Anorectal symptoms during pregnancy: how important is trimester?

The frequency of anorectal symptoms amongst pregnant women has not been objectively investigated in the United Kingdom. The aim of this study was to determine the frequency of anorectal symptoms during each trimester of pregnancy. Women attending the antenatal clinics at a London teaching hospital were asked to complete a questionnaire. The presence or absence of common anorectal symptoms experienced both before and during the current pregnancy together with demographic and pregnancy data was collected. Statistical analysis was performed using Fisher's exact test. Two hundred seventeen patients (first trimester n = 75, second trimester n = 70 and third trimester n = 72) participated. A significant increase in the frequency of symptoms was observed in the third (43.1%) compared to the first (16.0%, p < 0.001) and second (22.9%, p = 0.013) trimesters. The incidence of per rectal bleeding was significantly greater in the third trimester (30.6%) compared to the first (10.6%, p = 0.004) and the second (12.9%, p = 0.014) trimesters. Similarly, anal pain was significantly more frequent in the third trimester (34.7%) compared to the first (13.3%, p = 0.003) and the second (12.9%, p = 0.003) trimesters. The frequency of anorectal symptom reporting appears to increase as pregnancy progresses. Further investigation and research is warranted to determine the configuration of services that may be required to treat those affected.