agonizing pain from anal fissures... please help!

[reallystruggling82]

I have 2 anal fissures as a result of constipation post-pregnancy. The pain when going to the toilet is indescribable. Far, far worse than childbirth which I managed without any pain relief. But it is only short term agony compared to the throbbing pain for about 8-12hrs after every bowel movement. It's making caring for my 1 month old very difficult as I am in such pain I cannot sit down or even concentrate on anything other than the pain. I can't even sleep on the few occasions I have to try!

I'm veggy so have a pretty high fibre diet already but have consciously tried to up this even more, I am only drinking water, easily 8-12 pints a day as I'll have a pint glass with every feed. In terms of diet/lifestyle I cannot do anymore to prevent the constipation. I've been to GP. Her basic response was that there is not much they can do as I am breastfeeding.
Breastfeeding has been a real challenge for me and my little one but we are finally getting there but I am seriously starting to consider giving up as I cannot take the pain anymore.

Any advice/anyone had any similar problems? Did giving up breastfeeding help ease the constipation or did you find another way to heal these fissures?

Thanks any advice you can give!

I'm pretty sure there must be some laxatives that won't affect breastfeeding. Try seeing a different GP? As a junior doc in A and E years ago we prescribed GTN ointment for fissures (relaxes the sphincter making it less painful) and lignocaine jelly ( local anaesthetic). I wouldn't have thought either of those would pass into your bloodstream in significant amounts, let alone into breastmilk.Hopefully someone else may have more experienced advice though.

Been there, done that . They're the bane of my life, although I've just had a few good days in a row. They started when I was constipated after an EMCS and tore, 5 years on I still get problems as IBS stops them healing up. I hated sitting down to bf as the pain was awful and I couldn't stop it.

And yes, I eventually stopped bf DS because of it. The midwives gave me lactulose after my c-section but it just resulted me being on the loo all the time and making the fissures a million times worse, they wouldn't let me have movicol (stool softener that I know works and is more gentle IME). With my second CS I insisted the GP gave me movicol, I told them I would not bf otherwise.

I know it's mental but cutting back on food was one thing that helped. I have had loads of creams over the years but having IBS and constantly going to the loo made it worse. Am under consultant care now.

I find that prosectodyl suppositories help too, I think they're for piles but are ace painkillers.

You have my sympathy as it's a rotten thing to put up with.

I had this too after developing it in labour with DC1. I'm sorry to say it took months to heal and has recurred occasionally in the years since, but to nothing like the same degree. GTN is good stuff, though I used to get a headache straight after using it every time. In the end it was my second pregnancy and the increased blood flow that seemed to help it heal properly. I then had a small mildly irritating one at some point between DC2 and 3, and nothing since thank goodness. I think mine were exaccerbated by a GP prescribing too high a dose of steroid foam stuff that thinned the skin a bit -that was the same one who mis-diagnosed it as piles .

I even got referred to a specialist eventually, who prescribed higher dose GTN and then when I went back declared me 'fixed' and discharged me, despite me saying I was still getting bleeding and still in pain . Mind you, the remaining options involved surgery to cut some bit of the sphincter permananetly and allow it to relax more easily and carried a risk of incontinence, so weren't an option I was keen on .

There's lots of info out there on the internet if you search. I found doing 'bottom kegels' helped a bit and that actually less insoluble fibre reduced the frequency wit which I had to go and ttherefore helped healing. Insoluble fibre (eg strawberries) really helped. Lactulose is good too, but a bit bleugh. I had an allergic reaction to the anaesthetic stuff, so that just made everything 10 x worse (itchy and ouchy!).

Huge sympathy here too. I found my GP not overly helpful - she talked about treating things like fissures & piles 'very conservatively' (which meant not really providing any treatment at all). Pretty sure she'd never had one since she seemed to think I was exaggerating the pain.

So - after 8 weeks of hideousness - I self-medicated with Fybogel (2 sachets a day, then 1 when things started to improve), drank plenty of water, switched completely to wholegrain (bread, rice, pasta) to really up my fibre intake, and ate SO FUCKING MANY dried apricots it was untrue. I also gave up all caffeine, but that was coincidental timing, not part of my anti-fissure plan.

Giving up breastfeeding wasn't an option since my baby refuses bottles, so I just did everything I could to stay hydrated (I set a three-hourly alarm on my phone & drank 500ml water each time it went off) and have healed fine while still exclusively breastfeeding.

The apricots gave me insanely bad wind (really, it was awful. Thankfully my husband thinks farts are funny), but it was totally worth it. Within four days I was able to go to the loo without crying. And now, 15 weeks post-birth, I'm totally sorted, as well as being regular in a way I never was before - turns out that wholegrain-is-good-for-you business is true.

Oh I really feel for you. I was you exactly a year ago after having DS (forceps delivery) I couldn't imagine ever being able to go to the toilet normally and couldn't imagine having to live the rest of my life like that. It is the most terrible pain and you have my utmost sympathy.

However it will improve and you won't always be in the misery you are in now. Your GP sounds very unhelpful. There are things that can help you whilst breastfeeding. I was prescribed diltiazem cream (also goes by the lovely name of anoheal ) It seems to have fewer side effects than the GTN cream and is safe to use whilst breastfeeding. See link here.

It does take a few weeks to work but it should improve things. I was also given some little packs of clear gel (can't remember what they were called at the moment) They were just a local anaesthetic gel that I would put on about half an hour before going to the loo and they did help a little. Movicol is also very good for constipation (and I also second dry apricots!)

I would go back and see the GP again and ask her to prescribe the diltiazem. Have you got a good HV? Mine was very sympathetic and really helped me to get the treatment I needed. I do hope that things get better for you.