THE UNCOMFORTABLE TRUTH
One of the less glamorous aspects of pregnancy is the onset of haemorrhoids or piles. This uncomfortable, itchy and unsightly condition is caused by hormonal changes softening the walls of the veins in the back passage which coupled with the extra weight from the uterus will cause them to prolapse and result in fleshy lumps protruding from the bottom.
The good news is that most cases of piles which arise during pregnancy and childbirth will naturally resolve themselves when the pelvic floor returns to normal but for others it can become a seriously difficult long-term problem. Thrombosed and bleeding piles can sap your energy at a time when you already exhausted and the constant pain may prevent you keeping up with the demands of motherhood and even put you off having more children.
This was the case for 28 year-old mum, Natalie Prytherch.
Piles affected everything
“I developed piles when I was around 7 months pregnant with my second child and even though they were painful, my doctor said that there were no safe treatments for me, not even creams, so I had to put up with it.” She says.
After her son was born the condition just got worse.
“Having piles affected everything. I couldn’t go to the toilet properly because the swollen veins were protruding and I always felt unclean afterwards like I wanted to take a shower, but with two young children to take care of, there wasn’t always time for that. And when my period came it was even more painful.
“On nights out I found I couldn’t have a glass of wine as this seemed to make the situation worse so I couldn’t really enjoy a social life. While at home it affected my relationship with my husband because I felt sore and didn’t feel I wanted him to get close to me. It was a nightmare really.”
Natalie suffered in this way for two and half years and during that time underwent two outpatient procedures of banding which proved unsuccessful. So when she found out about the latest new treatment, a procedure called Transansal Haemorrhoidal Dearterialisation (THD) she was prepared to give it a try, although by that time she had reached the stage of thinking that nothing could help her. “After a while, you begin to think the pain is normal and you just don’t realise how bad things have become,” Natalie explains. Consulting with colorectal surgeon and world renowned THD specialist, Pasquale Giordano, Natalie immediately knew she was in good hands. “Unlike my other consultations, he was asking me how piles were affecting me day to day so he could understand how bad they actually were.”
Natalie finally had her THD treatment in October 2012 which involved using ultrasound to accurately locate the arteries that were feeding the haemorrhoids and then ligate (tie) them, the second part of the procedure involved using sutures (plication) to pull the prolapsing haemorrhoids back into place. Because there is no cutting, there is minimal pain, no scarring and therefore faster recovery. 24 hours after the operation Natalie was back doing the school run and day to day activities – what’s more she’d gained a cosmetic benefit too, improving her confidence as well as her comfort.
Piles – or haemorrhoids – can affect people of all ages and gender. No matter how severe or longstanding the problem, help is available. Visit www.thehaemorrhoidcentre.co.uk for further information.
Pregnancy makes you susceptible to piles and so most women will get them no matter what but there is plenty you can do to manage them and stop them getting any worse.
Increase your fluid and fibre intake to prevent constipation as this will cause you to strain on the loo. If need more help, there are plenty of natural, gentle remedies which are safe for use in pregnancy to ease constipation.
Support the perineum when you pass a motion and use a footstool to lift your knees so that your body is in the right position to open your bowels easily.
During the delivery stage of labour the Midwife will support the area and may use an ice pack to ease swelling.
Pelvic floor exercises which you will be doing anyway will strengthen and lift the rectum but take care if the piles are large and swollen.
How THD Works
Transanal Haemorrhoidal Dearterialistation (THD) is a procedure designed to eradicate piles without the need for cutting. As such, it is relatively pain free, and most patients are back to normal activities after 24-48 hours a real plus for busy mothers, with only a minimum of discomfort, which if there is any, is no more than a mild a throbbing in the rectum.
The basis of the operation is to restore the piles back to their anatomical position, and reduce the blood supply to the vascular cushions forming the piles, resulting in them shrinking. The operation is best performed under general or spinal anaesthesia.
A highly accurate procedure THD uses a miniature Doppler ultrasound device to locate branches of arteries supplying the piles. These blood vessels are tied off, and the piles shrink over the subsequent days and weeks.
As well as resolving the problem of piles, the THD procedure has an immediate cosmetic improvement pulling the rectum back in place as well as tucking the prolapsed tissue inside.
The beneficial effect on the pelvic floor area has been seen in women having the procedure after a difficult delivery even when conducted long after childbirth.
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