Treatment of haemorrhoids (piles) in pregnancy

(Date: September 2020. Version: 2)

This factsheet has been written for members of the public by the UK Teratology Information Service (UKTIS). UKTIS is a not-for-profit organisation funded by the UK Health Security Agency (UKHSA) on behalf of UK Health Departments. UKTIS has been providing scientific information to health care providers since 1983 on the effects that medicines, recreational drugs and chemicals may have on the developing baby during pregnancy.

What can I use to treat haemorrhoids?

Haemorrhoids (piles) are common in pregnancy, particularly after the first trimester.

Constipation (also a common pregnancy problem) can trigger haemorrhoids or make them worse. Drinking plenty of fluid (between 1.5 and 2 litres a day), eating foods that are rich in fibre, and taking regular exercise all help to avoid constipation. Iron supplements can also cause constipation. If necessary, your doctor can prescribe a slow release iron tablet which is less likely to cause problems. If you feel you need to use a laxative, your doctor or pharmacist will be able to advise you on which is the most suitable. For more information, see the bump leaflet on constipation. For some women, these measures may be enough to resolve piles.

If you need to treat piles, there is no evidence that any of the available treatments pose any risk to the baby. Paracetamol can be used if pain relief is required, but ibuprofen should generally be avoided in pregnancy, and codeine should not be used as it can cause constipation.

What are the benefits of treating haemorrhoids?

Haemorrhoids can cause pain and discomfort and so treating them can greatly improve symptoms, promote healing, and help stop them returning.

Are there any risks of treating haemorrhoids?

There is no evidence that any of the available prescribed or over-the-counter haemorrhoid treatments cause any problems, particularly as they are used topically so only quite small amounts are absorbed into the bloodstream and reach the baby in the womb. Additionally, most pregnant women develop haemorrhoids in the second and third trimesters when the baby is already fully developed. Use of medicines at this stage of pregnancy cannot cause structural birth defects.

Are there any alternatives to using haemorrhoid treatments?

Possibly. If haemorrhoids are caused or worsened by constipation, lifestyle measures as described above can first be tried to improve symptoms. Some women find that discomfort can be improved with use of cold packs.

What if I prefer not to use medicines to treat haemorrhoids?

Haemorrhoids are uncomfortable and sometimes painful, but generally do not pose a significant health risk. Therefore, some pregnant women may choose not to use haemorrhoid treatments. However, if haemorrhoids are affecting quality of life (such as causing pain, affecting sleep etc) then the benefits of treatment may outweigh any worries about hypothetical risks. Your doctor or midwife will be happy to discuss any of your concerns.

Will my baby need extra monitoring?

Most women will be offered a scan at around 20 weeks of pregnancy to check their baby’s wellbeing as part of their routine antenatal care. No additional monitoring is required following use of haemorrhoid treatments.

Who can I talk to if I have questions?

If you have any questions regarding the information in this leaflet please discuss them with your health care provider. They can access more detailed medical and scientific information from  

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General information 

Up to 1 out of every 5 pregnancies ends in a miscarriage, and 1 in 40 babies are born with a birth defect. These are referred to as the background population risks.  They describe the chance of these events happening for any pregnancy before taking factors such as the mother’s health during pregnancy, her lifestyle, medicines she takes and the genetic make up of her and the baby’s father into account.

Medicines use in pregnancy

Most medicines used by the mother will cross the placenta and reach the baby. Sometimes this may have beneficial effects for the baby.  There are, however, some medicines that can harm a baby’s normal development.  How a medicine affects a baby may depend on the stage of pregnancy when the medicine is taken. If you are on regular medication you should discuss these effects with your doctor/health care team before becoming pregnant.

If a new medicine is suggested for you during pregnancy, please ensure the doctor or health care professional treating you is aware of your pregnancy.

When deciding whether or not to use a medicine in pregnancy you need to weigh up how the medicine might improve your and/or your unborn baby’s health against any possible problems that the drug may cause. Our bumps leaflets are written to provide you with a summary of what is known about use of a specific medicine in pregnancy so that you can decide together with your health care provider what is best for you and your baby.   

Every pregnancy is unique. The decision to start, stop, continue or change a prescribed medicine before or during pregnancy should be made in consultation with your health care provider. It is very helpful if you can record all your medication taken in pregnancy in your hand held maternity records.

Disclaimer: This information is not intended to replace the individual care and advice of your health care provider. New information is continually becoming available. Whilst every effort will be made to ensure that this information is accurate and up to date at the time of publication, we cannot cover every eventuality and the information providers cannot be held responsible for any adverse outcomes following decisions made on the basis of this information. We strongly advise that printouts should NOT be kept for any length of time, or for “future reference” as they can rapidly become out of date.

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