Post-birth agony!

[rose1986]

Hi everyone

This is my first post and I am desperately hoping somebody has some idea what could be going on as my doctors seem to have given up on me!

I had my first child 10 weeks ago, after half an hour of pushing I ended up needing an episiotomy and forceps delivery due to DD heart slowing.

The problem is I am in complete agony when moving my bowels. The pain seems to be getting worse rather than better and it is excruciating to the point I feel sick and dizzy and my only saving grace is to have a bath run ready for me to jump in straight after as the warmth and water relieves the pain slightly but even that isn't doing much to help anymore.

I have been back and fore to the doctors many times now and even ended up in hospital overnight with this last week (I also have gallstones so was in pain with stomach too hence admission). I have had 3 x internal examinations and nobody knows why Im having this pain. Apparently I do not gave any internal or external haemorrhoids.

In hospital they gave me morphine before doing the examination as I am too sore and even then I was reduced to tears. I'm on constant pain relief, have 2 x numbing creams and laxatives to take as and when needed to prevent constipation but nothing is helping to relieve this.

As a result I have been diagnosed with postnatal depression and am at my wits end. Please if anyone has had as similar experience and knows what this may be I would love to hear from you.

I spoke to my doctor today in tears with desperation only to be told they have tried everything they can think of and I just need to wait to let things heal. Surely I should be getting more help than this? I have a 10 week baby to care for which is becoming increasingly difficult when I am in unbelievable pain.

Sorry for such a long post. Any info greatly appreciated x

Hi Rose, I don't know if this will help. I had dd in August and a few weeks after she was born I started having a lot of pain with bowel movements - agony, as you describe, sweating and crying while on the loo, felt like I was pooing glass. Then I'd have a burning crampy pain for hours afterwards. Was really affecting my enjoyment of my beautiful baby. I assumed it was haemorrhoids but when I eventually went to GP they diagnosed a fissure - basically just a cut but they're a bugger to heal. I would have thought the docs would have been able to diagnose this if it was your problem though, so this whole post may be irrelevant. Your post just sounds a lot like my experience so thought I'd share.

I was given a cream to relax the sphincter, which did help a bit. For me, the key things have been:

1. mega doses of lactulose (30ml twice a day) plus lots of fruit, particularly kiwis and prunes - I basically got my poo VERY loose, almost diarrhoea.
2. being brave about having a poo every day - don't avoid it so you avoid the pain for one day (SO HARD) as it just makes things worse the next day.
3. I started taking a hefty magnesium supplement. No idea if it caused an improvement, but the pain started to improve when I started the magnesium. I gave it a go as some people think it helps with constipation and muscle spasms.

I have no idea if it makes any medical sense, but I sort of wonder whether all the pushing I did with dd (short labour but quite a lot of it was pushing) led to some kind of rectal/pelvic floor spasm, which then led to the fissure. Dunno. Anyway, it was really really awful for a good few months but through all the stuff above I'm now pain free, though still keeping my poo super soft.

Really feel for you - I know just how painful it is. Sorry for all the poo chat!

P.s. The cream that helped was glyceryl trinitrate. But if you had a fissure I would have thought you'd have bleeding, which you don't mention. Plus I would expect that the docs would notice the sphincter to be v tight on examination...

My DD is 20 weeks now, but her birth was exactly as you describe your DD's - pushing for an hour and then episiotomy and forceps due to bradycardia. It took me about 4 days to pluck up the courage for the first loo visit and it was undeniably painful, but all the pain had gone by a few weeks postpartum so it definitely sounds to me like you have some other issue going on. It sounds to me like your Doctor is trying to fob you off. By 10 weeks things should have definitely healed to the point of not being agony if not completely.

I hope you get to the bottom of it OP - no pun intended!

I don't have any direct experience of this per se, however, I gave birth to dd1 in Feb 2009 and took months to heal.

Her birth wasn't as invasive as yours: I'd pushed for 2 hours and she was getting distressed, so I had an episiotomy and she was delivered via ventouse.

My undercarriage was completely numb for 2 weeks and I couldnt really feel bowl movements during that time.

When dh and I tried having sex again, it was so painful - and I didn't feel right for several months.

So, whilst I have learned that time is a great healer, what you're experiencing sounds very distressing.

Perhaps you might need to ask to be referred to a gynaecologist, as I'm suspicious that the forceps delivery has caused trauma to your pelvic floor or even the bowel itself.

Have you seen a specialist or just the GP? Keep insisting on being referred on.

Thanks for all your replies.

Monkfish I did wonder if it could be a fissure but surprised the doctors haven't picked up on this?

I have had bleeding, sometimes quite a lot! Fresh red blood so it does indicate that there is some kind of wound. It really does feel like razor blades. The pain really is unbareable

I feel like my GP practice has given up and fobbing me off. When I was in hospital the junior doctor suggested I had an enema (which I did) and then a colonoscopy but the doctor I saw later decided against this for some unknown reason and now I feel like I am banging my head against a brick wall.

The doctor I saw last week said she would refer me to a gynaecologist but unfortunately I need to wait until I hear back. I called the doctors today in despair and really feel I have been fobbed off when I hoped they could speed up testing or give me some kind of alternative relief.

