Postpartum hemorrhoids

Reviewed by Dr. Jennifer Lincoln
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Hemorrhoids are a common postpartum symptom, but several over-the-counter remedies can help speed up recovery.

What it is

Hemorrhoids are swollen and enlarged veins that crop up in and around your anus and rectum. You may notice them by feeling small bumps in or around your anus, or you may experience one of several symptoms, including:

Why it happens

All that pushing and pressure during labor can cause veins to weaken, blood to pool in those areas, and then veins to swell. Pregnancy hormones such as progesterone can also play a role, telling your body—veins included—to relax and slow down.

When it happens

Hemorrhoids can appear at any time, but they are most often associated with pregnancy, and the immediate days and weeks after delivery.

Who is most likely to experience it

Hemorrhoids are common following vaginal and C-section deliveries alike; one-third of people who give birth experience symptomatic hemorrhoids after delivery1.

What to do about it

While it might take some time for hemorrhoids to subside, there are some tried-and-true over-the-counter remedies that can help alleviate the symptoms and speed up the healing process:

  • Take a sitz bath: Soaking the area in water for 10 minutes two to three times a day can be one of the best ways to alleviate the pain associated with hemorrhoids. You can either fill your bathtub with 2 to 3 inches of water, or buy a sitz bath basin.
  • Sit on a bag of ice: Just as ice can help with the perineal swelling that results from labor and delivery, it can help with the swelling from a postpartum hemorrhoid. Try to sit on a frozen pad, diaper, or bag of peas for at least 10 minutes to help reduce the swelling.
  • Try perianal pressure/splinting2: If you don’t have stitches from a vaginal laceration, you can reduce straining during bowel movements by inserting a lubricated finger or tampon into your vagina and pressing back against your anus to help move the stool. You can also try a toilet stool and spend only the amount of time needed on the toilet; if you need a little time to yourself, use it sitting in the bathroom and not on the toilet.
  • Take a hydrocortisone suppository: Anusol, or Preparation H cream, can be used twice daily to reduce inflammation to the rectum, helping shrink the hemorrhoid and providing pain relief. It is not recommended to use for more than seven consecutive days.
  • Use an anesthetic cream: Benzocaine rectal ointment or spray (i.e. Dermoplast) can be used in the area up to six times a day. This is often provided while you are in the hospital.
  • Wear a pad soaked with witch hazel: Pads soaked in witch hazel, such as Tucks or Preparation H pads, can help dry secretions and soothe the area. They can be used up to six times a day. Topical zinc oxide, found in products such as Boudreaux’s Butt Paste and Desitin, works similarly to witch hazel, and can be used instead of or with it.
  • Soften stools to prevent straining: Colace decreases the amount of straining needed to have a bowel movement, preventing irritation of the hemorrhoids. Over-the-counter laxatives such as Miralax (polyethylene glycol) or milk of magnesia can also soften the stool by drawing water to it for easier bowel movements.
  • Drink water and eat fiber: To help prevent constipation, be sure to drink enough water—until your urine is pale yellow—and consume foods high in insoluble fiber, such as whole grains, nuts, beets, and the peels and skin of fruits. You can also supplement your fiber intake with products like psyllium.
When to get help

Call your doctor if:

  • You’re not getting any relief after trying some of these at-home remedies
  • Your hemorrhoid symptoms worsen

If you’re experiencing significant bleeding from your rectum, call 911, as it could be a medical emergency.

References

1 https://pubmed.ncbi.nlm.nih.gov/12865195/

2 https://medicine.umich.edu/sites/default/files/content/downloads/splinting.pdf

Additional resources

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