What haemorrhoids actually are
Haemorrhoids are not a foreign body but vascular cushions in the rectum that everyone has. They help to keep the anus sealed. Symptoms occur when these cushions swell, protrude or become inflamed.
In everyday language, haemorrhoids are often used as a catch-all for anything that itches, hurts or bleeds around the anus. That is why a clear distinction is useful so you do not treat the wrong problem.
Why haemorrhoids are so common after birth
Several factors come together in the postnatal period. Pregnancy increases pressure in the pelvis, tissues are 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, unfamiliar toilet routines and constipation. If stool is hard or you have to strain, the vascular cushion is additionally irritated.
Typical aggravating factors in the postnatal period
- Constipation and hard stool, often due to stress, lack of sleep, not drinking enough or iron supplements
- Straining during bowel movements
- Sitting for long periods, especially on hard surfaces
- Pain or scarring in the perineal area that causes unconscious tightening during toilet visits
How haemorrhoids can feel
Many people notice pain mainly 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
- Pressure sensation or lumps at the anus
- Bright red streaks of blood, usually small amounts
A good general overview of how haemorrhoids develop and common self-help measures is available from the NHS. NHS: Piles haemorrhoids
Important: not everything is a haemorrhoid
In the postnatal period, haemorrhoids are often confused with two other conditions. This is not being fussy 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 appear blue-violet and is frequently painful even when not passing stool. 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, stabbing pain during bowel movements, often like a cut, and sometimes persistent burning afterwards. Here stool softening and reducing irritation are especially important.
Safe relief: what usually helps in the postnatal period
The goal is not to make everything disappear. The goal is less pressure, less irritation and a bowel movement without straining. If this is achieved, many people’s symptoms settle within days to a few weeks.
Keep stool soft without drama
- Drink regularly spread over the day
- Fibre from food, for example oats, fruit, vegetables, psyllium husk with plenty of water
- Short toilet sessions, do not sit on the toilet for long
- If necessary, in consultation with your medical team a stool softener, especially if straining is otherwise unavoidable
The NIDDK provides a clear explanation of why soft stool and avoiding straining are central to managing haemorrhoids. NIDDK: Haemorrhoids
Sitz baths, cooling, heat
A sitz bath can be comforting if kept short and the water is lukewarm. Some people benefit more from cooling, others from gentle warmth. The key is that it soothes and does not dry out or sting.
- Keep sitz baths short and lukewarm, then pat gently dry
- Cool compresses for swelling, but not ice-cold and not directly on bare skin
- Heat is better for muscle tension if it feels soothing
Ointments, suppositories and what to bear in mind
Many ask about an ointment because they hope for quick relief. Topical treatments can reduce symptoms such as itching and burning, but they do not fix the underlying problem if you continue to strain. Use for a short period, with a clear indication and good tolerability. 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, if possible, clean with water or with soft, unscented toilet paper
- Avoid aggressive wet wipes with fragrances or alcohol
- Breathable underwear, avoid tight seams that chafe
Everyday tips that are often underestimated
In the postnatal period, it is often the small things that make a difference. If you are in pain, you may unconsciously tense up, hold your breath and end up straining anyway.
Practical relief
- Soft seat cushion or sitting sideways if sitting directly is painful
- Getting up over the side rather than straight up to reduce downward pressure
- During bowel movements, raise your feet slightly to make it easier
- If you notice yourself straining, stop briefly, exhale and try again
When a check-up is sensible
Many cases are unpleasant but manageable. However, there are clear situations where you should not just wait, because something else may be going on or because you are suffering unnecessarily.
Seek assessment if
- you have heavy bleeding or blood in the stool that becomes more frequent or larger
- you notice dizziness, marked weakness or a fast heartbeat
- you have a fever or the area is very red, hot and increasingly painful
- you develop a suddenly very painful, hard lump
- you have no noticeable improvement after one to two weeks despite soft stool and relieving measures
If you feel that the symptoms are disrupting your daily life in the postnatal 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 postnatal period
- Myth: An ointment alone will solve the problem. Fact: Relief mostly 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 checked.
- Myth: Sitz baths must be hot. Fact: Lukewarm is often better tolerated; too hot can irritate.
- Myth: You must not talk about bowel movements. Fact: Talking about it is often the lever that brings the quickest relief.
Conclusion
Haemorrhoids after childbirth are common, especially when constipation and straining occur. The safest measures are to keep stool soft, reduce irritation and adjust daily life to reduce pressure. Sitz baths and ointments can ease symptoms, but the most important step is a stress-free bowel movement. If bleeding increases, large painful lumps develop or there is no improvement, seek assessment.
