Coloproctologic Disorders During Pregnancy And In The Postpartum Period

During pregnancy the anatomy and physiology of the pelvic floor and the perianal region is modified, due to endocrine, metabolic and immunologic changes. This can lead to a change in the observed incidence of coloproctologic disorders or an alteration of pre-existing coloproctologic diseases. In patients requiring specific treatment prior to or during pregnancy the possibility of adverse effects on the antenatal or postnatal development of the child has to be considered carefully. It is necessary to evaluate whether the therapeutic strategy needs to be modified or even discontinued. The aim of this review is to present the current state of knowledge on the medical care and treatment of coloproctologic disorders during pregnancy. Diagnostic approaches and therapeutic options for haemorrhoids, anal fissures, perianal thrombosis, perianal abscesses and fistulas, anogenitals warts, colorectal malignomas and inflammatory bowel diseases are presented. Therapeutic options are discussed with regard to their applicability during pregnancy and in the postpartum period.