Poor blood clotting.	The candles are not pushed in with effort, but are held at the entrance for 2 minutes until dissolved.
Suppositories with diphenhydramine, carotene, shark liver,	Relieve sphincter spasm, accelerate wound healing	There are no contraindications	The candle from the refrigerator should be kept warm.
,	Complex analgesic, astringent and wound healing action	Lidocaine can cause fetal bradycardia and hypoxia	Use as needed, periodically
based on heparin, prednisolone and anesthetic	Relieves itching, inflammation, spasms, prevents blood clots	Not recommended for long-term use if there is a threat of miscarriage	Can be applied multiple times throughout the day
Relief Advance with shark liver oil and benzocaine	Relieves inflammation, relieves pain, stops bleeding	Reception is undesirable for hypertension	Can be applied up to 4 times a day
Troxerutin	Strengthens the tone of the veins, relieves pain and swelling, is indicated for dense nodules	Suitable for all stages.	1-2 times a day, the gel is applied on a gauze bandage.

Local preparations can cause allergies. If after a week there is no positive trend, you need to be tested again. To provoke a miscarriage by the use of suppositories with belladonna (Anusol, Bellataminal).

Remedies for hemorrhoids during pregnancy, intended for systemic treatment, are prescribed in the form of capsules or tablets.

Name	Indications	Restrictions	Method of use
Venotonic Detralex	Strengthens veins, relieves inflammation, good antioxidant	Do not use during lactation	The course is 2-3 weeks with a break of 1-2 months.
Aescusan and other preparations based on horse chestnut	Improves blood flow, relieves inflammation, edema, blood viscosity	Not useful in pregnancy before 14 weeks	12-15 drops 3 times daily before meals
Troxerutin (Troxevasin)	Reduces inflammation and capillary fragility	Use with caution in renal failure	The gel is applied around the weeping wound in the morning, the capsules are washed down with water during meals.
Ginkor forte with ginkgo biloba	strengthens veins, reduces inflammation	Allergic reactions are possible	Swallow 1-2 capsules a day whole
Aspirin, courantil	Thinning blood, preventing thrombosis	Limitations in heart failure	Consume on an empty stomach, dose - individually
Regulax, Duphalac, Forlax, Prelax	Laxative effect, liquefaction of feces	All analogues that increase the tone of the uterus are contraindicated.	3-4 times 30-45 ml, to support the chair 2-3 p. in a day

I have a second pregnancy. And here on you: at the end of the eighth month, crap got out! I'm in shock !!! he gives me a lot of uncomfortable things! and terribly unnerving! Tell us what to do with hemorrhoids in the 3rd trimester of pregnancy?

Expert answer:

Remember: in whatever trimester hemorrhoids appear, be sure to see a doctor. The sooner you start to act, the more likely you are to get rid of this unpleasant ailment. Do not make "noble self-sacrifices" for the health of the unborn baby, postponing treatment until the postpartum period. Firstly, your constant nervous tension is transmitted to the child and is unlikely to have a beneficial effect on him. Secondly, the nature of the disease can worsen and cause a lot of trouble during childbirth, or even develop into a chronic condition. And thirdly, large hemorrhoids cause inflammation and tissue death, which significantly increases the risk of contracting an infectious disease. All these are not horror stories at all, but, unfortunately, realities. That is why at the first signs of hemorrhoids (pain during the act of defecation, the appearance of blood in the stool, itching around the anus or sagging purple nodes from it), you should consult a doctor, and not self-medicate. Depending on the stage of hemorrhoids, as well as taking into account individual physical characteristics, he will prescribe you an effective treatment. As a rule, these are suppositories, ointments or rectal suppositories that are allowed for pregnant women, therefore they are absolutely safe for a woman and her unborn baby. Among such drugs are heparin ointment (inexpensive, effective in the initial stages of hemorrhoids), sea buckthorn suppositories (sea buckthorn oil promotes healing of cracks and tissues of hemorrhoids), Posterisan, Neo-Anuzol (not prescribed for those who may have intolerance to iodine-containing drugs), "Relief" (based on shark liver). As for traditional methods of treatment, among them local baths of herbal decoctions may be acceptable. For example, such a collection relieves the inflammatory process well: oak bark, flax seeds, chamomile (taken in equal proportions). Pour a tablespoon of the mixture with a glass of boiling water, insist for half an hour, filter and take a bath for no longer than 15 minutes. A mixture of calendula, sage, nine-strength, nettle, chamomile, yarrow, shepherd's purse is also suitable. Take 4 tablespoons. mixture, pour a glass of boiling water, let it brew for 4 hours, strain and also do a local bath. But to put homemade "candles" from potatoes is not worth it - it is unhygienic. By the way, personal hygiene for hemorrhoids should be thorough. An intimate shower must be carried out after each act of defecation, and at least once with antiseptic agents (the above-described trays with herbs or a solution of potassium permanganate are suitable). Surely the doctor will also advise you to adjust your diet and add more vegetables, fruits, cereals, prunes, herbs, cereals, fermented milk products to the diet, which have a beneficial effect on the digestion process. And also a moderate but active lifestyle with walks in the fresh air. Don't ignore your doctor's advice and you will be fine.

