Q. I am 19 weeks pregnant with my third child and have been experiencing a painful swelling on the left side of my vagina, in the back toward my anus. It hurts when I sit or stand. What could be causing the painful swelling?
-Anonymous, New Jersey
A. It sounds like the horrific hemorrhoids that are very common during pregnancy. The majority of my girlfriends and I all experienced them to varying degrees.
My friend Linda never knew what a hemorrhoid was until her 20th week of pregnancy. While in the shower, she felt a bulbous and painful bit of flesh next to her anus. She screamed, called her husband into the bathroom and insisted he inspect it immediately. Linda thought that the baby had dropped down into her bowels and was trying to push a fist out through her butt. Her husband loves to tell that hilarious tale after a few too many drinks.
To keep your hemorrhoids from getting further aggravated, you may try: not straining while having a bowel movement; keeping your feet elevated as much as possible; sleeping on your left side; using Tucks, Preparation H and other topical medicines; and keeping bowel movements regular with stool softeners and/or fiber.
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Q. I'm nine weeks along. The doctor told me to "take it easy" because I have been spotting, although the baby seems to be fine. My question relates to pregnancy constipation. I end up straining sometimes when I'm using the bathroom. Can I hurt the baby if I push too hard? I keep having this (probably irrational) fear that I'm going to accidentally push the baby out, or cause some kind of permanent damage.
-Anonymous, North Carolina
A. Straining while having a bowel movement will not harm the baby, but you could harm yourself in the end – and I mean your rear end. Constipation is a very common symptom of pregnancy and so are hemorrhoids, which are often brought on by pushing too hard while pooping. Once you develop a hemorrhoid, this area of your rectum will be forever weaker and prone to future hemorrhoid episodes.
Being a Hemorrhoid Queen myself, I would like to advise you to do all you can to stave them off, and if you do get them, do all you can to minimize them. Mine were so bad that I had to have surgery. I can honestly say it was the worst pain I've ever experienced – ten times more painful than a C-section, if you can believe that.
Back to the subject of your constipation and straining, you might try adding more fiber to your diet, drinking more liquids and, if all else fails, try the three tablespoon of olive oil method. My sister swears that olive oil was the only thing that got her digestive tract lubed up again.
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Q. So I read all about cheeseburger crotch, but I think I have cheeseburger anus–seriously. I have been pretty constipated since the first trimester, but I have been able to ease it with high fiber food and drinking lots of water. Now, at week 22, the constipation has come back with a vengeance. Whenever I manage to poop, I notice that my anus seems swollen, and looks as if it's actually been turned inside out: A soft flap of tissue pokes out of the anus opening and I have to push it back into me. Help! What's going on? I know it's silly, but I am too embarrassed to ask my doctor about this.
A. My term for your condition is "cauliflower butt" and yes, I've had it too. Cauliflower butt is brought on by building pressure and weight gain in the lower body and constipation, which in turn, brings on hemorrhoids.
Hemorrhoids are almost unavoidable during pregnancy. Some women get them all throughout the pregnancy, while others just get them during labor and delivery.
There are two types of hemorrhoids - external and internal. An external hemorrhoid is a vein that pokes out through the muscle wall near the anus. It usually looks like a swollen blueberry or cherry sticking out. Poking it back inside your rectum with your finger may provide some temporary relief as less ballooning out of the vein means less discomfort. Internal hemorrhoids are the same thing, just inside of the rectum. This puffing out of veins around your rectum may give your butt a cauliflower appearance, thus explaining the term "cauliflower butt."
To help ease the swelling and pain of cauliflower butt, you might try an old trick of mine: after every bowel movement, gently clean the cauliflower with Tucks medicated pads and then pack a bunch of clean pads on and around your anus. Change the pads every time you go to the bathroom. The witch hazel will cool the area and help reduce swelling.
Also, to keep your hemorrhoids from getting further aggravated, you may try: not straining while having a bowel movement; keeping your feet elevated as much as possible; sleeping on your left side; using Preparation H and other topical medicines; and keeping bowel movements regular with stool softeners and/or fiber.
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Q. Why do hemorrhoids flare up during pregnancy? Can this start in the first trimester?
A. A number of factors can contribute to the appearance of hemorrhoids during pregnancy, such as: dilation and expansion of blood vessels, frequent bouts of diarrhea, straining during bowel movements due to constipation, and the pressure of the growing baby and uterus pushing on the pelvis area and bowels. Some women don't get a single hemorrhoid until pushing during delivery. Some women get hemorrhoids almost immediately after becoming pregnant. The increase of hormones can enlarge blood vessels and cause irregular digestion and/or irritate a pre-existing hemorrhoid condition. And, some women never get hemorrhoids at all. Lucky them!!