Expert: Dorothy H, LCCE - 3/24/2009

Question
I am 10 weeks Pregnant, a week or so ago I had a hard stool that felt like I may have ripped a part of my anus and my stool was filled with blood, and i have pain in my anus.  Since then I have had bleeding everytime I have had a bowel movement whether it be a soft stool or hard stool.  At times there has been a little mucus included and at times there are dime sized red blood clots.  The bleeding is always bright red.  I am concerned because I am 10 weeks pregnant.  My sister is a nurse and said as long as I'm not having any stomach pain I am probably ok.  I plan on calling my OBGYN on Monday if it hasn't gone away.  Can anyone help me with this?  Again there is no pain when passing stool now just that one time and I have no stomach pain.  

Answer
Hello and congratulations on your pregnancy!

Especially because your symptoms started with a painful stool, it sounds likely that your symptoms are being caused by an internal hemorrhoid, which can develop from straining to move stool. Hemorrhoids are also common among pregnant women due to hormonal changes, as well as the pressure of the fetus later in the pregnancy. For most women, hemorrhoids caused by pregnancy are a temporary problem.

The most common symptom of internal hemorrhoids is bright red blood, sometimes with mucus, covering the stool, on toilet paper, or in the toilet bowl.

To help with the symptoms, you can try increasing fiber and fluids in your diet. Eating the right amount of fiber and drinking six to eight glasses of fluid a day can result in softer stools. A softer stool makes emptying the bowels easier and lessens the pressure on hemorrhoids caused by straining.  

Good sources of fiber are fruits, vegetables, and whole grains. In addition, doctors may suggest a bulk stool softener or a fiber supplement such as psyllium (Metamucil) or methylcellulose (Citrucel).

Exercise, including walking, can also be helpful as well.

If you have already increased fluids and fiber in your diet and your symptoms are not getting any better, definitely give your OBGYN a call.

Please let me know if I can be of any further help.

Sincerely,
Dorothy Haines, LCCE