Haemorrhoidal Disease in Pregnancy: Results From a Self-assessment Questionnaire Administered by Means of a Social Network

Abstract Background: The anal symptoms occurring pregnancy and post-partum, mainly related to Haemorrhoidal Disease (HD), have been reported with a wide range of incidence in the Literature. Although in many cases the course of the disease is mild and self-limiting, sometimes it is severe enough to give a bad quality of life. Methods: Our study has been conducted by means of a questionnaire administered via of a social media with the aim of obtaining an epidemiologic data on incidence of symptoms of HD in an unselected population of pregnant women. In addition, we investigated for the presence of those factors notoriously predisposing or associated to haemorrhoidal disease (constipation, straining on the toilet, low dietary fibers and fluid intake). Results: Out of 133 patients 51% reported Symptoms of HD during pregnancy, mainly in the second and third trimester. Constipation, straining on the toilet, low dietary fiber and fluid intake were not significantly related to incidence of haemorrhoids. Only a previous history of haemorrhoidal disease correlated to onset of hemorrhoids in pregnancy and reached a statistical significance (odds ratio = 5.2, p<0.001). Conclusion: Although with the limitations posed by the nature of our retrospective study via a self-assessment interview, our results suggest that the occurrence of HD in pregnancy seems not sustained by the classical risk factors observed in the general population. At the moment, specific therapeutic measuresare lacking and treatment relies on empiric suggestions concerning diet, fluid intake, bowel care, local ointment. Further studies are needed in order to identify a targeted etiologic treatment, taking in mind however, that surgery can be an option in selected cases.