# FREEPIK
dealing with it . Back to point where Sheena is pregnant and because of the physiological changes in pregnancy women have a greater propensity to develop piles , which is the other name for haemorrhoids .
During pregnancy due to changes in levels of the hormones oestrogen and progesterone , there is an effect on the nerve action of smooth muscles and the entire gastro-intestinal tract is composed of smooth muscle .
This leads to delayed gastric emptying , with acid build up , resulting in symptoms of nausea , vomiting and hyperacidity . For small bowel due to sluggish activity , it leads to constipation and buildup of gas i . e . bloating .
These symptoms can be avoided by eating small frequent meals , avoiding very spicy , acidic or oily food , drinking adequate amounts of fluids ( 2-3L / day ) and by taking a diet rich in fibre which can be found in fruits such as berries , apples , mangoes , vegetables especially leafy green vegetables , and whole meal grains and legumes .
Sheena at this point is on the verge of tears and I reassure her and Gilbert , that she will notice a marked improvement with medication . I quickly jot down a prescription and ask her husband to take her home and ensure she takes the medicine but more importantly adhere to the dietary advice . If she is able a sitz bath ( soaking area with warm salty water ) would also help to alleviate the symptoms . They leave the office just as they came in - duck style , but you can see there is some relief and hope in their composure .
Two weeks later Sheena returns for her scheduled follow up appointment and this time there is a completely different person . She is walking normally and has a bright smile on her face . The joy of being a doctor when things work out as anticipated . She is finally enjoying her pregnancy as she should . I normally tell my clients that second trimester is the best , you know you are pregnant , yet you don ’ t feel pregnant .
I know this is the story of many women and even men but this was a rather simple case . The symptoms were able to resolve with medication . In some cases , other treatment can be employed from rubber banding the haemorrhoids to sclerotherapy , staples and outright removal - haemorrhoidectomy .
For women who are contemplating removal they must be sure they have completed their family size i . e . they do not want to have more children and are on some form of contraception , as with subsequent pregnancies they can get a relapse of the symptoms . Other non-medical ways of managing or preventing piles include exercise , weight loss and avoiding to carry heavy objects .
I hope the article is of use and please remember that this is a very common pathology and has several very effective modes of treatment and as always prevention is better than cure so eat right , exercise and enjoy life .
Dr . Maureen Owiti is a practicing Obstetrician Gynaecologist and fertility consultant based in Nairobi . You can commune with her on this or related matters via email at : Drmaureenowiti @ gmail . com .
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