Hemorrhoidal inflammation is considered the most common ailment. It is characterized by blood flow disturbances in the hemorrhoidal venous canals, which provokes their expansion, clogging, and bleeding. About half of patients with hemorrhoids are girls in position. And if mom is carrying a baby for the first time, then the likelihood of hemorrhoids during pregnancy in the 3rd trimester doubles. Moreover, a similar pathology is detected in every second pregnant woman after 30 years.

When carrying, vitamin complexes are often prescribed.

The mechanism of development of hemorrhoidal processes is due to large-scale transformations taking place in the mother's body during gestation. In the third trimester, the uterus begins to grow rapidly, displacing adjacent structures. There is a serious violation of the blood supply, venous blood congestion develops.

Often, women suffer from hemorrhoidal inflammations against the background of chronic constipation, which usually occurs against the background of a decrease in the nerve impulse perception of the intestinal muscles. As a result, patients have difficulties with intestinal emptying, defecation requires excessive straining, which in combination provokes the development of hemorrhoidal processes. In general, the development of varicose veins of hemorrhoidal veins occurs for the following reasons:

Lack of mobility. In the last months of gestation, mommy tries to rest more, moves very little. All this adversely affects blood circulation in the lower half of the body. As a result, stagnation and loss of the formed nodes are formed.
Stool problems. This phenomenon is usually associated with the fact that in order to prevent premature delivery for protective purposes, a decrease in muscle tone occurs. As a result, defecation processes are hampered, fecal stagnation occurs. Solid masses of feces injure the intestines, provoke blood circulation disorders.
Diet disorders. Sometimes pregnant women begin to abuse foods generously seasoned with hot spices. Such dishes provoke blood flow to the intestinal tissues and low-basal structures, which provokes stagnation and inflammatory lesions of hemorrhoids.
The pressure of the uterus is the most obvious factor causing hemorrhoids in the last trimester of pregnancy. Under the influence of blood flow disturbances, varicose veins of the pelvic floor occur, which further leads to the loss of the formed nodes.

A frequent provocateur of varicose veins of hemorrhoidal veins is a hereditary predisposition and the patient's mature age, over 35 years. Also, the risk of developing hemorrhoidal problems increases with the second or subsequent pregnancies, with chronic constipation or sudden hormonal disruptions. The risk group also includes mothers who suffer from thyroid disorders, lead a sedentary lifestyle and eat improperly.

Stages of the disease

You should eat foods that help avoid constipation.

Modern doctors classify hemorrhoidal pathologies into two forms. The primary one involves the development of varicose veins of the anal veins against the background of an improper lifestyle and genetic predisposition, hormonal disorders, etc. The secondary form involves the development of pathology due to severe cardiovascular anomalies, low-basal pathologies, tumor-like intestinal processes that impede blood circulation.

In accordance with the development of the pathological process, hemorrhoids in the 3rd trimester during gestation are divided into 4 stages. At the first stage, the nodes do not fall out, although they protrude into the intestinal lumen. When the stool moves, it injures the nodes, as evidenced by the appearance of blood from the anus. At the second stage of development, the inflamed nodes fall out, but after the end of the bowel movement, they adjust back on their own.

At the third stage, the loss of inflamed nodes occurs not only during bowel movements, but also during exertion or straining. To return them back, you need to adjust the bumps manually. At the fourth stage of the hemorrhoidal process, the formed bumps constantly fall out, while they are no longer set back.

Hemorrhoids are classified by location. It is divided into mixed, external and internal. With inflammation of the internal type, the nodes are located under the mucous layer, above the anus. With the external form, the nodal structures descend below the anus line. And with combined hemorrhoids, the two types described above are combined.

Clinical manifestations of pathology

Varicose veins during gestation at the earliest stages are often latent, their symptoms are formed and build up gradually. Over time, the clinical picture becomes overgrown with new symptoms, the patient's condition gradually worsens, defecation becomes difficult.

At first, the patient feels the appearance of uncomfortable sensations in the anal area, which are manifested by burning, itching, a foreign object in the anus and burning.
Then there are signs of bleeding that occur during intestinal emptying, while the blood is scarlet. It is located on top of the feces, without mixing with it. The intensity of bleeding is different - only a few droplets may appear or an abundant discharge of blood may be found.
Pain syndrome occurs when inflammatory processes are triggered, nodes fall out or their infringement occurs. Pain also occurs during bowel emptying, disturbing the patient for some time after a bowel movement.
Itchy sensations are caused by irritation of the skin around the anus. Long-term irritation provokes the development of eczema, the likelihood of purulent lesions and trauma to the anorectal region increases.

