Pregnancy and Anal Fissure - Might be TMI but advice appreciated!!

[gemcxx]

Hi there,

Just wondering whether anybody has been in the same situation as me and can offer some advice. Backstory - Basically, I've had a chronic AF for about 5 years now, been to docs many times and have had tried loads of treatments but nothings worked long term. I went to see a surgeon a few years ago after getting fed up and he just told me that there was absolutely no way he was going to operate on me because it wasnt that bad in his opinion, and that I'm far too young (i was 19 at the time), so I basically went away thinking that surgery was never going to be an option for me. Anyway, I've learned to 'live' with it now, it has its good days and bad days and I can pretty much put up with it most of the time.

But my question is whether any of you have experienced a chronic AF during pregnancy, i.e. it existed before conception? Me and my boyfriend are wanting to start a family but I'm worried about the impact that pregnancy might have on the AF, not least the birth. I would imagine that giving birth naturally would not be good for an unhealed fissure - would this constitute as a 'medical reason' to have a C-section? If anybody has any advice I would appreciate it, it would be nice to know what to expect before hand!

Thank you in advance!

Hi gem. No experience myself but you may find it useful to post in the childbirth/pregnancy threads.

I have had a AF its not been truly chronic but it's made several appearances.

I deal with it by.

Lube before a poo, Vaseline, sudocrem....so poo slides out.

Zero straining....

Cut high fat foods and caffeine out your diet. Big hard sausage stools are cause by high fat foods. Chips, crisps pizza.

Have fibre, but not too much bread. Apple and pear every day.

Lots of water.

Good luck.

For the c section...I doubt it. They made me try for a vbac after a awful previous section.

You must work hard especially during the third trimester not to get constipated so wheatgerm every day, prune juice etc
Be aware that piles can be an unwanted pregnancy symptom.
If you end up with intervention/episiotomy that won't necessarily affect your internal bowel wall but you have to go very easy with going to the toilet and not straining with your stitches eg cold flannel and again take some meds so you don't withhd/end up being constipated.
If you end up with vaginal tearing it may not have much effect on your anal fissure. However with my third I ended up with a severe rectal tear which was a direct result I think of incorrect pushing/unsupportive midwife and having had a weak intestinal wall/fissure already.
I assume you gave already used internal lubricant/antiinflammatory/anusol type equivalent but it has never actually fixed your problem.
I have not had an elective c section but know that gas and discomfort and constipation post op can occur. However having had a severe rectal tear I shod bave gone for one and in your shoes, I would certainly ask. If they refuse on physical grounds then emotional ones ie fear of the birth/tokophobia? is what you should insist on a a referal for. Do the research and weigh up the pros and cons but a lot of female gynaes opt for sections, there was an article in the guardian about it, as they have seen some car crash deliveries and their patients' trauma they have had electives themselves, some not all, but a significant number.