Or should the GP have known better.

[Pittcuecothecookbook]

Gave birth 7ish weeks ago. I have absolutely incredibly painful piles, to the point I have to BF standing up as I can't sit down without incrutiating pain. Finally got the courage to visit GP. I confirmed I'd been using germaloid cream, regular paracetamol and taking lactulose but it wasn't improving. He told me to up the lactulose and went to the effort to prove to me it was safe while BFing on an app that listed medicines and various details.

He also prescribed a steroid oitment and I've just gone to use it and on the instructions it says in bold: do not use this product if pregnant or breastfeeding

So aibu to be mega pissed that this was prescribed to me when gp was fully aware I was a breastfeeding new mum?! And what do I do now? Call the reception tomorrow to make a new appt, or just call and ask to speak to him on the phone? Or just leave it?

Sorry your gp is useless go and see someone else. I would say the anusol is safe given the other one is.

Anusol has 0.25g hydrocortisone per 100g the one I've been given is 5mg per 1g!!! So yep given I'm able to use it in pregnancy I would without hesitation use the anusol when breastfeeding.

Get some witch hazel too someone recommended it to me on my thread the other day it's brilliant and Andrex flushable wipes instead of loo roll

It might not be the one that the doctor actually prescribed, sometimes if they don't have it in stock the dispensary puts one in that does the same thing.
Not really the same but I have this with my pill, my doctor puts the prescription through for a certain one and they give me another one that I can't take because it gives me terrible mood swings, I have to check every time there and then to make sure they have given me the right one.

What they often mean is that "this medicine hasn't been tested on pg/bf mums" because understandably not many people are willing risk that if they don't need it.
In order for it to be declared safe in this country it has to have been tested on a certain number of pg/bfing people.

That is fine during pg and breastfeeding. You can buy it over the counter hence the hyperbolic warnings.

If your piles are that bad you need better stuff - scheriproct or protoctsedyl - they’re expensive so they try to palm you off with cheaper stuff first. You need suppositories and ointment together.

Lactulose is helpful but I’d add in Fybogel.

You have my utmost sympathy. I’ve suffered the same and it’s hell. Worse than the delights of SPD at times and c-section recovery.

Bit of a leap to say the GP is useless meltingpregnantlady

Here is the info you need about anusolHC, OP. breastfeedingnetwork.org.uk/wp-content/dibm/haemorroids-oct14.pdf

The BNF doesn't list it as a problem either, there are loads of medicines which will say things like this in the leaflet that are totally fine to use, they just want you to have checked with a professional generally. If you're ever unsure check the breastfeeding network, ask your pharmacist or double check with your GP.

It sounds like a social problem to me that you need to learn to manage and to be patient with. There will be techniques to learn. Hopefully too you will be able to recover.

Sorry wrong response op. I thought you were someone else.

Well they've left her in distress so I'd say that qualifies them as a little bit useless!

My GP did a quick search on her computer to see if the medication was safe in pregnancy before prescribing it, something OPs own Dr could have also done.

agree with others - call and ask but honestly so many medicines say this and its usually because the drug company have not carried out the tests needed to confirm its ok to use while breastfeeding but years of experience tell your GP its probably fine.

Over the years I would imagine a GP would see thousands of mothers with piles

the website someone upthread posted has been useful for me over the years, Hope you feel better soon and congratulations on little one.

Read this breastfeedingnetwork.org.uk/wp-content/dibm/haemorroids-oct14.pdf

Would you prefer he left you in pain ?

As the registered medical practitioner he has weighed up the pros and cons of this treatment for you.

The cons are absolutely minute btw.

YABU in that the medicines you can buy over the counter tend to have blanket warnings about pregnancy and breastfeeding because there isn’t the professional appraisal of the complaint, the medicine, the benefits, the disadvantages that you have with a qualified doctor doing the prescribing. Being over the counter they have that blanket warning to cover themselves whereas a GP can prescribe using professional judgement and the pharmacopoeia information. A bit like if you take your dc to the hispital, they can and will prescribe more generous doses of paracetamol or ibuprofen using a calculation of weight etc, whereas the dosage instruction in the otc paracetamol will be more conservative.

