Hemorrhoids are veins in the lower gastrointestinal tract that have ballooned, or prolapsed, under too much stress.
They are caused by too much pressure on the perineum, which is also basically straining.
That said, the strain can come from more than just holding your breath and pushing on the toilet.
Straining
Straining means that there is too much downward pressure on the pelvic floor. This can result from a couple of circumstances.
There is the circumstance of holding your breath and pushing (also called valsalva), which results in an automatic contraction of the pelvic floor, as the muscles in the pelvic floor attempt to brace against the strain to keep the organs in the body.
This can be a habit we have on the toilet or have developed to gain strength with lifting, or it can be a result of specific coaching during childbirth. In the case that it is coached during the pushing phase of birth, you can reasonably deduce that the hemorrhoids will be created or existing hemorrhoids exacerbated, as some women are coached to do this for up to four hours.
Under threat of c-section no less, so it makes sense they are giving it their all.
When the muscles around the pelvic floor are tight and contracted, they sinch around blood vessels. When we add pressure from above, this creates a ballooning in the veins as they are the path of least resistance in the pelvis.
Imagine squeezing a toothpaste container without a lid. The pelvic floor is your hand, the hemorrhoid is the toothpaste coming out the top.
Hemorrhoids are more likely to develop under the heavy strain of pregnancy, where the uterus is creating constant pressure in the pelvis, and there is generally more blood flow to the area.
That said, it's not a guarantee you will develop hemorrhoids during pregnancy. If you do, there is a good chance you have tight pelvic floor muscles as well.
Do They Go Away?
Once developed, hemorrhoids remain scar tissue unless they are inflamed again by another bout of straining/pregnancy/childbirth.
Postpartum hemorrhoids may take some time to improve, but with good pelvic floor therapy, diet and regular. healthy bowel movements they will.
They do not go entirely go away. They flare and create discomfort, or they remain deflated and cause no issues at all.
If your hemorrhoids flare, it's a good sign that something is not optimal regarding your bowel movements or pelvic floor.
You Are Not Alone
A lot of people have hemorrhoids, and it does not mean anything bad about you. It simply means that there is tension in the pelvis that we need to manage, or you've had to strain hard during childbirth.
Either way, hemorrhoids are manageable and you won't even notice them once they heal. If you have developed a hemorrhoid either through chronic straining or childbirth, know that they are generally harmless.
Most people are not educated on how to prevent hemorrhoids, so there is no need to blame yourself. There is nothing wrong with you.
If you are worried you've developed hemorrhoids, make sure to book your session with pelvic floor PT today.