Postpartum Rectal Bleeding: Causes, Tips And Prevention

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Postpartum rectal bleeding usually occurs due to hemorrhoids, especially in women who have undergone a vaginal delivery. Hemorrhoids or piles are referred to the inflamed or swollen veins in the areas surrounding the rectum that cause bleeding and discomfort. Some common symptoms of this condition include itching in the rectal area, pain, bowel movements accompanied by bleeding and swelling around the anal region (1). Although this is a common condition, it is advised to consult your doctor and seek medical care. Read on to know more about rectal bleeding after delivery, its symptoms, treatment, and preventative methods.

Causes Of Postpartum Rectal Bleeding

The possible causes of rectal bleeding after delivery include.

  • Hemorrhoids (swollen veins in the rectum and anus): Hemorrhoids are common during pregnancy, especially in the third trimester and first few weeks after delivery. These swollen veins rupture and bleed as you strain while passing hard stool as a result of postpartum constipation (2) or when you wipe the anal area using a tissue.
  • Anal fissures: Hard stools could also cause cracks in the skin around the anus, known as anal fissures. These could be painful and cause bleeding (3).

Therefore, if you have a history of rectal bleeding before pregnancy due to hemorrhoids or anal fissures, inform the obstetrician so that he/she can suggest you medical management for the same as the condition can get aggravated post delivery.

How To Deal With Postpartum Rectal Bleeding?

Here are some of the ways to manage hemorrhoids and anal fissures and soothe postpartum rectal bleeding (2) (4).

  1. Try a warm water bath. You may use a sitz bath, which is a small water tub that fits over the toilet seat. Sitting in the sitz bath for about 10 to 15 minutes after each bowel movement or for two to three times a day could soothe irritation. Add Epsom salt to water to help reduce swelling and pain.

You can also soak yourself in a bathtub. Relax the anal muscles while soaking in the bathtub. It helps maximize the blood flow and speed up healing. It can also lower the pain associated with bowel movements.

  1. Apply ice compress (wrap some ice in a clean cloth) on the hemorrhoids and leave it for about ten minutes. This helps reduce swelling and discomfort. Alternate between hot and cold treatments — begin with ice compress and follow it up with a warm sitz bath.
  1. Clean the anal region using a soft and unscented tissue. You may also use medicated wipes or moist the tissue with witch hazel to speed up the healing process.
  1. Practice kegel exercises as they could help improve blood circulation in the rectal tissue region and the perineum. They also help tone the vaginal and pelvic-floor muscles (5).
  1. Sit on a soft cushion or a pillow to get relief from the rectal pressure. Sitting on a recliner or a rocking chair is likely to be more comfortable than sitting on a straight-backed chair. Doughnut pillows are very helpful in this situation.
  1. Limit activities that induce rectal pressure. Hemorrhoids generally occur due to the pressure exerted on the rectal area. The risk factors are likely to be obesity, lifting of heavy items, constipation, straining to have a stool, or sitting on the toilet seat for a prolonged period.
  1. Do not control the urge to pass stool as it could aggravate the pain and discomfort caused by hemorrhoids and make the stools dry.
  1. Limit the time spent in the toilet as sitting for a long time puts pressure on the rectal veins, which could increase bleeding.
  1. Use over-the-counter hemorrhoid creams, suppositories, ointments, or sprays after consulting a doctor. They could relieve itching and discomfort in the rectal region.
  1. Address constipation by including high-fiber foods in your diet and drinking enough water. These could ease constipation and reduce the discomfort caused by hemorrhoids and rectal bleeding.

If these home treatment measures do not provide you relief from postpartum rectal bleeding, your doctor might prescribe medicines such as stool softeners, opioids, and pain relievers.

When To See A Doctor?

Seek the help of your healthcare provider if you experience the following symptoms:

  • Significant rectal bleeding that is continuous or heavy
  • Abnormal growths in the anal region
  • Fresh blood in your stools
  • Change in the stool color
  • Pain while passing stool or urinating
  • Lack of control over stool passage
  • Dizziness or shortness of breath

Your doctor may schedule lab tests or imaging tests to determine the cause of blood in the stools.

How To Prevent Postpartum Rectal Bleeding?

Take measures to prevent constipation,  which could decrease the possibility of postpartum hemorrhoids and anal fissures, the main causes of postpartum rectal bleeding (6). The following measures could help you prevent postpartum rectal bleeding.

  • Drink enough water and other healthy liquids
  • Eat dietary fiber diet that includes whole-grain products, beans, cereals, fresh fruits, and vegetables in your everyday diet.
  • Limit intake of processed food, meat, and meat products.
  • Listen to your body and attend the nature call when you feel the urge.
  • Maintain a healthy body weight.
  • Take a probiotic supplement or a fiber supplement after checking with your doctor.
  • Do regular exercises, such as walking and swimming, and practice yoga.

Is It Normal To Bleed When You Poop After Having A Baby?