Such symptoms become aggravated and subside. But already at the first pathological signs, you urgently need to contact a specialist and undergo the appropriate treatment for hemorrhoids during pregnancy, prescribed by a specialist.

Diagnosis of the disease

With frequent pain - urgently see a doctor

Specialists usually do not see any difficulties in diagnosing the disease, because the pronounced clinic and complaints of the patient, as well as the data obtained during a visual examination, clearly indicate the development of the pathological process. Sometimes, to clarify the pathology, rectoscopy or anoscopy, a general blood test are prescribed.

Rectoscopic examination is carried out with a rectoscope along the entire length of the intestine. The sensor of the device is inserted into the anus by about 30 cm. In this way, as a rule, tumors are detected and the mucous membrane is examined.

Anoscopic diagnostics is carried out using an anoscope, which is inserted into the anus by 12 cm. The examination does not cause pain, it is not dangerous, it is aimed at identifying mucous lesions in the intestine. A general laboratory blood test is prescribed to the patient to identify anemic processes that are usually typical for hemorrhoids with severe bleeding.

Subtleties of therapy

Varicose veins of hemorrhoidal veins in pregnant women need to be urgently treated, because the pathology is characterized by a fairly rapid progression. The approach to therapy depends on the severity of the pathological process. At the initial stages, hemorrhoids can be treated during pregnancy using exclusively conservative methods, for example, exercise therapy or diet correction, etc.

If hemorrhoids have developed to a severe degree, then a comprehensive therapeutic approach is needed with the obligatory use of drug therapy and minimally invasive procedures, and in the most difficult situations, microsurgical intervention is prescribed. Although the pathology does not pose a direct threat to the patient's life, it can provoke purulent-inflammatory processes, intrauterine fetal infection, which will cause the birth of a baby with signs of an infectious lesion.

Fearing to harm the baby with drugs, mothers sometimes refuse hemorrhoid therapy or try to treat it at home with the help of folk remedies. If varicose veins of hemorrhoidal veins are diagnosed, then treatment cannot be postponed. The attending doctor fully describes the therapy regimen in order to reduce the probable risks to a minimum and at the same time completely cure the hemorrhoids in the mother.

If the pathology is not treated, then it can be complicated by a bacterial infection, which increases the likelihood of intrauterine infection of the fetus. Also, the mother may experience profuse bleeding, leading to the development of iron deficiency anemia and fetal malformations. The third trimester of gestation is considered a particularly dangerous period for hemorrhoids. To avoid complications during delivery, you need to remove the hemorrhoidal exacerbation even before it.

Medication appointments

Only a doctor will be able to correctly determine how to treat hemorrhoidal varicose veins with drugs. Usually, non-hazardous preparations are used for the fetus.

Suppositories Natalsid. The drug is intended for rectal administration, has a pronounced anti-inflammatory effect, stops bleeding. Safe for the treatment of hemorrhoidal pathologies during gestation. The course is usually a week, suppositories are administered twice a day - at night and in the morning.
Propolis suppositories Prostopin and their analogues provide a local anti-inflammatory effect, eliminate itching sensations and contribute to the resorption of nodes and restoration of blood circulation. The drug is indicated for anal fissures and severe inflammation in the nodes. Suppositories are administered 1 candle at night every day.
Sea buckthorn suppositories have a pronounced anti-inflammatory effect. The use of suppositories helps to relieve puffiness and itching, skin irritation. Effective for hemorrhoidal varicose veins of any form. Shows the introduction of 2 suppositories twice a day for a weekly course. If the pathological symptoms remain at the end of the course, then the therapy is continued until it disappears. Allowed for any gestational period.
Hepatrombin B in suppositories and ointments. These agents have an effective venotonic and anti-inflammatory effect, eliminate problems with blood flow, increase the elasticity of the vascular channels and prevent thrombus formation and blockages. Suppositories are used in the morning and every night for 1 candle. The ointment preparation should be applied to anal tissues and nodes at 2-4 r / d.
Heparin ointment. Effectively copes with puffiness and relieves pain, normalizes blood circulation. Recommended for external hemorrhoids. In the last trimester, it is prescribed with caution, it is necessary that the woman be treated under the supervision of a doctor, because heparin dilutes the blood flow, which can lead to bleeding.
Fleming's ointment. An exceptionally natural preparation made from ingredients like St. John's wort, sea buckthorn and chamomile. Has a pronounced anti-inflammatory effect, contributes to the destruction of pathogenic microflora, provoking purulent complications and irritation. It is applied 1-3 r / d throughout the week. If necessary, the course of treatment is extended.

Additional drugs

Any drugs are used only for medical prescription.

Ichthyol ointment has a strong antibacterial and disinfecting effect. Perfectly helps to heal minor cracks and wounds, to eliminate the inflammatory process. One gram of ichthyol is applied to inflamed bumps twice a day.

Posterisan in the form of an ointment and suppositories provides an anti-inflammatory effect, accelerates tissue regeneration and normalizes blood circulation. Suppositories should be inserted into the anus in the morning and at night.

