Hemorrhoids: Harmless Yet Horrible

by Michele Brown

Here's What You'll Find Below:  • What Are Hemorrhoids?
  • What Causes Hemorrhoids?
  • Symptoms
  • Therapy and Prevention
  • Dietary Factors

startled lookToday's pregnancy health topic is a bit delicate, but we have never been shy about discussing important health issues for pregnant women and we won't tip-toe around hemorrhoids, either. Fortunately there is nothing life threatening about hemorrhoids, but don't tell that to a pregnant woman who has developed symptoms. You may be risking a bloody nose.

The problem is two fold: Many women are embarrassed to admit, even to their doctor, that they have excruciating pain "down there." But pregnancy can exacerbate an existing condition or cause hemorrhoids to appear for the first time.

Approximately 40% of pregnant women develop hemorrhoids but only 10% require some form of therapy. They are more common in the second and third trimester of pregnancy, more common in women who have been pregnant several times and increase in severity with each subsequent pregnancy.

What Are Hemorrhoids?

Hemorrhoids, also known as piles, are a conglomeration of swollen blood vessels in and around the anus and lower rectum.

Hemorrhoids can be classified into two kinds, internal and external. Internal hemorrhoids lie inside the anus or lower rectum, beneath the anal or rectal lining and generally present with bleeding and discomfort due to prolapse. External hemorrhoids lie outside the anal opening and present with irritation and discomfort. Both kinds can be present at the same time.

Hemorrhoids are a very common medical complaint. More than 75% of Americans have hemorrhoids at some point in their lives, typically after age 30.

What Causes Hemorrhoids?

The causes of hemorrhoidal disease are similar to those which cause varicose veins, i.e., genetic weakness of the veins, excessive venous pressure, low fiber diets (associated with constipation and increase straining), prolonged standing or sitting, and heavy lifting are considered factors.

The physical and hormonal changes associated with pregnancy tend to make women more prone to develop hemorrhoids or worsen existing hemorrhoidal symptoms.

Those changes include:

  • Increased abdominal pressure caused by the pregnant uterus
  • Straining at defecation and constipation often accompanying pregnancy
  • Dilation and engorgement of the veins due to increased blood volume
  • Hormonal changes leading to increased laxity of connective tissue


The symptoms most often associated with hemorrhoids include itching, burning, pain, inflammation, irritation, swelling, bleeding and seepage. Itching is often due to the mucous discharge from prolapsing internal hemorrhoids.

Pain does not occur unless there is acute inflammation of external hemorrhoids. As there are no sensory nerves ending above the anorectal line, uncomplicated internal hemorrhoids rarely cause pain.

Bleeding is almost always associated with internal hemorrhoids and may occur before, during or after excretion. When bleeding occurs from an external hemorrhoid, it is due to rupture of an acute thrombotic hemorrhoid. Bleeding hemorrhoids can produce severe anemia due to chronic blood loss.

Therapy and Prevention

As with all diseases, the primary treatment of hemorrhoids is prevention. This involves reducing those factors which may be responsible for increasing pelvic congestion such as straining during defecation, and sitting or standing for prolonged periods or time.

A high-fiber diet is crucial for the maintenance of proper bowel activity. Spicy foods should be avoided.