Ako sa vyhnúť hemoroidom počas tehotenstva? Radia odborníci

Napísal Viktória Hudáková 18. september 2024

Tehotenstvo je jedno z najkrajších, no zároveň aj najnáročnejších období ženy. Budúce mamičky sa chystajú na príchod nového člena rodiny fyzicky i psychicky. V príprave tela na pôrod však mnohokrát zabúdajú na prevenciu pred hemoroidmi,...

... ktoré sa môžu vyskytnúť počas tehotenstva. Ako sa im vyvarovať a ako s nimi bojovať? Radí gynekologička.

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Zlatá žila aj v tehotenstve

Hemoroidy, známe aj ako zlatá žila, sú žilové ochorenie vznikajúce v oblasti konečníka – buď na jeho povrchu, alebo hlbšie v análnom kanáli. „Ide o chronické, pomaly postupujúce ochorenie, ktoré môže byť v istom období úplne bezpríznakové, respektíve môže mať len menej obťažujúce príznaky,“ vysvetľuje gastroenterológ MUDr. Radovan Juríček.  A hoci sa zdá, že hemoroidmi trpia prevažne starší ľudia, nie je tomu tak. Ohrozenou skupinou sú často aj tehotné ženy. „V ambulancii mám približne 25-30 % tehotných žien, alebo žien po pôrode, ktoré trápia hemoroidy. Odborná literatúra však hovorí až o 50 %,“ hovorí gynekologička MUDr. Zuzana Kosibová.

Hemoroidy pred aj po pôrode

Sliznica konečníka je vystlaná cievnou sieťou, ktorá vyživuje okolité tkanivo. Ak je však tlak na cievy priveľký, nahromadí sa v nich krv a vytvoria sa uzlíky – hemoroidy. Špeciálny tlak na cievnu sieť vzniká aj počas tehotenstva, kedy sa ženám spomaľuje črevná peristaltika a rastom plodu stúpa aj tlak maternice. „Vznik hemoroidov podporuje aj fakt zvyšujúceho sa objemu krvi v tehotenskom organizme,“ hovorí gynekologička. Zároveň vysvetľuje, že prítomnosť hemoroidov môže samotný pôrod zhoršiť, ale ide o krátkodobý stav. „Určite nie je dôvod na ukončenie tehotenstva cisárskym rezom z preventívnych dôvodov, aby sme zabránili prípadnému prechodnému zhoršeniu,“ dodáva MUDr. Zuzana Kosibová. Tiež vysvetľuje, že vhodnou prevenciou a liečbou hemoroidov sa dá všetkým komplikáciám, akým môže byť napríklad zápal, dobre vyhnúť.

Dajte stopku hemoroidom

Už pri vyšetrení tehotných žien sa venuje pozornosť vnútorným i vonkajším hemoroidom. „Akonáhle vidíme, že ide o vonkajšie hemoroidy, alebo nám tehotná žena opíše klinickú symptomatológiu vnútorných hemoroidov, doporučujeme preventívne opatrenia a vhodnú liečbu,“ vysvetľuje gynekologička. Na svrbenie, krvácanie či bolesť odporúča hlavne čapíky s protizápalovou, analgetickou a protiedematóznou zložkou. Po pôrode zas s čapíky s anestetickou zložkou. „Preferovala by som čapíky a gély s rýchlym vstrebávaním. Existujú aj čistiace produkty na oblasť konečníka, ktoré možno použiť po stolici. Chladná sprcha po stolici i preplach perianálnej oblasti môžu tiež veľmi pomôcť,“ hovorí MUDr. Zuzana Kosibová a zdôrazňuje, že sedacie kúpele v tehotenstve vôbec neodporúča. Vhodným produktom na čistenie môžu byť napríklad vlhčené obrúsky s extraktom listnatca pichľavého (Ruscus acuelatus), ktorý obsahuje ruskogenín a neoruskogenín. „Tieto látky sťahujú cievy a znižujú priepustnosť kapilár, čím sa znižuje opuch,“ vysvetľuje gastroenerológ MUDr. Radovan Juríček. U čapíkov je vhodnou zložkou lidokaín, ktorý ma anestetický účinok a prináša rýchlu úľavu od bolesti, a tiež tribenozid, ktorý znižuje priepustnosť ciev. „Krémy a čapíky s týmito zložkami sú vhodné pre ženy od 4. mesiaca tehotenstva a rovnako pre dojčiace ženy,“ hovorí. Budúce mamičky tak majú na výber z viacerých produktov, napríklad Procto-Glyvenovl či Preparation H.

Bezproblémové tehotenstvo = prevencia pred hemoroidmi

Hoci za vznikom hemoroidov počas tehotenstva môžu stáť faktory, ktoré nedokážeme ovplyvniť, svojou životosprávou im vieme aspoň čiastočne zabrániť. Gynekologička MUDr. Zuzana Kosibová odporúča:

-   Dostatočný príjem tekutín, ktorý je kľúčový pre fungovanie tráviaceho systému a prevenciu zápchy. Tehotné ženy by denne mali vypiť minimálne 2 až 3 litre tekutín. Okrem vody sú vhodnou alternatívou napríklad aj bylinné čaje.

-  Pestrú a vyváženú stravu, ktorá by mala byť bohatá najmä na vlákninu. Vhodné sú celozrnné produkty, mnoho zeleniny, ovocia, strukovín i orechov.

-  Dostatočný pohyb, ktorý okrem celkového zdravia pomáha aj predchádzať zápche. Dôležité je však venovať sa pohybu, ktorý tehotenstvo neohrozí.

-  Cviky panvového dna, známe ako Kegelove cviky. Tie okrem posilnenia svalov pomáhajú predchádzať opuchom a zápalom žíl, a tiež podporujú správnu funkciu tráviaceho systému.

-  Obmedzenie tvrdých stoličiek na sedenie. Podsedáky či mäkké vankúše zmierňujú tlak pri sedení. Pri sedavej práci je dôležité pravidelne vstať a prejsť sa aspoň na pár minút.

Zdroj foto: PickWizard

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