Levomekol is an ointment with a pronounced antibacterial effect. The tool accelerates cellular material exchange processes, kills pathogens, restores damaged cells. The drug should be applied at night.

Suppositories and ointments Relief quickly relieve irritation and itching, relieve pain during bowel movements. These drugs are more aimed at pain relief, therefore, they are recommended for the treatment of acute hemorrhoidal conditions, accompanied by severe painful sensations. Enter one candle in the morning and at night, the ointment is also applied twice a day.

Suppositories and ointment preparations during gestation have a local effect, therefore they cannot harm the baby in any way. But they still need to be applied strictly according to a medical prescription.

Minimally invasive therapy

If conservative methods do not help to completely get rid of hemorrhoids, then minimally invasive methods of eliminating the problem are prescribed for pregnant women, in which non-surgical therapy is carried out, which contributes to the destruction of nodes. One of the most common methods is sclerotherapy, which involves the introduction of special compounds into hemorrhoidal blood clots that stick together the bumps and lead to necrosis of the inflamed structures. Internal blood clots are removed about a week or two after the sclerosing procedure.

Ligation is the pinching of knots with latex rings. This procedure is used for the internal nature of hemorrhoids, if the nodes are single. As a result of the procedure, the tissue dies off within one to one and a half weeks, and then is rejected.

Also, minimally invasive therapy can be carried out using infrared exposure to the affected tissues. Infrared photocoagulation involves cauterization of the leg of the node, through which it is fed. As a result, the varicose nodule is cut off without residue.

Power features

It is good to drink plenty of fluids, including herbal teas

An important role in the treatment of hemorrhoids when carrying a baby is also assigned to nutrition. In order not to be disturbed by any diseases, you need to adhere to a special diet aimed at improving intestinal peristalsis, softening feces and improving material exchange processes. Experts recommend that pregnant women in the last trimester enrich their daily menu with plant fiber and fermented milk products. The basis of a pregnant woman's diet should be fresh fruits, vegetables, crumbly cereals and lean meats, fish and poultry.

Mothers should give up excess salt intake, exclude fried, smoked, spicy, bone-rich broths from the diet. Nutritionists also recommend giving up products that cause gas formation and allergic reactions. Do not forget about the drinking regimen, mom should drink at least 6-8 glasses of water a day.

A woman needs to organize food in fractional parts, while it is not recommended to drink food. You will also have to give up any caffeinated drinks during pregnancy. Rosehip broth and green tea, water or herbal teas are considered ideal for mothers. Every day, light vegetable or chicken broths should be present in the diet. Starchy foods and viscous rice porridge, hard-boiled eggs, jelly are prohibited, because these dishes have a strengthening effect and slow down intestinal motility.

Home remedies

When treating hemorrhoids in pregnant women, it is quite possible to use home methods, but only if they are agreed with a doctor. Traditional medicine methods help to quickly relieve puffiness and discomfort, stop inflammation and pain symptoms.

With external hemorrhoids, a cold compress helps to eliminate hyper-edema of the nodes and reduce their size. You just need to soak a soft tissue with cold water, squeeze it out and apply it to the anus for 2-3 minutes. This procedure should be carried out 4-5 r / d.
Water can be replaced with sea buckthorn oil or finely grated raw potatoes, which are recommended to be wrapped in a piece of gauze.
Excellent help with hemorrhoids and chamomile candles. It is necessary to freeze the chamomile decoction and inject small pieces into the anus. Such a remedy has an antiseptic effect, and due to the low temperature, it perfectly eliminates painful symptoms.

Experts do not recommend treating pregnant women with hemorrhoidal inflammation with the internal intake of a variety of herbal infusions or decoctions. Many medicinal plants have side effects and can negatively affect fetal development.

Preventive actions

In order not to suffer with hemorrhoids and the accompanying symptoms, experts recommend that mothers engage in timely prevention of unpleasant pathology. To do this, it is necessary to adjust nutrition and eliminate a hypodynamic lifestyle, and normalize intestinal activity. Personal hygiene has one of the leading preventive values, therefore, after each bowel movement, the anus should be washed with cool water. If this is difficult, then use wet sanitary napkins or special wet paper.

Another important point is therapeutic and prophylactic gymnastics, which will help to normalize the work of the large intestine and relieve low-basal congestion. Exercising every day in the morning, as well as avoiding prolonged sedentary work, you can successfully prevent varicose veins of the anal veins. If during gestation it was not possible to avoid hemorrhoids, but the mother successfully coped with the disease, then after childbirth, the pathology can usually be absent for a long time. Unfortunately, hemorrhoids don't go away forever. Under favorable conditions for the disease, he will return again, which often happens in women after the 40th birthday. But if you follow preventive measures throughout your life, that is, live actively, move more, eat right, give up unhealthy habits, monitor the intestines and exclude hypothermia, then relapse can be avoided.

