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[Haemorrhoidal disease in pregnancy]
Laurent Abramowitz1, Dalila Benabderrhamane, Julie Philip
1Hôpital Bichat-Claude-Bernard, unité de proctologie médicochirurgicale, 75722 Paris cedex 18, France. laurent.abramowitz@bch.aphp.fr
Abstract:
External hemorrhoids thrombosis affects 8% of women during last trimester pregnancy and 20% of women immediately after delivery. Their treatment is medical with local treatment (with corticoid and anesthetic), defecation regulation and paracetamol. NSAID can be used after delivery in absence of breath-feeding. Local excision is not possible in most of the cases because of inflammation. Surgery has to be an exception because medical treatment is sufficient in almost all cases. Anal fissure is the most frequent differential diagnosis, encountered in 15% after all deliveries. Symptoms associate anal pain during and after defecation with blood on toilet paper. The only identified risk factor for hemorrhoids thrombosis (and anal fissure) is dyschesia. We have to think about it.
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