What haemorrhoids actually are
Haemorrhoids are not a foreign body but vascular cushions in the rectum that are present in everyone. They help to provide a fine seal of the anus. Problems occur when these cushions swell, protrude or become inflamed.
In everyday language “haemorrhoids” is often used as a catch-all for anything that itches, hurts or bleeds around the anus. That is why a clear classification is useful, so you do not treat the wrong problem.
Why haemorrhoids are so common after childbirth
Several factors come together in the postpartum period. Pregnancy increases pressure in the pelvis, the tissue is more blood-filled and the veins are under strain. During birth, pushing and stretching add to this.
After birth, practical factors often worsen symptoms: fear of pain, less movement, an unfamiliar toilet routine and constipation. If stool is hard or you need to strain, the vascular cushion is additionally irritated.
Common aggravating factors in the postpartum period
- Constipation and hard stool, often due to stress, lack of sleep, insufficient fluid intake or iron supplements
- Straining during bowel movements
- Prolonged sitting, especially on hard surfaces
- Pain or scarring in the perineal area, which can cause unconscious tightness during toilet visits
How haemorrhoids may feel
Many people notice pain during bowel movements, burning, itching or a feeling of pressure in the anal area. Sometimes there is bright red blood on the toilet paper or on the stool. This can be alarming but is often superficial with haemorrhoids.
Common symptoms
- Pain during or after bowel movements
- Itching, burning, irritated skin
- A feeling of pressure or lumps at the anus
- Bright red traces of blood, usually small amounts
A good basic overview of how haemorrhoids develop and common self-help measures is provided by the NHS. NHS: Piles haemorrhoids
Important: not everything is a haemorrhoid
In the postpartum period haemorrhoids are often confused with two other conditions. This is not being finicky but practical, because treatment can differ.
Anal vein thrombosis
This is a sudden, very painful lump at the anus, often with a strong feeling of pressure. It can look blue–violet and often hurts regardless of bowel movements. Sometimes it is called an external haemorrhoid, but it is a different condition.
Anal fissure
A fissure is a small tear in the skin. Typical is a sharp pain during bowel movements, often like a cut, and sometimes ongoing burning afterwards. Here, softening the stool and reducing irritation are particularly important.
Relieving safely: what usually helps in the postpartum period
The goal is not to make everything disappear. The goal is less pressure, less irritation and a bowel movement without straining. When that is achieved, the situation calms for many people within days to a few weeks.
Keep stool soft without drama
- Drink fluids regularly throughout the day
- Fibre from food, for example oats, fruit, vegetables, and psyllium husk with sufficient water
- Short toilet sitting times, avoid sitting on the loo for long periods
- If necessary, in discussion with your care team use a stool softener, especially if straining would otherwise be unavoidable
The NIDDK explains well why soft stool and avoiding straining are central measures for haemorrhoids. NIDDK: Hemorrhoids
Sitz baths, cooling, heat
A sitz bath can be soothing if you keep it short and the water is lukewarm. Some people benefit more from cooling, others from warmth. The key is that it calms the area and does not dry out or sting.
- Short lukewarm sitz baths, then pat dry gently
- Cold compresses for swelling, but not ice-cold and not directly on bare skin
- Heat mainly for muscle tension, if it feels relieving
Ointments, suppositories and what to be aware of
Many ask about an ointment because it should help quickly. Topical treatments can ease symptoms such as itching and burning, but they do not solve the underlying problem if you keep straining. Use them for a short time, for a clear indication and ensure they are well tolerated. If you are breastfeeding or unsure, a pharmacist is a good point of contact to choose a suitable product and avoid interactions.
Hygiene without irritation
- After bowel movements, clean with water if possible or with soft, unscented toilet paper
- Avoid aggressive wet wipes with fragrances or alcohol
- Breathable underwear, avoid tight seams that rub
Everyday tricks that are often underestimated
In the postpartum period it is often the small things that make the difference. If you are in pain, you may unconsciously tense up, hold your breath and then end up straining.
Practical relief
- Soft seat cushion or sitting sideways if sitting directly is painful
- Get up by rolling to your side instead of pushing straight up, to reduce downward pressure
- Raise your feet slightly when on the toilet to make it easier
- If you notice you are straining, pause briefly, exhale and try again
When further assessment is advisable
Many cases are unpleasant but manageable. Still, there are clear situations where you should not just wait because something else may be behind it or because you are suffering unnecessarily.
Seek assessment if
- you have heavy bleeding or blood in the stool that becomes more frequent or heavier
- you experience dizziness, marked weakness or a rapid heartbeat
- you have a fever or the area is very red, warm and increasingly painful
- you develop a suddenly very painful, hard lump
- after one to two weeks there is no noticeable improvement despite soft stool and relief measures
If you feel the symptoms are keeping you from daily life in the postpartum period, that alone is a good reason to seek help. You do not have to endure it to prove anything to yourself.
Myths and facts in the postpartum period
- Myth: An ointment solves the problem by itself. Fact: Relief mainly comes from soft stool and less straining.
- Myth: Blood always means something dangerous. Fact: Bright red blood can occur with haemorrhoids but heavier or persistent bleeding should be assessed.
- Myth: Sitz baths must be hot. Fact: Lukewarm is often better tolerated; too hot can irritate.
- Myth: You mustn’t talk about bowel movements. Fact: Talking about it is often the lever that leads to the fastest relief.
Conclusion
Haemorrhoids after childbirth are common, especially when constipation and straining are present. The safest measures are to keep stool soft, reduce irritation and adjust daily habits to reduce pressure. Sitz baths and ointments can ease symptoms, but the most important step is a bowel movement without stress. If bleeding increases, large painful lumps appear or there is no improvement, seek assessment.