Hemorrhoids (literally translated from Latin - bleeding) is a disease resulting from the overflow of blood in the venous plexuses (cavernous bodies) located in the anus. It is these enlarged, altered veins that are called hemorrhoids.

Overflow of hemorrhoidal veins with stagnation of blood in them contributes to a sedentary lifestyle. A person sitting for a long time heats up the seat with the warmth of his body, forming something reminiscent of a heating pad. In these "greenhouse" conditions, hemorrhoidal cones begin to "mature" at an increased rate. Add to this the improper, irrational and irregular fast food nutrition of the average city dweller, leading to latent and obvious problems with the pancreas and (or) thyroid glands. And also extra pounds, which, in combination with the same sedentary lifestyle, gives rise to chronic constipation. Hereditary congenital insufficiency of the structure of the veins is also of some importance. The congestion of blood in the veins of the small pelvis also contributes to the intake of certain medicines, oral contraceptives, excessive enthusiasm for laxatives, abuse of alcoholic beverages, some sports: equestrianism, cycling, auto and motor sports, rowing, weight lifting. However, the latter is more related not to athletes, but to women with their eternal shopping bags.

Disease types

For reasons of occurrence, proctologists distinguish primary and secondary hemorrhoids. Primary hemorrhoids develop against the background of all of the above life moments. Hemorrhoids, which first develop in a woman during pregnancy or after childbirth, also belongs to this group.

As for secondary hemorrhoids, it is of little interest to us at the moment - these are the consequences of liver cirrhosis, some severe cardiovascular diseases, various tumor processes that disrupt blood flow in the veins of the small pelvis.

If hemorrhoids owe their appearance to pregnancy, then more often its formation occurs in its second half, and the family can aggravate it. According to statistics, women who have given birth at least once suffer from this disease 5 times more often than those who have not given birth. This fact is explained by the pressure exerted by the enlarged uterus on the pelvic floor and, first of all, on the hemorrhoidal venous plexus, in combination with such frequent constipation during pregnancy. The number of pregnancies and, accordingly, childbirth, as well as the age of the pregnant woman, affect the degree of risk of developing hemorrhoids. In twenty-year-old women expecting their first child, this very unpleasant disease occurs 3 times less often than in the same category of women in thirty years.

Geomrroy: why go to the doctor?

As statistics show, hemorrhoids occur in pregnant women quite often, but, firstly, it is an independent disease, and secondly, its development is in no way an inevitable "evil", a complication of pregnancy and childbirth, just as pregnancy is not an obligatory cause of the development of hemorrhoids. Therefore, if you have doubts about your health in this delicate area, you should go to the doctor and start treatment. After all, hemorrhoids, in addition to more or less pronounced discomfort at first, can disrupt the normal course of pregnancy in the later stages, and also affect the course of childbirth and the postpartum period.

Many are in no hurry to visit a doctor, mistakenly believing, especially in the early stages of the development of the disease, that hemorrhoids are harmless. But this is not at all true! Neglected, untreated hemorrhoids can cause anemia (a decrease in the amount of hemoglobin), diseases of the musculoskeletal system (for example, arthritis), the genitourinary system, skin (various rashes, including acne, etc.).

The manifestations of hemorrhoids resemble some other diseases of the rectum, and sometimes even cancer.

Internal and external hemorrhoids are distinguished according to the "depth of occurrence". Internal ones are formed inside the rectum, so they are not visible on simple examination. In the patient, such nodes cause a feeling of heat, itching, pain radiates to the back and sacrum. Bleeding from internal hemorrhoids is often more massive than from external ones. Internal hemorrhoids are often complicated by anemia. External hemorrhoids are located directly inside the anus, they often fall out, and they make it more difficult to empty the intestines due to significant pain.

According to the rate of increase in painful manifestations, chronic and acute hemorrhoids are distinguished.

A set of exercises for hemorrhoids for pregnant women

1. Starting position (ip) - standing, arms extended in front of you, feet shoulder-width apart. Turn the body to the right without lifting your feet from the floor, and take your right hand back as much as possible - inhale. Return to the starting position - exhale, turn to the left. Repeat 5 times in each direction.

2.I.p. - standing, hands are raised in front of you, fingers are interlocked in the lock. Perform body turns to the right and left, taking your arms back as much as possible. Repeat the exercise 5 times in each direction.

3.I.p. - sitting on the floor, resting his hands on the back. Bend your knees, while this movement of the heels should not be lifted off the floor. Extend your legs slowly. Repeat 5 times.

4.I.p. - while sitting, spread the legs to the sides as much as possible, while the legs should be firmly pressed to the floor, the knees should not bend if possible. Bend forward and touch your right and left feet alternately with your hands as far as possible, then straighten up. Repeat the inclines 5-7 times (recommended only for the first and second trimester).

5.I.p. - sitting in the same way as in the previous exercise, but tilting to the sides; the opposite hand is on the belt. Repeat 5 times in each direction (recommended only for the first and second trimester).

