Piles…haemorrhoids…bum grapes (yes, really)…whatever you want to call them, affect 1 in 10 women during pregnancy and around 25% of women who get piles during birth, still have them 6 months later. Talk about adding insult to injury right?! In today’s Mama Truths Daisy teacher Ceri gets to the bottom of piles (sorry) and how to deal with them.
What are piles?
In simple terms, piles are swollen veins in the bum. They may be inside the anus or stick out externally and can be as small as a raisin (bet you’ll never look at one of those the same way again after reading this…) or as big as a grape.
Will I know if I have piles?
Um, yes. If you are ‘lucky’ they will just be a bit itchy and uncomfortable. They can cause sharp pain and bleeding when you go to the toilet, and in some cases (and unfortunately, I speak from bitter experience here) they can be debilitatingly painful. They can make it difficult to sit down properly and make each bowel movement an excruciating experience that will require your Daisy Out breath just to get through it (and no, I am not exaggerating but not all cases are this bad).
Sounds terrible – how can I avoid them?
Unfortunately, for some women, pregnancy alone can just make you more prone to piles because of the pressure your growing uterus puts on the pelvic blood vessels. Also the hormones Relaxin and Progesterone seem to conspire against you to cause the walls of these veins to relax . This means that they swell more easily and slow down the intestinal tract which can lead to constipation; which likely results in prolonged straining during bowel movements. Straining is one of the biggest causes of piles.
During birth, it is the strain you can put on your pelvic floor, in particular the anus, whilst pushing that can cause piles to develop. This is another reason that we encourage you to bear down and not push during Daisy Birthing classes: we really don’t want you to get haemorrhoids if you can help it!
One of the best things you can do to lessen your chances of getting piles or to speed up the healing process if you do get them/have them already, is to eat a high fibre diet with plenty of water every day. This is probably more water than you think you need – around 8-10 glasses daily is ideal; and get some regular exercise too. This means stacking your plate with lots of fresh fruit, veggies, wholegrains and beans: a healthy balanced diet basically, and doing some light daily activity, perhaps a brisk walk with your baby or some yoga style stretches. All of this is to keep you regular, and keep thing moving along your digestive system and out – you do not want a build-up of bigger poos to have to pass due to constipation or sluggish digestion, believe me. And of course keep working on those pelvic floor exercises to keep things toned and maintained down there: all positive things which will help in other areas of your pregnancy and postnatal recovery as well.
What can I do to relieve the pain of piles?
Witch hazel will become your best friend so stock up on it now just in case! You can get some incredibly cooling and soothing pre-soaked witch hazel wipes specifically designed for treating piles. Alternatively, you can make your own cold compress by soaking a clean wad of toilet paper with some witch hazel. It works by helping to reduce swelling and discomfort and feels so good.
Ice packs covered in soft loo roll can give an instant relief to the area (never apply direct to your skin – ouch!).
Having a warm (not hot!) bath can also help and it ensures the area is kept clean, which is vital to prevent further discomfort and infection. Some people swear by lavender oil (a natural anti-inflammatory), but test a little first on a cloth to the affected area if you can, as it may aggravate any cuts or sensitive areas. Alternating ice packs with warm baths can also give some very welcome relief throughout the day.
You won’t want to wipe your bum as normal with a dry piece of toilet paper after a bowel movement as this can aggravate and open up any cuts which are starting to heal, so get a jug and wash the area instead, then pat dry gently with soft toilet paper, or use some moist baby wipes instead. This is also where the pre-soaked witch hazel pads can come in to their own too (I really cannot recommend them enough for such sweet relief after going to the loo as a piles sufferer and survivor).
Buy the softest plain luxury loo roll you can, you will thank yourself for it later, and please do yourself a favour and stay away from any scented varieties.
If sitting is uncomfortable, then you can buy doughnut shaped inflatable/stuffed cushions with a hole in the middle to help give you a softer landing, (or use an inflatable swimming ring if you have one). The idea is that this shape of ‘seat’ offers weight relief and takes the pressure off legs, thighs and the rear. Standing and sitting slowly with support can also help you not to twist or tilt or put pressure on the affected area – no sudden movements!
You can take pain relief tablets such as ibuprofen to help ease the swelling and pain, just talk to your GP first if you are breastfeeding. There are also over-the-counter creams, ointments and suppositories that you can buy to help with swelling and itching but don’t use them for longer than 5 days as they can make the skin more sensitive, which you don’t need. It’s always worth asking your pharmacist for advice, and if the problem lasts beyond a couple of days, seek your GP’s advice. They may also be able to prescribe other treatments such as steroid cream to reduce inflammation, laxatives or a stool softening solution to ease bowel movements.
If you have any rectal stitches from an episiotomy or tear, then please consult your GP before trying any of the above, and if the pain is unbearable or if you start to avoid going to the loo because you are afraid of it (I know I was, and this only makes matters worse because then you can cause your stools to dry up and harden meaning bigger and more terrifying consequences than before), please seek help. If the problem persists or gets any worse, always go to your GP sooner rather than later – your recovery is so important.
When will I be rid of them?
Piles can last just a few days, and for most women it’s just a temporary condition that passes quickly. They can however also last a few months, sometimes more in extreme cases. The piles will shrink and the pain will come and go though (in rare cases minor surgery may be required or specialist treatments) and they will become more manageable over time. I ended up giving mine nicknames as a sort of coping mechanism, and because they soon became just another part of my postpartum body that I learnt to deal with using a combination of the suggestions above. Do whatever you need to do to get through and follow these easy steps when you have to go to the loo
How to cope on the loo with piles
- Take your time – you may not poo straight away after giving birth, but when you do, relax, breathe deeply and let it go. And don’t be afraid: the pain will pass, it really will.
- Don’t push and don’t strain. As we teach in Daisy Birthing, a clenched jaw closes the pelvic floor and you really want your rear to be able to release with ease in this delicate situation, so keep calm and don’t force it out!
- Don’t sit on the loo for longer than you need to (read the magazine elsewhere – good diversion technique but it will encourage you to take longer!). Sitting in the same position for too long can put un-necessary pressure on an already delicate area, so just get the job done – gently – and get out.
- Go to the loo as soon as you feel that you need to, don’t wait even if you are scared of what is coming, as waiting makes it much worse (trust me!)
- Wipe gently, or better still wash and pat dry, and stay as clean as you can down there!
Good luck! You’ve got this.
Further reading on the power of the Out breath to help with opening the bowels (this can also be beneficial after an epidural/ c-section) as well as its power to help breathe your baby out: https://thedaisyfoundation.com/positive-induction-using-power-breath/