Feeling so upset from medical advice, slightly graphic

[XForL]

I had a telephone consultation with a GP on Thursday because I have anal fissures that have returned but the Lactulose isn't working and I have so much impactation I just can't shift now for days. It's like the stuff itself is WIDER than my own bottom

It was a locum I spoke to

I explained that I was concerned because I simply couldn't go, but I have no urge to really push? It's absolutely disgusting, I'm sorry, but I have to push on the bottom of my vaginal wall to encourage anything out. But even that isn't working at the moment, and whatever is there is bulging into my vagina?!

He said constipation is common in pregnancy. When I said that I couldn't 'go' unaided with my fingers pushing down, he said he'd never heard of that before but to not do it! He gave me a lecture about it causing a UTI and that can be harmful for babies (I'm on iron tablets and a whole host of meds for extreme sickness, that coupled with not a great diet due to sickness means I'm very constipated anyway).

He said his advice was to up the dose of Lactulose and that should work. He said he doubts I'd need to call back as that should fix it

But I've done as he's said. And it's now Sunday and I feel like there's a head crowning. I'm sorry to be graphic again but whatever's there is far far larger than my bottom hole and I can't can't can't get it out. It feels horrendous. Plus every time I try my fissures are bleeding a lot and so sore

What should I do? Is he right or was he insensitive? My GP surgery is usually fantastic by the way!

I pressed send before I'd finished posting -

Basically I've done something silly and thought an enema would be a good idea. Feeling desperate, I squired saline eye drops up there

They have made me pass a water like substance but now what's there seems to feel like a proper crowning but it's just too huge to get out and I can't. Not even if I bit down on a towel. It physically doesn't feel possible

And it's bulging right through my vagina

Without being gross, can you use your fingers to gently break it up?

I would speak to a pharmacist, they're likely to know a suppository you could use to help.

Can you try glycerine suppositories?

@October2020

Without being gross, can you use your fingers to gently break it up?

I would speak to a pharmacist, they're likely to know a suppository you could use to help.

I'd like to try but I have two large anal fissures and I cannot insert a finger

Plus it feels clogged back to the back of the vaginal wall so I dont think fingers can reach that far

I will try a pharmacy but from experience they won't give over a thing the moment you mention pregnant

Glycerine suppositories and lots of Vaseline and a pair of medical gloves. Good luck!

Moving forward ,talk to the GP about taking something like Movicol and drink LOTS of water.

When you sit on the loo put your feet on a small stool to raise them, or a couple of thick books. This helps a lot.

@MrsPelligrinoPetrichor

When you sit on the loo put your feet on a small stool to raise them, or a couple of thick books. This helps a lot.

Sound extreme but I'm terrified now, that it's got so big, that I'll end up literally ripping myself a new hole if I do that

It just doesn't feel passable anymore

@XForL why don’t you go to a and e? This doesn’t seem something you can deal with at home?

This is gross but could you have a bath and erm.....a rummage.

Have you tried lots of Vaseline?

The suggestion of A and E is not a bad one tbh.

Yes definitely to both PP ideas. Glycerin Suppository and footstool or books to elevate legs. Works for me every time.

@XForL also try foods to encourage it. I think bananas and tea etc? I’d still go to a and e though to be on the safe side

I had that just after I gave birth to my second, it was too large to get out and having just given birth I couldn't push it out anyway.

I'm afraid I had to get set up in the bathroom and spent some time putting my fingers up and breaking bits off piece by piece until I could finally pass it then lots of laxatives to make sure it didnt happen again.

Impacted faeces can cause a lot of issues and be quite dangerous so you need to get it out. Whether by yourself or go to A&E if it's that bad.

bulging right through my vagina
This is, I believe, called a rectocele and a doctor should have heard of it.

And this The suggestion of A and E is not a bad one tbh.

You sound impacted. Further medical assistance is needed.

Inadequate that he has never heard of that - it’s sometimes used by women who have prolapses, it’s called splinting. It even recently had a moment on Tiktok:

www.womenshealth.com.au/a-gynaecologist-weighs-in-on-tiktoks-viral-constipation-trick

Also mentioned in this summary: fascrs.org/patients/diseases-and-conditions/a-z/pelvic-floor-dysfunction-expanded-version

I have no advice but I just wanted to say I'm really sorry you're going through this

Ask your gp about movicol. That's way better than lactulose

And the pushing on the vaginal wall is not at all unusual. I suspect most women have found it to be a very useful maneouvre when constipated.

Had that gp been female you'd have had a different response.

But yes, maybe try pharmacist or even a+e. You are the only one who can guage that need.

Good luck

I I'd be gross and get in the bath and get the shower head up there warm water on the bum hole and just see if that helped. If it does then just go in the bath, then clean it a lot with bleach.

Or call ooh and get some extra help!

Ring 111 and consider urgent care centre.

Bless you, I had this after my 4th pregnancy. I felt exactly like you that there was just so much compacted that I wouldn't be able to pass it. I was still in hospital as my daughter had a heart problem so I asked the nurses what I could go. They had a midwife come and she gave me a suppository to push up there. It worked and a few hours later I was able to pass it all. The relief was immense, I was very sore for a few days after but I just kept drinking lots of water so that it didn't happen again. I'd go to A&E and ask for help as your gp doesn't sound very understanding. I hope you get sorted

God its a bit worrying from the GP. Seems to have quite poor anotomical knowledge. How would you helping it out cause a uti?

I'd speak to your GP again tomorrow or do you have a maternity assessment unit at your hospital?

I’m in a different country, can you buy saline enema’s there? Really easy to use and might be enough to soften and break it up.

If not, An Impaction may need to be cleared at a&e

I'm sorry. I think if you aren't able to go today you will have to go to a and e