Silly question about stitches (2nd deg)

[needsadviceplease]

... Why did the midwife stick her finger up my bottom afterwards?

Google yields nothing of relevance!

Just for fun

No, I think it's to check that they haven't stitched through to your back passage. Although I was still a bit off my face on gas and air so that may be a sketchy version of what my midwife actually said...

The doctor gave me a pain killer suppository but I think that was before stitches, it's all a little hazy now.

Ha! Yes, that was what I suspected. My mw said something like "I'm going to be very mean now, sorry" and did it - I think. I was also gassed and aired beyond comprehension at that point!

Whenever someone has a 2nd degree tear/epis/etc you have to do a rectalexam to check the anal sphincter feels intact & that no stitches have gone through to the rectal mucosa as this is very easily rectified at the time but if missed can have long term consequences. Hope that helps.

That helps a lot, thanks very much.

I am trying to work something out (or eliminate an improbable idea): I developed an anal fissure about 4weeks pp. I wasn't at any point constipated, and nor have I ever been. There was no apparent immediate cause.

Is it possible the fissure was caused by the tear, or by the rectal exam, or by the midwife accidentally nicking the anal mucosa whilst suturing? Or is that impossible, given I wasn't aware of any damage for a month?

I know the simple fact of giving birth can cause fissures, but my understanding is that it is more often following a long and effortful pushing stage - mine was rapid, and with only involuntary pushing. My tear was all internal, and my fissure is unusually high and anterior - ie they 'correspond' as I understand it.

It's not that I want to blame someone, at all - I just want a plausible story to settle on, to make some sort of sense of it. I had a lovely birth but have had a physically horrible recovery.

That helps a lot, thanks very much.

I am trying to work something out (or eliminate an improbable idea): I developed an anal fissure about 4weeks pp. I wasn't at any point constipated, and nor have I ever been. There was no apparent immediate cause.

Is it possible the fissure was caused by the tear, or by the rectal exam, or by the midwife accidentally nicking the anal mucosa whilst suturing? Or is that impossible, given I wasn't aware of any damage for a month?

I know the simple fact of giving birth can cause fissures, but my understanding is that it is more often following a long and effortful pushing stage - mine was rapid, and with only involuntary pushing. My tear was all internal, and my fissure is unusually high and anterior - ie they 'correspond' as I understand it.

It's not that I want to blame someone, at all - I just want a plausible story to settle on, to make some sort of sense of it. I had a lovely birth but have had a physically horrible recovery.

It's usually partly because of the stretching of the skin on the perineum and even if you're not constipated opening your bowels afterwards is irritant on the healing skin around there. It's really common and they usually heal very well!

Are you still struggling with the recovery? It's now from what I can gather more than 4 weeks after your DC was born and it should be gradually improving. Has someone checked your stitches because although there's no denying it's still uncomfortable at this stage, if there's not much improvement you should get them checked.

That makes sense - thanks (again!)

It's six months now. The stitches basically feel fine I think ie I am not aware of them any more, though they took longer to feel fine than I had expected (maybe around 3mths?). The stupid fissure refuses to heal - am under consultant care for that and don't think there is more I can do at this point, really. Hence distracting myself with silly questions, I guess.

Fissures are common (and horrible) but not directly related to birth or stitching. The usual cause is an episode of constipation where a hard poo overstretches and splits the delicate anal tissue and then every time you go it gets reirritated. A finger is not big enough to do this. Of course constipation is common in the few days after delivery.Avoid constipation by whatever works for you. Lubricate your anus with vaseline before you go. Washing with water after every poo, drying very gently (kitchen roll is good, just blot). All these encourage healing. Your GP can prescibe some bum cream with a local anaesthetic while it heals.

But that's exactly what's perplexing me - I was not, at any point, even slightly constipated. In fact I remember having great pride at my painless day 2 pp poo!
I know that the issue in healing a chronic fissure is that the anal sphincter goes into spasm - I wonder whether the whole perineal area was sort of in spasm to start with, for me, rather than becoming that way after the trauma of a hard poo.
I don't know. Every time I see a doctor they start harping on about fibre and lactulose and whatever - it frustrates me. I suspect my fanjo is all spasmed up too, but I don't know this for a fact so have nothing to go on.

Nothing works I'm on my second cream to stop the spasm (worked for a short while before relapsing, seems to make no difference since), and using copious amounts of vaseline before doing my business squatting in warm water (!!!) still doesn't make it in any way bearable. Anyway, like I say I'm under a CRS consult now, so all that's left for me to do is to whinge and obsess unhelpfully.

You poor thing. It does sound like a particularly hard case. The anus does stretch a lot during delivery as the head presses on the perineum. Maybe that started it? But I'm not aware of this happening to any of my clients.

Thanks. Stupid stupid fissure!

hi - not true that a finger is 'too small' to cause an anal fissure sorry.

It is not usual, but if you have delicate or traumatised (stretched) skin it is entirely possible. Also depends how well lubed the finger is!

long term fissure sufferer here. Three years and counting unfortunately. They come and go - I get months symptom free and fine, and then it can reopen and i'm back to square 1. And fissures tend to heal with scar tissue and a sentinel tag - which then makes one a bit more likely to get another.

best thing for pain is xyloproct or proctosedyl, and best medication is dulcoease. It bulks stools and makes them soft, which is what you want. The advice of 'fibre and water' is all very well but if you have a chronic fissure, meh.

3yrs and counting? Christ. Poor you...