6.I.p. - lying on your back, arms along the body. Pull the legs bent at the knees to the stomach and return to the starting position (recommended only for the first and second trimester). Repeat 7-10 times.

7.I.p. - lying on the right side, the right arm is bent at the elbow and lies under the head. Bend your left leg at the knee and press it to your stomach, you can help yourself with your left hand. Repeat 7-10 times. Then repeat the exercise lying on your left side (recommended only for the first and second trimester).

8.I.p. - sitting on a chair. Stretch the right hand to the side, raise the left leg, bent at the knee, forward and to the left, trying to bring it to the lateral surface of the abdomen, helping oneself with the left hand - exhale. Return to starting position - inhale. Repeat for both legs 5 times. Recommended for the third trimester.

Chronic hemorrhoids after childbirth

It begins gradually, a woman occasionally after a bowel movement has unpleasant sensations in the anus: a feeling of incomplete emptying of the intestines, soreness during the act of defecation, a small and fairly quickly passing itching, high humidity. With developing hemorrhoids, the pain may disappear on its own, and after a few days it will appear again. As a rule, at this stage of the disease, a doctor is not consulted. After a while, blood stains appear on the toilet paper. The duration of the initial period of the disease can range from several months to several years. Pregnancy, as mentioned above, helps to speed up the process. With the further development of the disease, defecation becomes more and more painful and is constantly accompanied by more or less massive bleeding. The increasing increase in internal hemorrhoids leads to their loss from the anus. With the prolapse of internal hemorrhoids from the anal canal, a woman experiences a feeling of fullness in the rectum and a desire to empty the intestines. Very often, itching is accompanied by scratching and bleeding. Skin irritation around the anus may persist due to persistent watery and mucous discharge.

There are three stages of prolapse of hemorrhoidal cones. In the first, the nodes fall out of the anus only during bowel movements with strong straining, and then they are set on their own, without the help of hands. In the second stage, the nodes fall out when visiting the toilet, but without pronounced straining, as well as when lifting weights. The nodes themselves are no longer set, but you can still "put them back in place" by hand. In the third stage, the nodes fall out with the slightest physical effort, for example, sneezing, coughing. The knots that have fallen out can also be adjusted by hand.

The disease goes through four stages in its development:

The first stage is manifested by discomfort in the anus, emptying the intestine is painful, often accompanied by more or less pronounced bleeding. On examination, hemorrhoids are visible, but they do not fall out, the rectal mucosa is reddened, inflamed, dilated small blood vessels are visible.
The second stage of the disease corresponds to the first stage of node prolapse. To the manifestations of the first stage of the disease, itching, discharge, pulling pains in the anal area are added, which can radiate to the lower part of the lower back and sacrum.
The third stage of the disease can be accompanied by both the second and the third stage of prolapse of hemorrhoids. You fall of hemorrhoids requires manual guidance. All painful manifestations intensify.
The fourth stage is the most dangerous. Fallen hemorrhoids cannot be repaired. This stage of the disease is often complicated by thrombosis, severe pain in the anus and massive bleeding.

Acute hemorrhoids in pregnant women

This name means thrombosis of hemorrhoids, which most often occurs as a complication of long-term chronic hemorrhoids. Describe cases of isolated thrombosis of external nodes. In this case, a single thrombosed node may not deliver pain to a person for a long time.

According to the severity of painful manifestations, there are 3 degrees of severity of acute hemorrhoids.

I degree. It is characterized by small, painful nodules on palpation (feeling), itching and burning in the anus, and non-purulent discharge. All these manifestations increase after bowel movement, and then gradually decrease.

II degree. The damaged nodes are larger due to a more pronounced inflammatory edema, which can spread to areas around the anus. Both the nodes themselves and the entire area of edema are reddened. The sphincters of the anus are reflexively clamped, an attempt to conduct a digital examination of the anus causes severe pain. At this stage, there are almost constant pains of considerable intensity, which intensify when walking, in a sitting position, not to mention trying to defecate.

III degree. At this stage, edema and redness are observed in the entire area of the anus, from which large bluish-purple internal hemorrhoids protrude. The spasm of the anal sphincter is also more pronounced; moreover, it may be accompanied by a reflex spasm of the sphincter of the bladder, which is manifested by urinary retention. The disease in its development can even reach the stage of necrosis (necrosis) of the nodes with the appearance of black areas on them. Complications of this stage can be paraproctitis (inflammation of tissues, including fatty ones, around the rectum, infringement of a thrombosed internal node with severe spasm of the sphincter.)

Impact of pregnancy and childbirth on hemorrhoids

As a rule, if a woman has hemorrhoids already during pregnancy, then for a long time the disease does not manifest itself in any way and the woman is not worried about anything. Hemorrhoids become an unexpected and unpleasant finding during a routine preventive examination by a surgeon or gynecologist.

