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The "Bottom" Line

Updated: Oct 4, 2023

This post is a little too close to my heart, or should I say my bottom.

Woman sitting down with postnatal hemorrhoids

I started suffering with hemorrhoids in my early thirties, so, as you can imagine pregnancy was bound to be a pain in my arse (pun intended).

I tried to be a little proactive. Before pregnancy I saw a specialist in Bangkok who recommended rubber band ligation. This is when a doctor places small rubber bands around the base of the hemorrhoid (inside your anus) to cut off the blood circulation, it then withers and falls out when you pass stools over the next few days. It isn’t a particularly horrible experience, it’s a little embarrassing, but the procedure itself involves a simple, very quick, instrument inserted in your anus, and it really is very quick and painless. In fact the only pain I ever felt was the first time I passed wind shortly afterwards (something that still makes my husband giggle).

Of course, that solved the small problem I had pre pregnancy, but after pregnancy, and vaginal birth, I knew I hadn’t solved the problem long term. I continued to manage the problem with topical treatments, pain relief and diet, but in all honesty I now wish I had done a lot more to solve the problem once and for all much earlier. Three and half years after the birth of my daughter my condition had come to the point that I could no longer go on family walks for example. My husband and daughter would walk to the park, but I would have to get a taxi, purely because walking would cause my hemorrhoids to prolapse.

I saw a specialist in Singapore, Dr Francis Seow Choen and he quickly diagnosed 4th degree hemorrhoids. Possibly the biggest revelation was that I may have been looking at my diet incorrectly. We are so frequently told to eat more fiber when we are constipated, or need to pass easier stools. NEW FLASH we might be looking at this the wrong way around. Protein and carbohydrates are almost completely digested by the body, thus producing little waste, whereas fiber (vegetables, fruit etc) leave a lot of fiber residue in our stools, bulking them up. Hence, if you have a pain in your arse, you might find that fiber makes the problem worse, increasing the size and density of your faeces. I am not recommending that you change your diet, but you may benefit from reading a little more about this approach and discussing it with your Doctor. As always there are a myriad of opinions out there, but here are two articles that you may wish to cite to your Doctor to start a conversation:

Although this diet approach now assists me to manipulate my faeces when I need to (not a phrase I thought I would ever write), the long term goal was to repair my haemorrhoids so that I could enjoy spending time with my family on walks and days out.

Surgeon operating on postnatal hemorrhoids

Under general anesthetic Dr Seow-Cheong performed a Stapler Haemorrhoidectomy, also known as the Longo Technique or PPH (Procedure for Prolapse and Haemorrhoids). It is a “new method of Haemorrhoid surgery aiming to minimize pain and improve healing properties associated with haemorrhoidectomy. The technique works by removing a cuff of tissue from the area just above the piles. This results in the piles being pulled back into their normal positions within the anal canal. The stapler also interrupts the blood supply to the piles causing them to shrink in size and stop bleeding.” The recovery from the PPH procedure was surprisingly, amazingly, quick and almost painless. I felt a heaviness in my anus for 48 hours, but it wasn’t pain, just a little uncomfortable. Maintaining a low fiber diet during recovery meant that my stools did not aggravate the internal sight of the wound. Honestly, within 48 hours I felt 95% back to normal.

What is the take-away from all this, well in my personal case this has changed my life in so many little ways. I now enjoy walks with my family, I don’t wince when I wash myself, my underwear is no longer uncomfortable, I don’t worry when I pass stools and I’m not paying for over the counter remedies every week.

Woman on beach in a swimming costume after postnatal hemorrhoids surgery

Bottom line (pun intended again) if you suffer from hemorrhoids then see a specialist as soon as possible! Being pregnant, becoming a mum, and everything that is associated with it, has so many less glamorous moments, don’t let hemorrhoids be part of this.

Don’t settle. Find a specialist.

If you have recently given birth and have any scheduled surgeries please make sure you have support and care arranged for you and your family. A postpartum doula can be arranged to ensure that you have hands on help at home for both you, your baby and immediate family. In circumstances where you are still recovering from childbirth but are proactive to have surgery for other ailments, you will benefit from having someone by your side, to discuss evidence based approaches to your recovery from birth and surgery, plus newborn care during this time.

Times are changing, and we are all becoming independent nuclear families, but you deserve care and support when you need it most.

Please note that neither Kathy, nor Empowa, has any affiliation with Dr Seow-Cheong. This is NOT a sponsored post.


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