I used instillagel after DS2 - mainly for my tear, but it helped numb the piles pain too.

You can also discuss this with your pharmacist. They will actually know about drugs than the doctor imo.

Because drug companies do not test on pregnant or breastfeeding mothers and they are aware of getting sued, the vast majority of drugs are labelled by the manufacturers as unsuitable.
Doctors use their experience to know what is known to be safe, what is known to be dangerous. They prescribe accordingly.
I would trust my GP more than a 'you can't sue me because' drug manufacturer leaflet.
Bourne out by all the links above.

Drug companies are incredibly risk adverse. Most drug company inserts are completely OTT . Prescribing during pregnancy is always a balance. I would be very happy using topical steroids when breastfeeding.

There may be some slight known risks attached when breastfeeding but your gp may well have weighed it up and decided the befits outweighs the risks in your case. The pharmacist would normally flag up any potential issues too if there are any.

I have the issue with contradictions with my constant medication. Not re breastfeeding as that's not relevant for me. But it means that my current daily meds often contradict with other medication and treatments including some antibiotics and painkillers. The GP will still prescribe them at times though. It's normally the pharmacist who will pick up on it and won't complete the prescription until they've spoken directly with my GP. The gp makes the decision based on the potential benefits.

You need Hemoclin...safe for using if bf an much better than anusol...it’s about £17 in Boots but I swear to god I’d have paid 50 quid for it at the time!

Surely he should have checked? It's his job, innit.

Oh for gods sake I’m sorry but comments such as yours really irritate me meltingpregnantlady You have no grounds upon which to say this. Just because the GP didn’t look it up in front of OP does not mean he doesn’t know already have the knowledge than anusolHC is totally fine to use in breastfeeding women. I don’t want to make light of the OPs symptoms as haemorrhoids postpartum can be horrible, but in a GPs working day this is bread and butter stuff - not something you’d need to constantly lookup. Topical steroids are fine breastfeeding. As PP have suggested a lot of these warnings from drug companies are just to cover themselves as trial data on safety of their particular brand may not be available compared to other brands.
I’m a GP - if I had to warn every patient of all the listed details of every drug I prescribe my 10 minute appointments would be 30 mins instead! That is what the SPC leaflet of pharmacists are there for.
Here signeth off a disgruntled GP sick of people quick to GP bash. OP- hope things settle soon

@Newbiecat I agree on all counts. OP I hope you feel better soon and yes, the medication is completely fine to use (also a GP).

@MeltingPregnantLady piles in pregnant and breastfeeding women are common and a GP who treats a lot of women in those categories won't need to look on their computer or on their lists of medicines to avoid during pregnancy/breastfeeding before issuing a prescription for that reason.

If they haven't prescribed a medicine before to a pregnant/breastfeeding woman they will definitely check even going as far as contacting a relevant consultant before issuing a prescription if they are unsure.

So far I've been prescribed/told to take 5 different things during my pregnancy. The GP checked one with a consultant, looked up one on their list of medicines to avoid then issued a prescription as it wasn't on the list, and didn't bother to do any checking on the other three.

The whole problem is that there is an expectation that a GP is being expected to have specialist knowledge. I assume you have asked your midwife or HV?

Also, for post birth piles there are some great things given to me here when I had my babies here in the US. Tucks made witch hazel pads and the hospital used perinatal ice pads under the pads used for bleeding until swelling had gone down. You can get them on Amazon. They are amazing for piles and drug free. Did they talk to you about sitz baths? My obn had me taking them from my 3rd trimester onwards in all 3 pregnancies as a preventive measure.

So in one breath people are criticising this GP for prescribing a medication they are concerned can't be used while breastfeeding (it can btw) and in the next breath they are criticising him for not prescribing a stronger version of a similar medication? The GP can't win.

Want2bSupermum the issue here isn't with the GP at all and this isn't a specialised problem, it is one GPs will see frequently. The issue is with posters making assumptions (almost certainly incorrect) about the GP's lack of knowledge and drawing conclusions from their own assumptions. People love to jump on the criticising HCPs bandwagon.

OP postnatal piles are hell, I hope you find some relief.