Piles is a common complaint that affects many during pregnancy and after giving birth – in fact, about 30-40% of people who are pregnant get haemorrhoids. The joys.
But the issue often goes under the radar, with some mums suffering in silence (not to mention, discomfort).
Haemorrhoids are swollen veins on your anus which pop out and look a bit like a skin-coloured miniature bunch of grapes. “Just like varicose veins in the legs, the veins are swollen, can be painful, itchy and may bleed,” Dr Deborah Lee, of Dr Fox Online Pharmacy, tells HuffPost UK.
Anyone can get them, but being pregnant raises your risk because the weight of your baby and hormone changes create the perfect conditions for them to erupt. The strain of pushing in labour can also create problems.
A mum recently took to Reddit to talk about how people “should talk more about what pregnancy does to our bodies and that some things can be fixed” – and judging by the hundreds of responses from women experiencing similar issues.
She explained how during both her pregnancies she suffered with bad haemorrhoids, on and off, which could be really painful at times. At one point, they even became thrombosed.
This is a “worrying situation,” says Dr Lee, as it means there is a blood clot inside the pile. People with this issue have a lot of pain in the rectal area.
After giving birth, the haemorrhoids shrunk and went away eventually, but the mum was gutted to find she’d been left with a bunch of anal skin tags.
“I had to Google it, nobody told me this was a thing,” she wrote.
Of course, with extra bits of skin hanging from her bottom, it meant that cleaning after going to the toilet was a bit of a minefield.
She would use a peri bottle (a bit like a portable bidet) to clean the area, before patting dry. And she kept up this routine for four years.
“My second has turned one and I figured since we don’t want any more kids, I should get rid of those skin tags. They make me feel dirty, they itch and I shouldn’t have to live with that until I’m 80-something,” she wrote.
After a trip to the hospital, she claims she was told that the removal of the skin tags wasn’t “medically necessary” so they wouldn’t do it. She was also given the news that she’d developed eczema down there.
“I felt so offended!” said the mother. “Why can’t I reclaim my body if I feel dirty! And it does feel necessary if the things end up giving me eczema. I shouldn’t have to live with this issue for the rest of my life!”
After hitting this brick wall, she opted to go to a private clinic where she was told the issue was common and could be fixed.
She was also told using the peri bottle wasn’t a good idea, as the eczema she’d been diagnosed was actually a yeast infection from the humidity she’d been exposing her nether-regions to.
“I’m glad I found someone who told me and is going to help me fix it. So I’m here to pay it forward!” said the mum.
“If you think you have skin tags and they bother you, set your shame aside, find a good (private) proctologist and get yourself looked at.”
Symptoms of piles
- bright red blood after you poo,
- an itchy anus,
- feeling like you still need to poo after going to the toilet,
- mucus in your underwear or on toilet paper after wiping your bottom,
- lumps around your anus,
- pain around your anus.
Treatment for piles
Typically, piles go away on their own. During which time, the NHS advises people to drink lots of fluids, eat plenty of fibre and wipe after a poo with damp toilet paper.
Other remedies include: taking paracetamol, taking a warm bath, using an ice pack, gently pushing the piles back from inside your anus (fun!), exercising regularly and cutting down on alcohol and caffeine.
To keep the area clean, Dr Lee advises against using wipes, which can irritate the skin, and instead to use water. “If needed, an emollient such as aqueous cream can be used as a soap substitute,” she adds.
Pharmacists can also suggest creams to ease the pain, itching and swelling.
Hydrocortisone cream, ointment or sprays are “very useful” for haemorrhoids, says Dr Lee. “Hydrocortisone is a steroid which is a potent anti-inflammatory.
“They are usually applied several times a day, such as morning and night and after having had a poo. They should not be used for more than seven days, and after this, you must see a doctor.”
Lidocaine creams and ointments are another possible treatment. “Lidocaine is a local anaesthetic. These are applied several times a day and work within an hour.”
Suppositories can also help to ease the discomfort, itching and swelling.
If they don’t go away, what are your options?
The first thing to do is not ignore the issue. If symptoms continue after seven days of treatment at home, or you get recurring piles or notice another change around your anus area, you should definitely see a GP, who might prescribe stronger medication for the area.
They’ll also check the suspected piles aren’t a sign of something else more serious, like bowel cancer.
If there’s no improvement, you might have to go to hospital for treatment.
According to the NHS, non-surgical treatments include:
- Rubber band ligation: where a band is placed around your piles to make them drop off.
- Sclerotherapy: where a liquid is injected into your piles to make them shrink.
- Electrotherapy: where a gentle electric current is applied to your piles to make them shrink.
- Infrared coagulation: where an infrared light is used to cut the blood supply to your piles to make them shrink.
If this doesn’t work, surgery is another option – although you may need to stay in hospital for more than a day for this. There are a few routes you can take:
- Haemorrhoidectomy: where your piles are cut out.
- Stapled haemorrhoidopexy: where your piles are stapled back inside your anus.
- Haemorrhoidal artery ligation: where stitches are used to cut the blood supply to your piles to make them shrink.
It’s worth noting though that even after surgery, sometimes they can reappear.
And what about skin tags?
“Unfortunately following the natural resolution of haemorrhoids postpartum, women can be left with anal skin tags which can stay around eternally and become quite bothersome,” says Dr Semiya Aziz, who works as a GP.
Skin tags are a little different to piles, as they are “floppy pieces of skin originating externally”, according to Jonathan Wilson, a colorectal expert.
Unlike haemorrhoids, they can’t be pushed back inside, and can be solitary or multiple.
Treatment is usually steroid creams for those with minimal symptoms, while others might require surgery under sedation. But Dr Lee notes: “The NHS does not routinely remove anal skin tags.”
“Many women choose to leave well alone, especially if it’s not too uncomfortable, although inconvenient,” says Dr Aziz.
“The only problem in this situation is that large anal tags may get in the way of keeping the anus clean, and cause possible infection.”
She adds that wiping after a bowel movement might also be ineffective when skin tags are present – some mums might find residual stool sits on the skin, causing irritation and itching.
If you have anal tags but don’t want to get them removed, she recommends:
- Always wiping from front to back to avoid any infections.
- Keeping the area as clean as possible, carefully washing and gently drying the area at least once a day and after each bowel movement.
- Using soft toilet paper or damp cotton wool after a poo. Then drying the area by gently patting with a soft towel or tissue.