anal pain since childbirth - breastfeeding stopping healing?

[MaeBee]

hi,
tomorrow i have a hospital appointment again. i have, i think, an anal fissure.
i gave birth to my baby 8.5 mths ago, forceps delivery, episiotomy and all that, and a couple of weeks after got this extraordinary pain when shitting, and blood etc. firstly, was diagnosed as having haemorroids, but eventually they decided it was a fissure.
last appointment it was too painful for them to look, but they said yes, probably a fissure, suggested anoheal - which i have found is safe for breastfeeding and am using and helps - but im not healed yet.
possibly might have to have surgery, which carries a risk of fecal incontinence. ugh. but im getting desperate. at the moment the pain is manageable, but sometimes it hurts not only having a bowel movement, but for hours afterwards.
i havent had penetrative sex since the birth, feel too afraid and in pain, the vagina too close to the anus.
and, im worried it might be worse than a fissure. rectal bleeding, lost lots of weight, need to shit at 5ish most mornings, often really urgently and very loose (sorry TMI!) and ive been thinking its my period coming back but now imwondering if its abdominal pain cos of some irritable bowel disease?
anyway, if anyone else has suffered this please let me know! and, im breastfeeding, and ive heard from other bf mothers that there fissures healed after stopping feeding, maybe low eostegen interfering with healing???
dreading my appointment tomorrow, cos its embarassing and probably pointless (they havent yet managed an internal examination cos too painful), but then i dread going to the toilet every morning too.
wish me luck!

Not thought about food triggers

moosma - they say ALWAYS go to drs with rectal bleeding. don't panic, but its best to get it checked out.

i avoid cheese and meat cos i think they constipate me...or rather, make my stools at all solid, and, horrible image but appropriate, best to have them the consistency of tarka dall! i also avoid white foodstuff: always do wholemeal bread, pasta etc. i have dried fruit every morning in my museli. apricots are good. baked beans can help, also heaps of water. i avoid coffee too now, but can't give up my chocolate habit. hard fats are the big baddies though!

basset, of course will let you all know how it goes with surgery/examination. will be great to have an interested audience rather than a perturbed and disgusted one!!!

tomorrow is op day. have been pain free again for the last week, so im not so secretly hoping the surgeon will postpone it all because im obviously healed. my bowels generally seem a bit better:not waking up desperate.or in themiddle of the night.
have got a good book to take with me for the dull wait. i hate hospitals, i feel quite panicky about them.

Good luck for tomorrow, I hope you don't have to have surgery, I'm sure if you say you're healed they won't push you to have it, surely it would save them money anyway!

cheers moosma!
im not at all sure i am healed....im just hoping they will declare i am just by some magic knowledge, looking at my face or something!
how are you doing? been to the drs yet?

No I haven't (naughty me) but I seem to be getting much better just by being careful with position (TMI) and what I eat (lots of fruit - bleugh).

Hope all goes well tomorrow.

well ive had the op!
went in this morning,and they said they would examine me, if they found fissures they would do the tiniest of cuts (limited lateral sphinctorectomy). apparantly the incontinence rate is much lower than the 1 in 20 i had been quoted, cos they don't cut as deep or as big anymore. i was nervous as hell, but apart from the usual problems with my hard to get veins, i was out like a light, minimal bleeding, no complications so far.
was out by midday....my baby didn't even notice i'd gone. feel great at the moment but am still woozy from the anesthetic! am expecting pain, especially with a bowel movement. the surgeon said it would be minimal pain but he was a brusque type (is that the word!?)
will keep you updated as to how it goes tomorrow! im quitely worried but most say the pain is no worse than the fissure anyway.
they say that its a quick recovery, and a very high success rate. oh, and also farted twice since and was able to control it (tmi??)

Hmm that might be slightly tmi, but glad it went well. Fingers crossed for you tommorow (not sure I've ever wished anyone a happy poo before ).

Hi Maebee

Well done you! Was thinking about you the other day and wondering how it was all going. You are brave, I would have been sooo nervous.