Even if throughout the pregnancy hemorrhoids "behaved decently" without causing any concern to the woman, childbirth can provoke a sharp exacerbation of this disease. And the longer the birth process, the higher the risk of exacerbation, the more pronounced it can be.

According to statistics, exacerbation of hemorrhoids during pregnancy is observed in about 50% of women suffering from this disease. The reason is that when the child's head passes through the small pelvis, the maternal organs and tissues located in this area are compressed, and first of all, the venous plexuses. The venous outflow is disturbed, the stagnation of blood in the veins of the small pelvis increases. The existing nodes increase, acquire a denser consistency.During contractions, and especially attempts, the nodes may bulge, redden or even turn blue. In the period between attempts, when the intra-abdominal pressure decreases, the pressure on the venous plexus also decreases; the nodes take on a calmer appearance. Thus, the very mechanism of childbirth can lead to a complication of preexisting hemorrhoids, provoke the prolapse of internal nodes and even their rupture. Cases of infringement of the fallen out nodes, their thrombosis are also described.

Diagnosis of hemorrhoids

It is usually not difficult for a doctor to identify hemorrhoids. Specific complaints allow a quick diagnosis. Finger examination is mandatory. Sometimes, to clarify the diagnosis, it is possible to carry out sigmoidoscopy - a study in which a special optical apparatus is inserted into the rectum. It allows you to see what is happening in the rectum.

Timely identification of pregnant women suffering from hemorrhoids, the timely treatment prescribed for them makes it possible in many cases to prevent the further development of this disease, complications in childbirth and the postpartum period.

Prevention and treatment of hemorrhoids during pregnancy and after childbirth

First of all, the patient needs to get rid of constipation and improve bowel function without prolonged straining. A diet rich in fruits and vegetables can help with this. With hemorrhoids, any alcoholic beverages, salty, spicy, spicy, pickled, peppery dishes are strictly prohibited - these products increase the blood circulation in the veins of the pelvic floor and, first of all, hemorrhoidal venous plexuses. You should not eat fatty foods: it slows down the passage of food through the intestines, thereby creating the prerequisites for the development of constipation. Try to eliminate fatty meats, high-calorie dairy products, and buns from your diet. It is better to limit the consumption of onions, mustard, black bread, legumes, unripe fruits and berries. Broccoli, corn, carrots, ripe apples, beets, cauliflower, potatoes, raisins, prunes, dried apricots and honey are recommended. Porridge, especially pearl barley or oatmeal, also prevents the development of constipation.

They help to improve the function of the large intestine, increase the tone of the muscles of the anal region and abdominal wall, reduce congestion in the veins of the small pelvis, physiotherapy exercises, morning hygienic gymnastics familiar to us from childhood. It is also recommended to lie on your back 2 - 3 times a day for 15 minutes with the pelvis raised. for example, on a small pillow.

It is very important to avoid hypothermia (especially in the lower body), do not sit on * cold surfaces, give up long (more than an hour) walks and long-term work in a standing and sitting position.

Mandatory hygiene procedures after each bowel movement have a good preventive effect. You need to wash yourself with cool, even cold water, you can arrange for yourself a short (15-30-60 seconds) ascending cold irrigation of the anal area (just turn the shower over and direct its jets upward, like a fountain).

Determining the tactics of treatment, there are three groups of pregnant women with hemorrhoids.

The first group includes women with asymptomatic hemorrhoids. For them, only preventive measures are carried out - diet, physiotherapy exercises, walks, a water toilet in the anus after a bowel movement, laxative herbs, laxatives.

The second group consists of patients with complaints of constipation, bleeding, pain during bowel movements, anal itching, that is, patients with the first or second stage of the development of the disease. In this case, treatment is carried out with candles and ointments, warm sitz baths with a weak solution of potassium permanganate, herbal infusions, drugs taken orally. After a bowel movement, it is possible to use rectal suppositories containing anesthesin, novocaine, etc. (consult your doctor), based on lanolin or cocoa butter. With a spasm of the sphincter of the anus, it is possible to add suppositories with diphenhydramine, an oil solution of vitamin A, sea buckthorn oil.

Given the variety of forms and stages of hemorrhoids, the peculiarities of the course of the disease, the possibility of complications, the selection of treatment should be individual and carried out by a qualified proctologist.

Here are some of the drugs commonly used to treat chronic and acute hemorrhoids.

To prevent complications of chronic hemorrhoids, ROXERUTIN (TROXEVASIN, TROXERUTIN) is prescribed, which reduces capillary permeability and fragility, and has an anti-inflammatory effect.

GINKOR-FORTE contains, in addition to troxerutin, an extract of the gingo dicotyledonous tree. The drug strengthens the venous wall, has an anti-inflammatory effect.

Escin derivatives (AESTSIN, ESCUZAN, REPARIL) are obtained by processing horse chestnut seeds. They have an anti-inflammatory effect, increase the tone of the veins, improve blood circulation through the smallest blood vessels, reduce the swelling of the inflamed node, blood viscosity and thrombus formation.

