To heal thrombose hemorrhoids when pregnant take warm baths with Epsom salt, use ointments, suppositories, and witch hazel compress. Thrombosed hemorrhoids often go away on their own in a few weeks.
While pregnancy and childbirth are generally regarded as happy episodes in female life, these events can be tainted with painful proctological conditions that are much less pleasant. Less than 50% of women are aware of these potential inconveniences. While all proctological conditions can be observed during pregnancy, the most common pathology is thrombosed hemorrhoid, which is a source of acute anal pain “hemorrhoidal crisis”.
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Also, make sure to watch the video on pregnancy thrombosed hemorrhoids!
Risk Factors During Pregnancy
During pregnancy, various factors promote the occurrence of pregnancy thrombosed hemorrhoid, especially during the third trimester of it:
- Altering the venous return, caused by an increase in blood volume, and hormonal fertilization that causes relaxation of tissues including the vein, and the gestational uterus that presses on the pelvic area.
- Constipation (by straining to defecate) due to a decrease in bowel movement, which is itself a result of hormonal changes and the weight of the uterus.
- Tissue relaxation under the influence of hormones, knowing that hemorrhoidal tissues are very rich in estrogen receptors and therefore are very sensitive to hormonal changes.
- The intense expulsion efforts during childbirth also promote the appearance of postpartum thrombosed hemorrhoids.
How to Heal a Pregnancy Thrombosed Hemorrhoid
During pregnancy, the thrombosed hemorrhoid treatment is based on hygiene and dietetic rules, and medication treatments.
It is advisable to carry out a toilet clean after each bowel movement with a neutral soap, a lotion, or washing foam based on burdock. In the event of associated pruritus, it is recommended to use instead of toilet paper cotton wool soaked in cleansing milk based on sweet almond oil
Very Painful Hemorrhoids During Pregnancy
It is essential to fight against constipation by starting by adopting the classic hygienic-dietetic measures, namely good hydration and a sufficient fiber intake (fruits and vegetables, whole grains). If constipation persists, laxatives can be used knowing that during pregnancy, laxatives of ballast based on mucilage (sterculia, Espagnol, psyllium, guar, or bran gum), osmotic laxatives (macrogol, lactulose, lactitol, sorbitol) are preferred. ), and if necessary occasionally, a lubricating laxative.
Is Hemorrhoid Cream Safe While Pregnant
Local treatment: a cream containing a local anesthetic with or without corticosteroids may be prescribed during pregnancy.
In the event of associated venous insufficiency, oral vagotonic treatment may be prescribed. Diosmin, hesperidin, troxerutin, and rutoside are the preferred molecules in pregnant women.
Instrumental treatments (sclerosing injections, infrared photocoagulation, elastic ligatures, cryotherapy, mono, and bipolar coagulation) and surgery should be avoided during pregnancy.
Thrombosed Hemorrhoid Pregnancy Treatment
Caution should be exercised in thrombosed hemorrhoids in pregnant women due to the iatrogenic effects of the drugs on the fetus. The Teratogenic Agent Reference Center, which is easy to search online here, MotherToBaby, has developed recommendations for the use of different classes of drugs during pregnancy.
Non-steroidal anti-inflammatory drugs (NSAIDs), which are considered to be very effective in pain caused by hemorrhoids, and thus are officially contraindicated from the 24th week of menopause (5 months of pregnancy completed) due to the risk of premature closure of the ductus arteriosus that caused it.
This recommendation also applies to aspirin (dose = 500 mg/day) and COX inhibitors – In severe edema, oral 
corticosteroid therapy may be prescribed without risk (40 to 60 mg/day for 3 to 5 days).
Rarely, an incision or excision under local anesthesia is possible as a general rule, as these procedures are only indicated in cases of an individual non-swollen external thrombosed hemorrhoid.
In all cases, the regulation of intestinal transit is indicated, it uses mucilages, osmotic or oily laxatives which are not absorbed and therefore harmless to the fetus. The preventive efficacy of this type of treatment for thrombosed hemorrhoid disease has not been evaluated.
However, two Chinese studies support the recommendations for Clinical Practice concerning hemorrhoidal disease validating their use. Specialties containing a corticosteroid and/or a local anesthetic should be favored for their anti-edematous and analgesic effect.
Depending on the intensity of the pain, level 1 to 2 analgesics may be used. Paracetamol and, if necessary, dextropropoxyphene or codeine can be used at the usual dosage. Tramadol, as a short course, may be prescribed if previous treatment options are ineffective.
Mild opioids used up to childbirth in supratherapeutic doses may be responsible for withdrawal syndrome in the newborn. Exceptionally, the intensity of the pain may necessitate the use of level 3 analgesics, in which case morphine is to be preferred because it is the analgesic of this class that has been best studied during pregnancy.
If the treatment is continued until childbirth, it is necessary to inform the maternity team to allow them to adapt the reception of the newborn (risk of withdrawal syndrome or even neonatal respiratory distress in the event of use of large doses just before or during childbirth).
How to Relieve a Thrombosed Hemorrhoid While Pregnant?
Relieving thrombosed hemorrhoids while pregnant it’s depending on the severity of the pain, analgesics level 1 to 2 may be used. Paracetamol and, if necessary, dextropropoxyphene or codeine may be used in the usual dose. Tramadol may be prescribed, as a short course, if previous treatment options have been ineffective. Mild opioid analgesics used until birth in extra therapeutic doses may cause withdrawal syndrome in the newborn.
Exceptionally, the severity of the pain may require the use of level analgesics, in which case morphine is preferred because it is a sedative from this category that has been best studied during pregnancy. If treatment continues until birth, the maternity team should be informed to allow them to adjust the reception of the newborn (risk of withdrawal syndrome or even neonatal shortness of breath if large doses are used just before or during birth).
It is possible to use intravenous (flavonoids) during pregnancy, but the effectiveness of this type of treatment on the clinical manifestations of hemorrhoidal disease is debated.
Automated therapy is not effective on the thrombotic features of hemorrhoidal disease, and sclerotherapy is also prohibited during this period.
Exceptionally, when multiple internal-external hypertrophic thromboses occur, emergency surgical treatment may be necessary. This procedure does not have any complications specific to pregnancy but, like any surgery in pregnant women, it requires close monitoring of the fetus.
Conclusion
The proctological manifestations of pregnancy are dominated by pregnancy thrombosed hemorrhoid and anal fissure. Constipation, which is favored by hormonal changes during pregnancy, is the main etiological factor in these pathologies. The treatment of these painful conditions is most often medical, it must take into account the rules for the use of treatment during this period of pregnant women.
