It is recommended to consult a physician about the use of drugs for hemorrhoids during pregnancy. There may be no problem with the application of OTC ointment or cream medications for topical use. However, some people may develop eczema or allergies; therefore, caution should be exercised. If any such abnormality occurs after using an OTC drug or if there is no alleviation even after using such a drug for about one week, consult a specialist. However, if anal bleeding occurs, see a doctor immediately.
Steroids may be used in the acute phase; in such cases, there may be no problem if topical steroids are used only for a short period of time.
However, long-term topical steroid use is not recommended. This is not recommended not only for pregnant women but also for all patients. All patients including pregnant women must avoid using steroids over the long term.
With regard to the use of OTC drugs for hemorrhoids, there is usually no problem with topical drugs even during pregnancy; however, pregnant women who are concerned may consult a pharmacist on OTC drug use. If an OTC drug is used, follow the specified dosage and administration. However, when a patient purchases an OTC drug at their own discretion, it is most important to choose a drug appropriate for the patient’s symptoms. Patients often use an inappropriate dosage form of an OTC drug and say, "It worked before," because they felt it had been effective before. However, this might not have been the case and there may have been other reasons for the cure which the patient was unaware of. If there is no alleviation of symptoms after the use of an OTC drug, the drug may be inappropriate or used incorrectly. In such a case, a specialist must be consulted.
With regard to the effects on fetuses, there may be no problem with the application of topical medications for hemorrhoids. Oral medications may have some effects on fetuses, so it is recommended to have such medications prescribed at a hospital. The same precautions apply to breast-feeding women. However, at present, it is said that breast-feeding women can take antibiotics and analgesics, and the number of oral drugs that can be used for breast-feeding women is increasing compared with the past. Following the advice of a physician and taking prescribed drugs will give the patient a sense of security.
OTC drugs for hemorrhoids used during pregnancy vary depending on gestational week. Nonsteroidal drugs in prefilled disposable applicators for hemorrhoids are recommended for patients before reaching the stable stage of pregnancy. Consult a physician or pharmacist before use.
At our hospital, steroids are used for pregnant patients during the period from the stable stage of pregnancy to childbirth. Steroids are not used during any gestation period other than the above-mentioned. As for oral drugs, laxatives such as magnesium oxide and Daikenchuto (Kampo formulation) will be prescribed; however, basically, oral drugs to prevent hemorrhoid swelling will not be prescribed. Pregnant women should be cautious about taking even only a single dose of a common cold medication. In my opinion, pregnant women must select a drug only after discussing various options with a physician.