Haemorrhoids in twin pregnancy. The unspoken joys of a multiple birth pregnancy!

Hemorrhoids with Twin pregnancy

(Please note: This article is an overview of haemorrhoids in twin pregnancy, or triplet pregnancy, and should not replace your health care professionals advice).

Ahhh……the joys of being pregnant with twins or triplets.  Particularly the joy of haemorrhoids.  Haemorrhoids are one of the fun things that nobody mentions when talking about being pregnant with twins or triplets.

What are haemorrhoids?

Haemorrhoids (or sometimes referred to as piles) are enlarged veins in your anus and lower rectum.  The swelling makes them susceptible to irritation.  This can cause anal bleeding, painful bowel movements, anal pain and itching.  Although haemorrhoids can be painful and very unpleasant, they can be treated quite easily, and even prevented. Unfortunately, it is quite common to get haemorrhoids in twin pregnancy. And in triplet pregnancies as well.

constipation in twin pregnancy

There are several types of haemorrhoids.

Internal haemorrhoids – these sit inside the lining of the rectum, and are generally not obvious unless they are large and can be felt.  Generally these are discovered when there is rectal bleeding during a bowel movement.

External haemorrhoids – these are located underneath the skin that surrounds the anus and can prolapse to the outside of the anus (generally during a bowel movement), so you can see and feel them.

Thrombosed haemorrhoids –occasionally blood may pool and form a clot in (thrombus) in an external haemorrhoid.  This can result in a hard lump near your anus.  These need to be treated (generally lanced) by a doctor.

twin pregnancy and haemorrhoids

What causes haemorrhoids in twin pregnancy? Or triplet pregnancy?

Haemorrhoids are related to constipation, which we know is common in multiple birth pregnancies.  Straining during a bowel movement can put pressure on the rectal area and cause the veins to bulge and swell.  Your growing babies also put pressure on the vein in the colon, causing it to bulge.

By the time you have reached the third trimester, which is the usual time for haemorrhoids to appear, you will have probably will already have lost your normal sense of dignity! Let’s face it; there is nothing dignifying about being pregnant.   So please don’t feel embarrassed.  If you think you may have haemorrhoids, please speak to your health care professional as they will be able to provide you with the right medication and advice to relieve the discomfort. 

While estimates vary, it is thought that 25–35% of pregnant women are affected by haemorrhoids (Staroselsky et al 2008; Abramowitz & Batallan 2003).  This increases in multiple birth pregnancies.  

Haemorrhoids may also develop postpartum as a result of pushing during labour.

constipation in twin pregnancy

Home remedies and over the counter medications for haemorrhoids

ALWAYS seek medical advice before trying any home remedies and check with your health care provider before taking any haemorrhoid medication.

Some home remedies that may help include:

  • Increase your fibre intake, or take a fibre supplement
  • Increasing your water intake
  • Switch to a liquid iron supplement, as they can be not as constipating
  • Wipe with unscented baby wipes and not toilet paper
  • Soak a pad in Witch Hazel, put it in the freezer for a few minutes and wear overnight.
  • Try sitting in different to positions to lessen the pressure on that area
  • Ice them.  Freeze ice in long thin sticks and sit on it.
  • There are several over the counter creams you can get from the chemist.  Be sure to tell the chemist you are pregnant as some haemorrhoid creams are not suitable for pregnancy.
  • Numbing creams.  These won’t cure them, but they can give you some relief from the discomfort.
  • A donut cushion can give some relief when sitting
  • Short sitz bath with Epsom salts
  • Stool softeners may help
  • Never strain when moving your bowels
  • Try not to sit on them for long periods
  • Only wear only cotton underwear

How long do haemorrhoids in twin pregnancy last for?

Haemorrhoids will usually go away soon after your babies are born. If not, at least you can start using some of the stronger over the counter creams.   If they haven’t disappeared in a few months you will need to speak to your doctor again. This is because if they are left too long they can become a skin tag, and no cream will remove them.   

Haemorrhoidectomy

If your haemorrhoids are quite severe, or they have not responded to simple treatment, your doctor may suggest a procedure, such as rubber band ligation (banding).   Should this not work, or not be possible, you may need a haemorrhoidectomy.  A haemorrhoidectomy is a surgical procedure to remove extensive, or severe, internal or external haemorrhoids.

Isn’t being pregnant with multiples awesome?   I promise you, it will all be worth it in the end!

Haemorrhoids with in triplet pregnancy

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