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!

Oh OP you poor thing. I have had similar with feeling it was too big too pass, needing to break it up etc. I got in the bath (sounds grim but I was desperate). I also found putting my fist in my mouth helped me relax a bit (it’s a childbirth trick, supposed to relax your pelvic floor). Again, I was desperate!
But I agree with PPs that if you feel it’s bulging through the vaginal wall, maybe A & E?
I really hope you get sorted soon x

The bulge sounds like my problem and I definitely have a large rectocele. A GP should have some basic knowledge of female prolapses!

You can buy glycerine suppositories most places now, I think you do need to bring out the bug guns (so to speak) so suppository or enema now it’s so far down, oral laxatives are not likely to work anymore.

Hope you get some relief and do speak to your GP if you continue to have prolapse issues. I need to get help but have had this issue for many years and I think surgery may cause as many problems as it solves now due to my managing the rectocele for so many years so don’t leave it too long!

Poor you. It sounds very distressing. I would go to hospital and let them help .it needs tackling from both ends but it needs to be he shifted and they can give you painkillers

I honestly think sitting with your knees raised on a stool would be beneficial and much easier and less likely to hurt you.

Thinking hospital is your best bet now

Yes A&E in immediate instance and yes probably a rectocele by the sounds of it. Poor you. Hope you are more comfortable soon.

You have my sympathy! I suffered with a fissure for 7 months after child birth and it was awful!

The one thing I will say for lactulose is that, to make it work, you need to drink a tonne of water! I think I aimed for 6 litres a day. Otherwise it won't help!

I used aquaphor (similar to Vaseline) when I needed to go and basically lubed up as much as possible. Gross but using your finger to lube the actual loo if you can..! Needs must!

I don't know about impaction but think you've had some good advice above. I got rid of my fissure eventually by being religious with the water, 3 x a day lactulose, aquaphor to lube up, a stool to put my feet up when going, wiping with toilet wipes instead of loo roll and using cavilon (a barrier cream afterwards)
Good luck!!

• the actual poo, not loo! I'm not sure that would help!!

Like PPs have said, sounds like you may have rectocele. I'd be tempted to ask to be referred to a gynae doctor (once you've dealt with the poo issue) I have rectocele myself after my first child so I know this situation well. If you go to A&E they will most likely manually remove it. If it's impacted and really hard I doubt there is much a suppository will do, ime they didn't do jack!
Get a towel, bite on it and get a digit up there, do your best to break it up and I promise you it will start coming away. It's gonna hurt, but it'll hurt more if you leave it. I went 7 days PP without a poo.. it started making me scarily ill. I hope you get sorted lovely, sending hugs. X

Bless you, are you taking ondansetron by any chance?

I’m pregnant and that’s what I’ve been on and I’ve been in exactly your position and it is AWFUL. The suppositories that are being suggested on here are good I think if over 12 weeks, and lactuloose. Look at the dosage because I think it’s higher for impaction and then you’ll need a regular dose to keep you going. Fresh orange juice, cups of tea 3 sugars. Something warm on your tummy. I’ve had to poo in the shower fully squatting that helped, also like pp have said if you can remove some of it yourself with your hands that will help you. Have a good dig around and try get some bits out. Even little bits passing is helping you in the long run I promise. Honestly been exactly where you are and it is absolutely awful I really feel for you. It will pass tho!!!

I had constipation so bad in pregnancy I had to manually break it up, if you can't do that I would call 111 and try to get a nurse appointment or a trip to A&E isn't unreasonable. When you're feeling better send an email to your GP practice manager as feedback.

@CrouchEndTiger12

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

My toddler takes something called cosmicol, is that it?

I’d say hospital too.

When you’ve got this blockage sorted - prunes, prunes, and more prunes. They really do work but you've got to keep taking them.

I think you’re going to need an enema. You could go to A&E

You need to get it sorted today OP. My sister nearly poisoned herself not pooing as she was so afraid after having her baby. She really became very ill.

If you go to A&E they will most likely manually remove it. If it's impacted and really hard I doubt there is much a suppository will do, ime they didn't do jack!

How does that work?! Sorry, thought the best medical staff can do is put stuff up to soften it and make it come out

If you’re sitting on the toilet, raise your feet up on a toddler step or a pile of books.
I know it hurts, Ive had a fissure too, but try and relax and let it happen.
Are you drinking coffee ? One might help you go.

@XForL

If you go to A&E they will most likely manually remove it. If it's impacted and really hard I doubt there is much a suppository will do, ime they didn't do jack!

How does that work?! Sorry, thought the best medical staff can do is put stuff up to soften it and make it come out

They remove it bit by bit with their fingers.

It will be manually done I expect OP, I'd much rather do it myself!

@Ilikechips

Bless you, are you taking ondansetron by any chance?

I’m pregnant and that’s what I’ve been on and I’ve been in exactly your position and it is AWFUL. The suppositories that are being suggested on here are good I think if over 12 weeks, and lactuloose. Look at the dosage because I think it’s higher for impaction and then you’ll need a regular dose to keep you going. Fresh orange juice, cups of tea 3 sugars. Something warm on your tummy. I’ve had to poo in the shower fully squatting that helped, also like pp have said if you can remove some of it yourself with your hands that will help you. Have a good dig around and try get some bits out. Even little bits passing is helping you in the long run I promise. Honestly been exactly where you are and it is absolutely awful I really feel for you. It will pass tho!!!

Yep, Ondansetron! And iron tablets

@XForL if your heavily impacted generally they will try manual removal as it'll most likely be more successful than a suppository. X

You need your title edited this is more than ' slightly 'graphic. Noone needs to read about breaking up a massive shit with their fingers at Sunday teatime

They remove it bit by bit with their fingers.

They can't I have two large fissures (I had Botox surgery on them 12 months ago but it didn't work very well). They can't be putting fingers up there. The bloody pain would be too much just laying there like that

It’s called a manual evacuation.