Treatment of haemorrhoids (piles) in pregnancy
What can I use to treat haemorrhoids?
Haemorrhoids (piles) are common in pregnancy, particularly after the first trimester.
Constipation (also a common pregnancy problem) can trigger haemorrhoids or make them worse. Drinking plenty of fluid (between 1.5 and 2 litres a day), eating foods that are rich in fibre, and taking regular exercise all help to avoid constipation. Iron supplements can also cause constipation. If necessary, your doctor can prescribe a slow release iron tablet which is less likely to cause problems. If you feel you need to use a laxative, your doctor or pharmacist will be able to advise you on which is the most suitable. For more information, see the bump leaflet on constipation. For some women, these measures may be enough to resolve piles.
If you need to treat piles, there is no evidence that any of the available treatments pose any risk to the baby. Paracetamol can be used if pain relief is required, but ibuprofen should generally be avoided in pregnancy, and codeine should not be used as it can cause constipation.
Benefits
What are the benefits of treating haemorrhoids?
Haemorrhoids can cause pain and discomfort and so treating them can greatly improve symptoms, promote healing, and help stop them returning.
Risks
Are there any risks of treating haemorrhoids?
There is no evidence that any of the available prescribed or over-the-counter haemorrhoid treatments cause any problems, particularly as they are used topically so only quite small amounts are absorbed into the bloodstream and reach the baby in the womb. Additionally, most pregnant women develop haemorrhoids in the second and third trimesters when the baby is already fully developed. Use of medicines at this stage of pregnancy cannot cause structural birth defects.
Alternatives
Are there any alternatives to using haemorrhoid treatments?
Possibly. If haemorrhoids are caused or worsened by constipation, lifestyle measures as described above can first be tried to improve symptoms. Some women find that discomfort can be improved with use of cold packs.
No treatment
What if I prefer not to use medicines to treat haemorrhoids?
Haemorrhoids are uncomfortable and sometimes painful, but generally do not pose a significant health risk. Therefore, some pregnant women may choose not to use haemorrhoid treatments. However, if haemorrhoids are affecting quality of life (such as causing pain, affecting sleep etc) then the benefits of treatment may outweigh any worries about hypothetical risks. Your doctor or midwife will be happy to discuss any of your concerns.
Will my baby need extra monitoring?
Most women will be offered a scan at around 20 weeks of pregnancy to check their baby’s wellbeing as part of their routine antenatal care. No additional monitoring is required following use of haemorrhoid treatments.
Who can I talk to if I have questions?
If you have any questions regarding the information in this leaflet please discuss them with your health care provider. They can access more detailed medical and scientific information from www.uktis.org.