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Ask Dr. Sears: Answers to Common Pregnancy Questions

Swelling

Q. My hands and feet are swollen. Is this normal?

A. Your blood volume surges by 40 percent during pregnancy, slowing down your circulation, which can cause a swelling in your hands and feet known as edema. Your growing uterus can compound the problem by putting pressure on your vena cava (the large vein that brings blood back from your lower limbs). So put away the pinchy pumps and look for some loose-fitting loafers.

To help control swelling, avoid sitting or standing for long periods of time. Get up and get moving -- exercise such as walking or swimming improves the circulation in your hands and feet. Elevating your feet and ankles for an hour, especially at the end of the day, will also help. Whatever you do, don't restrict fluids -- your body needs to be hydrated to maintain a healthy pregnancy.

If you're worried about swelling, try this test: Press your finger against a swollen ankle. If it leaves a noticeable dent, try elevating your legs for an hour. Then press your ankle again, and if this still leaves a mark, you'll want to talk to your doctor about it. Excessive swelling can be a sign of preeclampsia, which produces high blood pressure in the mother and prevents the baby from growing normally. At regular visits, your doctor will check you for other signs of the condition: high blood pressure, sudden weight gain, or the presence of protein in your urine. Tell your doctor if you are worried about the swelling, but if your blood pressure and urine are normal, you need not be concerned about the health of your baby.

Constipation and Hemmorrhoids

Q. What can I do about constipation and hemorrhoids?

A. Constipation is an occupational hazard of pregnancy and the postpartum period because hormones slow down the movement of food in your digestive system. The iron in your prenatal vitamin can add insult to injury. Remember the two F's of constipation prevention: Eat more fiber and drink more fluids. Fruits, vegetables, and whole grains soak up water in your intestines and help keep waste moving along -- try prunes, pears, figs, apricots, carrots, zucchini, and celery. Eating whole wheat breads, cereals, and pastas will also help you bulk up your fiber intake. Another easy trick: Add a few tablespoons of wheat germ to your cereal or to a fruit and yogurt smoothie. To increase your fluids, make a water bottle your constant companion. Try to drink at least eight glasses of water a day, and treat yourself to different types of fiber-rich juices such as apricot, prune, and pear nectars.

Hemorrhoids can be a side effect of constipation. Pressure from the enlarging uterus along with the increased blood volume of pregnancy can cause the veins in the rectal wall to enlarge, bulge, bleed, and itch. Hemorrhoids are harmless, but they are a pain in the butt! Constipation and straining during elimination aggravate the pain and can make you miserable.

Fluids and fiber in the diet will help keep hemorrhoids to a minimum. For a nutritious stool softener, we recommend adding one tablespoon of flax oil to a daily smoothie. Kegel exercises (tightening and releasing the muscles in your pelvic floor at least 50 times a day) will improve blood flow to the area and strengthen the tissues. Exercise also helps because it prevents blood from stagnating in the lower areas of the body.

To soothe the itching and sting of hemorrhoids, use cool compresses, such as crushed ice in a clean sock. A cotton ball soaked in witch hazel will help shrink hemorrhoids and ease discomfort, and a warm bath may be soothing as well. Talk to your doctor before trying any over-the-counter remedies available at the drugstore.

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