Monkfish where did you get the magnesium supplement from as I am willing to give anything ago! I have been taking paracetamol, duclofenac, anusol, lactulose, laxido and fybogel aswell as another steroid cream on prescription from the doctor to no avail. The doctor previously had me on co-codamol which actually made everything worse as it can cause constipation!

Glad you have all mended - hope it is me soon! X

Sounds a lot like an anal fissure. Get back to GP. You need

1. Gtn cream
2. Anaesthetic cream
3. Lactulose to make poo nice and soft and easy to pass
4. Keep well hydrated.

I'm a Dr and had one of these after DD1. Pain was horrendous. Hope that helps.

Have a look on the Any Old Prolapse etc thread. Someone there had really bad post op pain which was like nerve pain, and has found a surgeon who can help. It might be something like that.

I just got the magnesium from Boots. Was quite ££ but I would have tried anything! It's a grey and red pot.

My "successful" regime was:
Morning: 30ml lactulose, 2x375mg tablets magnesium, porridge, 3 prunes.
Evening: 30 ml lactulose, 2xmagnesium, 2xkiwi fruit, more prunes, more fruit as available, veg with dinner, brown rice/pasta instead of white.
Lots of water through the day. After a poo I used to have a hot bath then take paracetamol and ibuprofen. Don't need to do this now. Poor dd would be crying on the bathmat while I was crying in the bath...

I tried fybogel but stopped cos it made my poo enormous. Lactulose makes it soft without adding bulk. I also used anusol and a steroid cream for a while but stopped and I think they weren't helping the fissure heal. If you know you don't have piles I'd suggest you could stop them?

Your description sounds so much like what I experienced -really does sound like a fissure. if so, all the internal exams will have made it worse, as they can cause more injury. And co-codamol - argh! You could try treating it as if it was a fissure, but you could do with the GTN cream from your doc. Really does help break the cycle of the fissure causing the sphincter to spasm, which prevents the fissure healing.

Thanks ladies.

It does sound to me that it is fissures I am suffering from too. I would honestly prefer to give birth again! Haha

I'm going to go and buy some magnesium supplement today and have made a doctors appointment for tomorrow to ask for the GTN cream. I was prescribed just 2 x 5ml dose of lactulose a day but going to increase this and see if that helps too! Will stop taking the fybogel, drink even more water than I already am and see if this helps.

Xx

Almost forgot a really good tip I got from another thread on mumsnet - how to get the poo out with less pain!

It's here - scroll down to post from madmomma. May sound silly but I found it did help. Got some funny looks from 8 week old dd.

Good luck OP - really hope you get this sorted soon.

Thanks monkfish I will give that a go, as silly as I will feel, ha ha!

I went to the doctors today and got GTN cream so hopefully this will so the job. Did you have any unwanted side effects apart from the headaches? I'm a bit worried about using it incase it relaxes things too much!

Xx

Fresh blood and pain? Sounds like there is definitely something going on. You've had some really good replies here, but you might also want to post here:

www.mumsnet.com/Talk/general_health/1597449-Calling-all-Raggedies-the-THIRD-Ragged-Bits-thread-Childbirth-injuries-sphincter-problems-fistulae-all-welcome

Some women on this thread have had fissures and other painful bum problems after giving birth.

Movicol is a great and gentle softener/bulker. I never got on with lactulose.

I'm so sorry. X

Another thought - if you can get your GP to prescribe you some instillagel that might help (I realise this is a long shot, as they seem to be so crap.) This is a local anaesthetic gel and applying this to your bum before doing a poo might help to take the edge off things a bit. I've had a lot of very painful and invasive gynae surgery to repair birth injuries, and I've found the gel really helpful. It doesn't sort the problem, but it can make things more bearable whilst things are being sorted out/healing.

It dis give me headaches immediately after but these were manageable compared to my bum pain. I Moses lactulose with Oj and took 20-30mlz 3-4 times a day till my poo was very soft and easy to pass. Hope things improve soon.

Yep, headache and light-headed feeling. Both faded pretty fast and paracetamol sorted out any headaches that lingered. The side effects got better with time.

You do need to get the cream inside, which can be tricky to start with if it's all tight. Can help to put some on outside, wait a few mins, then try to get the rest more inside.

Thanks so much for the replies.

Cardsamomaginger they used a good anaesthetic gel when I was in hospital last week which really made a difference so I wonder if it was the one you mentioned? I will ask as the anusol and xyloproct are not very effective.

I had a good "look" today and feel like part if my scar from the episiotomy is what is causing the problem and that I have a fissure on the scar itself due to being stitched too tightly! At my original appointment I mentioned to my GP I felt things had tightened too much and my scar was "covering" part of my rear (sorry tmi!) and when doing an examination she did mention it may have tightened but it could also have been down to my nerves with examination. However today the scar that runs from vagina to bum covers my bum slightly and there is a tear there and a lot of pain so I think the scar tissue is stretching each time and creating a fissure on the scar itself, which probably won't heal unless they correct the scar tissue somehow.

How miserable feeling like this! X

Must be the same stuff - it's the bog standard local anaesthetic gel for these sorts of things.

What you describe sounds like a plausible explanation. How horrible for you .