Hope you get a chance to rest up and good luck with the next few days of recovery. A controlled fart sounds very positive!

I'm much the same but hopefully things are slowly, slowly improving. Just got to try to rest a bit more despite that being impossible with a baby!

Keep updating when you can

Moosma: Yep, I'm sick of fruit now too!

well, won't go into tmi, but so far so good still! bowel movement wasn't as horrendous as i feared: below average fissure sort of pain!!! and no control issues yet. so that must be a good sign?!
basset: i WAS really nervous! i tried to talk the surgeon out of it! (before i got anethetised that is!)

took my ds to a babygroup today, i was feeling that well. me and dp are meant to do 50/50 childcare, and i had done all day wed and all day tues to earn my operation day off, and then i was out at midday,and today am feeling okay. so my dp has got off dead lightly! he's taking the wee un out this afternoon though so i can rest up. with the book i never got to read in the waiting room.

ok: a few days since op and everything seems steadily improving. still a bit sore and bruised but thats to be expected!
oh, dead tired though cos my little one got a really sudden fever lastnight and i had to bring him into bed with me, poor mite. mysteriosly he seems fine this morning! just tired!
either the magic of calpol or breastfeeding i suppose.

Glad to hear things are improving, hope they've continued and that your LO is OK. Mine was on the calpol the other evening for some mysterious trouble...seemed to do the trick tho

Don't know what's going on with me right now. Got food poisoning (just the vomiting kind oddly as I haven't been sick in about 10yrs) and since then haven't been as much as norm so its hard to tell how the state of play is. Doesn't help that I haven't eaten a proper meal since Sunday.....

Going back to title of this thread...
I saw a consultant t'other day about my non-healing bits and she told me that my periods restarting would be a Very Good Thing. It's something to do with blood flow (internal) and hormones - didn't really understand all of what she said). So maybe it's not the fact that you're bf-ing but the lack of af which delayed things?

moosma - think you are spot on with that theory! not that my period has returned yet...

i still seem to be fairly painfree. a tiny bit of bleeding still, but seems like the surgery worked.

hope you are all doing okay.

x

I did think that my period made things worse but it could be really individual in terms of how having your period affects your digestion (eg. make your stools harder or softer). The pain seemed to be worse when I had my period but that's common generally, like not waxing at that time cos its more painful.

I do think, though, that gradually my hormones are settling down and now my period doesn't seem to cause a prob. I definitely think that hormones and stress play a large part in all this. Resting seems to have a huge positive affect. I took it really easy (well, had no choice!) when I got food poisoning, for a week or so and I feel much better since.

Hello everyone. I'm new to motherhood - DS is 6 weeks old - and to Mumsnet! I'm so pleased to find this thread as I've been suffering dreadfully with my rear end since DS's birth (the pushing part of labour was 4 hours and he popped out at 10lb 2oz!) I had a 3rd degree tear, which then got infected, followed by a pile and a chronic anal fissure. I'm in loads of pain with the fissure and so far haven't had much luck in relieving the pain. I'm eating loads of fibre, taking psyllium husks and using wet wipes which all help, but I'm still in agony. After going to the doctor who then referred me to the hospital (to check my fissure is not connected to my stitches) I was prescribed Rectogesic. I've only started using it since yesterday but not only has it given me a headache, my DS's poo has been very mucusy and runny today which makes me think it might not be doing him any good. Although the doctor told me it's OK to use when b/feeding, the instructions and everything I've read on the internet tells me not to!

Would welcome other's experiences re Rectogesic. It would seem that most of you recommend Anoheal instead. I'm off to my 6 week postnatal check up next week, so need to get my head round what I want to get out of it. I really don't know how so many of you have suffered for so long - the very thought gives me a cold sweat and deep depression!