Finding drops or streaks of blood in your postpartum poop, toilet bowl, or tissue during the first few days after childbirth is common. You may also notice it in your panty after you visit the washroom.

Frequently Asked Questions

1. Can postpartum hemorrhoids be permanent?

Postpartum hemorrhoids are not permanent and should typically shrink back in about two to four weeks. However, if the discomfort increases, you must consult your OB/GYN (11).

2. What test is done to check hemorrhoids?

The doctor will first inquire about the symptoms, medical history, and current medical condition. Based on your condition, they may perform a physical examination of the visible symptoms. For internal hemorrhoids, an anoscope or proctoscope may be used to view the inside of the rectum, colon, and anus (12).

3. Does walking help hemorrhoids?

Yes. Exercises such as walking, biking, short distance running can help manage and prevent hemorrhoids by improving bowel movement and digestive problems (13).

Postpartum rectal bleeding is usually not a cause for concern. It mainly occurs due to hemorrhoids (swollen veins in the rectum and anus) and anal fissures. However, it is advisable to seek the help of your doctor if you notice severe symptoms, including constant and heavy bleeding. Also, taking measures to prevent constipation will decrease the possibility of postpartum hemorrhoids and anal fissures. You can address constipation and other discomforts that follow it by including fiber-rich foods in your diet and drinking ample water.

References:

MomJunction's articles are written after analyzing the research works of expert authors and institutions. Our references consist of resources established by authorities in their respective fields. You can learn more about the authenticity of the information we present in our editorial policy.
  1. What to Know After Having Your Baby (if you had a vaginal birth); UNM Hospitals
    https://hsc.unm.edu/health/patient-care/womens-health/doc/patient-education/postpartum-vaginal-birth-english.pdf
  2. Common Conditions; University of Rochester Medical Center
    https://www.urmc.rochester.edu/ob-gyn/obstetrics/after-delivery/common-conditions.aspx
  3. Hemorrhoids and what to do about them; Harvard Health Publishing
    http://www.health.harvard.edu/diseases-and-conditions/hemorrhoids_and_what_to_do_about_them
  4. Donna Freeborn et al.; Hemorrhoids and Varicose Veins in Pregnancy; University of Rochester Medical Center
    https://www.urmc.rochester.edu/encyclopedia/content.aspx?contenttypeid=134&contentid=9
  5. Richard Burney; Thrombosed External Hemorrhoids; Michigan Medicine
    http://www.med.umich.edu/1libr/Surgery/GenSurgery/ThrombosedHem.pdf
  6. Stool Softeners; NIH (2018)
    https://medlineplus.gov/druginfo/meds/a601113.html
  7. Meghan Duck; Postpartum Assessment and Common Postpartum Complications: Pain management Urinary Retention & Hematoma; UCSF Benioff Children’s Hospital (2018)
    https://bchsfoutreach.ucsf.edu/sites/bchsfoutreach.ucsf.edu/files/handouts/Washington%20Hospital%20Postpartum%204-2018.pdf
  8. Meredith Portalatin and Nathaniel Winstead; Medical Management of Constipation; Clin Colon Rectal Surg (2012)
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3348737/
  9. Treatment of Hemorrhoids; NIH (2016)
    https://www.niddk.nih.gov/health-information/digestive-diseases/hemorrhoids/treatment
  10. Hemorrhoids What Is It; Harvard Health Publishing (2019)
    https://www.health.harvard.edu/a_to_z/hemorrhoids-a-to-z
  11. Beginning: Pregnancy Birth and Beyond; Allina Health
    https://www.allinahealth.org/health-conditions-and-treatments/health-library/patient-education/beginnings/your-recovery-at-home/your-changing-body
  12. Diagnosis of Hemorrhoids; NIH
    https://www.niddk.nih.gov/health-information/digestive-diseases/hemorrhoids/diagnosis
  13. 5 Simple Ways To Prevent Hemorrhoids; Cleveland Clinic
    https://health.clevelandclinic.org/5-simple-ways-you-can-prevent-hemorrhoids/
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Rebecca Malachi

Rebecca is a pregnancy writer and editor with a passion for delivering research-based and engaging content in areas of fertility, pregnancy, birth, and post-pregnancy. She did her graduation in Biotechnology and Genetics from Loyola Academy, Osmania University and obtained a certification in ‘Nutrition and Lifestyle in Pregnancy’ from Ludwig Maximilian University of Munich (LMU). She has been into health and... more

Dr. Rana Choudhary (Khan)

(DNB, DGO)
Dr Rana Choudhary works at T.N.M.C & B.Y.L. Nair Hospital, Mumbai. She is also an honorary consultant obstetrician, gynecologist and reproductive medicine specialist at Wockhardt and various other hospitals in Mumbai. Previously, she worked as a clinical associate at P. D. Hinduja National Hospital & MRC, after completing her Masters in Reproductive Medicine & IVF from Homerton University Hospital, NHS,... more

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