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How to treat piles during pregnancy?

Q: My sister is pregnant for the second time. For the last 3 days, she has been experiencing pain in the buttocks and suspected piles as it starting bleeding. She consulted a doctor, who advised surgery. I am concerned, as this has happened during pregnancy. Is it OK to perform surgery for piles during the 8th month of pregnancy? Please advise.

A:She probably has a fissure-in-ano. Fissures are common in pregnancy, and present with rectal pain and bleeding. Most patients have constipation. The treatment is with laxatives. About 1-2% of patients will need surgery. If the patient truly has piles, these are even less likely to need surgery during pregnancy. Piles can be tackled after delivery. Your sister should take mild laxatives as permitted by your obstetrician. She MUST take a second opinion about the rectal bleeding.

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