Calcium dobesylate (DOXIUM) normalizes vascular permeability, improves microcirculation, reduces swelling of the inflamed node, blood viscosity and thrombus formation. This drug is used for acute inflammation of hemorrhoids.

MISVENGAL (extract of a mixture of medicinal plants: husk of wild chestnut seed, marigold flowers, larkspur root, yarrow herb, chamomile flowers, shepherd's purse, gentian root) strengthens the vascular wall, improves venous blood flow, has a local anesthetic effect, reduces edema, promotes healing of erosion , ulcers and cracks, has an anti-inflammatory and disinfectant effect.

VENITAN (gel) - prescribed as an analgesic and antipruritic drug.

PROCTOGLIVENOL is a combined preparation produced in the form of ointment bases and rectal suppositories. It reduces capillary permeability, improves microcirculation, increases venous tone, has anti-inflammatory activity, and has a pronounced analgesic effect.

GEPATROMBIN is available in the form of ointments, gel and suppositories. It has a pronounced analgesic and anti-inflammatory effect.

When hemorrhoids are combined with an anal fissure in acute hemorrhoids, one should try to do with conservative inpatient treatment. It includes: complete rest, diet, cleansing enemas, laxatives, novocaine blockade in the anus, suppositories and dressings with HEPARIN, CHIMOPSIN, etc. operations. In almost all cases, patients can achieve a clear improvement in their condition and carry out childbirth without exacerbating hemorrhoids. If there is a prolapse of internal nodes without acute inflammation, then you can limit yourself to careful repositioning of the nodes after defecation (it is better to do this in a warm sitting bath). Small cleansing enemas are recommended for the urge to stool. Such women are strictly prohibited from heavy physical labor and certain types of housework (washing, washing the floor). They are prescribed candles with novocaine and belladonna.

The tactics of surgical treatment of a pregnant woman is chosen strictly individually. If hemorrhoids are manifested mainly by bleeding with signs of severe anemia, then sclerosing injections can be performed (more on them below).

The third group includes pregnant women suffering from hemorrhoids, with prolapse of internal nodes and frequent exacerbations of the disease, that is, subject to hospitalization and surgical treatment. The timing of the operation is worked out individually. Emergency hospitalization is prescribed for profuse hemorrhoidal bleeding, and, of course, for infringement and necrosis of fallen out hemorrhoids. Patients with similar complications of hemorrhoids should be treated with an operative way (they undergo hemorrhoidectomy - excision of nodes) or with minimally invasive methods of treatment (small or bloodless operations). These methods include sclerotherapy - the introduction of special sclerosing drugs into the site; ligation - the knot is pinched with a special latex ring, which causes rejection, dying off of the knot in 7-10 days; infrared photocoagulation and laser coagulation (exposure to a laser or high temperature on the base of the hemorrhoidal node at 3 to 5 points; this results in a burn, which subsequently causes necrosis of the node with its subsequent fallout; the process also takes 7-10 days). If the condition of the pregnant woman allows, then the doctors are trying to postpone all these interventions until the woman recovers from childbirth.

Careful attitude to your health, timely access to a doctor, examination, correct diagnosis and timely treatment will help to avoid or minimize hemorrhoidal problems.

Herbal medicine against hemorrhoids in pregnant women

For oral administration:

Brew an incomplete tablespoon of chopped dried herb of lungwort medicinal with a glass of boiling water and leave for half an hour. Strain and take 1 tablespoon 3 times daily before meals.

For topical use:

Cold lotions will help to reduce the size of hemorrhoids, as well as get rid of discomfort. It is necessary to apply to the area of the anus for 1-2 minutes a gauze napkin moistened with cool water and slightly wrung out (a wide bandage folded several times, etc.). If possible, repeat the procedure 3-4 times a day.
For washing at night and after visiting the toilet, infusions of chamomile flowers, calendula flowers, flower shoots of St. John's wort, meadow clover flowers, ordinary viburnum flowers, brewed separately are suitable. These infusions can be used both at various stages of the development of the disease and for the prevention of hemorrhoids.

For sitz baths:

Mix equally the flowers of chamomile, stinging nettle herb, plantain leaves. To prepare a bath, it is necessary to pour 20 g of herbal collection with 2 liters of boiling water, insist in a warm (in a thermos) for 2 hours, strain, dilute with warm water to a total volume of 4-5 liters. The water in the finished bath should be hot, but not scalding. The duration of each procedure is 5-7 minutes, the baths are taken daily for 10-12 days. Hot baths, especially sedentary ones, are contraindicated in case of increased uterine tone and other "alarming" obstetric conditions.

Attention! Herbs should not be used if there is an allergic reaction to them or if you generally suffer from hay fever (allergy to pollen). There are a number of other diseases in which certain plants are contraindicated. Therefore, if you want to use medicinal herbs, consult your doctor first. It should be noted that the use of medicinal herbs does not replace traditional treatment.