Anal pain - frightened of the toilet - TMI

[Nancynew]

Really sorry for this post (TMI , alert) but I am getting quite upset about this issue and wondered if I am alone in this - it certainly feels like it, but then it is not the sort of thing usually discussed . Basically because of anal pain when going to the loo, I am now terrified of going to the toilet . After the birth of my first child 4 months ago I did not go to the toilet for 6 days, and the experience was horrendous - in fact I went into shock afterwards. Thereafter I have experienced sharp cutting pains on going to the toilet which is excruciatingly painful. I was prescribed proctosydel cream as the GP suspected fissures. This helped a bit and I thought it might have gone, but it is still uncomfortable / sore now, but not excruciating. I am eating a high fibre diet to help with the fissures but this makes me go a lot , which I am sure is not helping the soreness. It is really starting to affect my happiness as I worry so much about what I eat IYKWIM . The doctors don't seem to think there is anything major wrong, but it has gone on for so long now, and it is so uncomfortable. In labour I tore badly (2nd degree, but only just not a 3rd degree) and it is infected/not healed and am awaiting surgery for this, and taking antibiotics to work on the infection. I just wondered if anyone else had experienced anything similar, or if I really am as weird as I feel sometimes when I cry just at the thought of having to go!

Nancy you poor poor thing, I totally feel for you. I went through the mill slightly when DD was born but the very worst thing about it all was the fissure caused by constipation from the iron tablets. It is truly horrible isn't it? I was bleeding every time I went to the toilet and ended up literally unable to sit down. I went back to the GPs and was eventually given Movicol - fantastic stuff which softened the poo enough to allow the fissure to heal. You need a proper diagnosis (suspecting is not really enough, is it?!) and better support with this problem. You are not weird at all I honestly do understand how horrible it is.

Also recommend wipes rather than normal loo roll, softer and get you cleaner.

Yes I've had similar-sounding problems in that area before and I know it can be very very painful and distressing :(

There might be various things you can try, 'stool softeners' like DulcoEase you can get from the pharmacy. And there's a local anaesthetic cream you can get on prescription (can't remember the name but you could ask GP) as a temporary measure until things heal up properly. Make sure you're drinking plenty of water, especially if you're having a high-fibre diet!

I know exactly what you mean about being frightened to 'go', I used to really dread it, but one of the important things is not to put it off and don't ignore the 'urge' - the longer you leave it the worse it gets IYSWIM. It can take a while for these problems to heal, but they do eventually, do keep bothering the GP if it's not getting any better though.

I had a 3rd degree tear and now get fissures and the only thing that helps for me is the lactulose, it's really cheap from the chemist and it really works. As long as you're not diabetic you can take it as long as you need to and it should really help. If you're still on free prescriptions you can get the GP to prescribe it, don't keep on suffering go and speak to the GP, they will help you.

I hope you feel better soon

So much sympathy, I'm trying to heal a fissure just now and it's the second time I've had this problem so I know exactly what you mean about the pain and dread. Poos leave me in tears and squirming on seats afterwards and it's so hard not to hang on and put it off. You need soft poo so drink lots and lots. I've also been using Anusol afterwards and it is soothing. Take heart because it does get better, I promise (especially quickly if you take care to eat less processed carbs and more wholegrains).

Just to add I persisted with Lactulose for ages to no avail, and they finally gave me Movicol which worked a treat, so if Lactulose doesn't work quickly then go back and ask for Movicol!

You are not being a wimp for being so scared to go , it's a horrible thing to put up with. I tore after being constipated following an em cs and that pain made labour seem easy. I have IBS (so fibre upsets my stomach and I would be on the loo all day) and the fissures still flare up quite often so I just eat less, not a great solution but I tend to think what goes in must come out.

Movicol is very good, get your GP to prescribe some for you.

Titian meentions iron tablets - they totally bunged me up! The MW suggested only taking them every other day but I just stopped; which helped.

I stopped taking them because the bottom problems were worse than the low iron and at the time they would only give me lactulose which wasn't helping. The end result is that DD is now 9mo and I am BACK ON iron because my levels were still borderline when tested recently. I wouldn't recommend stopping taking iron if you are on it OP, but do ask for Movicol - the GP who eventually prescribed it to me told me it is known in the practise as 'the magic stuff' - so why on earth I wasn't prescribed it earlier I don't know. The other thing that rankled is that they really ought to have prescribed stool softneners when they started me on iron in hospital - constipation is a virtually guaranteed side effect as far as I can tell. Whinge over.

Thank you all so much. It really helps to know that I am not the only one with this pain - although sorry you have all experienced it too - and that with time it should hopefully improve. TitianTinselTemptress I very much know where you are coming from with the winge - same thing happened to me too: iron tablets plus powerful pain killers and confined to bed = severe constipation. I did get stool softeners in the end, but by then it was too late IYKWIM. I really think that this is a key piece of advice I would like all new mums to know, but it is hard to talk about it - but I so wish someone had told me sooner. Thank you all again, I hope it improves soon, and I will persevere with the All Bran!

Feel so sorry for you.

another vote here for daily Lactulose. helped me enormously.

TitianTinselTemptress for what it is worth regarding the iron tablets - have you tried Floradix (you can get from Holland and Barrett etc) it is a liquid iron supplement, I was recommended it by several midwives in light of my bottom issues! It worked well for me; it is true that the concentration of iron is much lower than in the tablets, but it is easier on the stomach and I was told by midwives (although I have received so much conflicting advice post-birth that I am never 100% sure), that the body doesn't absorb iron in very high concentrations anyway, so a lot of the tablet is wasted IYSWIM. Anyway, it worked for me in terms of iron levels and I lost a LOT of blood and was transfused and had low levels even then. All the best.

Magic movicol and sudocrem :-)

i suffer from fissures as a matter of course - and they have been pretty bad throughout this pregnancy. one thing i have found that really helps is using wet wipes and a good slab of vaseline after each 'movement'....keeps things nice and lubed and can make things a little less painful all round.

Unrelated to childbirth but I've had trouble passing stools for most of my life. The pain is horrendous at times, utterly shocking, and you're right; it's the anticipation of the pain that is the worst thing. There are various psychological tricks you can learn but one of the single biggest physical things you can do to help yourself is to make sure you are properly hydrated. Proper hydration helps create soft, maleable stools which minimises any actual pain and over time helps with the anticipation issues too. I simply cannot stress enough just how much doing that one little thing improved the situation for me. And especially with a high fibre diet, because fibre is very irritating to the bowel (that's kind of the point, to help you go!), and it requires better hydration to have most effect. Make sure you are drinking a small glass of water at least every 90mins-2hrs. It doesn't have to be gallons, but it does have to be an increase on what you drink now, and at regulsr intervals.

Hi there, I have not yet experience childbirth (will do in two months!) but have had ongoing probs with fissures etc. and have had anal surgery a year ago. I agree with everything above - definately use Lactulose , and eat lots of fruit every day. The thing that helped the MOST though, was running a warm shallow bath at the same time as I was about to 'go', then jumping straight into it afterwards - immediate pain relief!! Honestly - it's really worth doing, and helps ease the anxiety you feel in the lead up to needing to go,as you know that the bath is there for you to jump into straight away :0)