hi miffymoo, firstly, big big sympathies and a hug. the early days of motherhood are difficult enough without the literal pain in the arse of a fissure. welcome to mumsnet anyway! its a bloody lifesaver!
i don't know about rectowhatsit, but i really, really recommend anoheal. its new (i think in phase 3, which i think translates as you have to ask your doctor for it!) although i had to have surgery in the end, the anoheal helped loads with the pain for the last three months. i found out from the breastfeeding network that it was fine to use for breastfeeding too, cos i was worried about that. you could ask the breastfeeding network pharmarchist about rectostuff, she usually answers really quick. they have a website, can't remember it, do a google search for breastfeeding network! if you ask her today you could find out if you should use it for another week until your checkup.
with anoheal you have to get it inside, which, as you no doubt figure, can be painful in itself! keep those nails short! but apart from that, it seems the worst side effect can be a possible allergic reaction whereby you get skin irritation on your anus.no headaches.
other tips have been put on here, having your feet 6inches off the floor (put them on a book or something), or squatting, lots of soft fruit, wet wipes not toilet roll,drink lots of water, go when you need to go, don't hold back, try to relax (ha!) that sort of thing. i sometimes tried chanting just to take my mind off the pain. it's a bit like all the advice you have for labour, stuff can take the edge off, but its a horror nonetheless.
don't be too worried about months and months of agony. most fissures do heal quicker than that. i can't believe i did 9 months off a fissure, but it wasn't megapain every day. there were good days and bad days. at it's worst, in the beginning, it hurt for several hours after each bowel movement. then it seemed to go off and on, most days were just painful at the time of the bowel movement, but not crying sort of pain. i guess they partially healed, although mine kept reopening. too tightarsed. which is why i ended up having surgery, which, for all my worries, has seemed to go really well. ive even eaten meat and im fine!
keep us updated. and do ask for anoheal. oh, and theres a good selfhelp page, again, can never remember the address, i do a google for "anal fissure self help page"! and that really helped me.
it will get better, somehow, sometime. this isn't the rest of your life!

Hi Miffymoo

Sorry to hear you've got this hell to deal with. Mine came 4wks after the birth of my baby in Dec. I had 3hrs of pushing and she was large too. Had an episiotomy.

I was prescribed rectogesic but I haven't used it yet...I read the side-effects and it put me off. I think its a really good idea to check with the bf network, just in case. I was going to ask for Anoheal but I'm using homeopathy (with a lady who helped me through the pg)and the pain is now light enough to not need anything else.

What I have found useful is keeping the area clean (warm baths or pouring warm water over the area - from front to back while sitting on loo), all the bits of advice mentioned by Maebee are great and it sounds like you're doing all the diet things. Try to rest as much as you can (laughable I know when you have a tiny baby)and keep positive...they do go away eventually sometimes it just takes time for the body to heal. I've found that each month it seems to get a little better.

Many thanks MaeBee and Basset for your responses. Just your support is such a help (and I still chuckle that I have lost all inhibitions about talking in such depth about my bottom!). I haven't bled for a couple of days now so feeling a twinkle of optimism that the healing process is starting, but still v v painful throughout the day. Thanks too for the tips. Didn't know about the b/feeding network pharmacist (what a great idea!), so have now emailed about using Rectogesic and awaiting a response. Interesting too that homeopathy is helping you Basset - maybe something I'll look in to.

hows it going miffymoo? have you been to the dr's yet?

Went for my 6 wk post natal check up with consultant yesterday. He was more interested in my stiches, which still need "more time" for proper healing and whether I had resumed intercourse yet!!! (and that was AFTER listing all my woes to him and reeling in pain when he examined me!) He didn't even inspect my rear end/fissure, but I've been using the Rectogesic cream over the last few days again after the b/feeding network pharmacist said it's safe to use & feed. That & the paracetamol is helping with the pain when evacuating and also the deep aching after. So I guess it's grin & bear it for the time being, and see how I am when I have my next apt in 8 weeks.

Hi Miffymoo

Well, you can tell the people who have never had a fissure (eg. your consultant)

Going back to the homeopathy. I was given (and still am) numerous remedies and it is still a work in progress but at least you can use it alongside conventional treatment. I definitely recommend having it from a qualified person cos they are great at listening and understanding too.

grrr to your doctor miffymoo. i think fissures aren't very well understood or known about - i was first misdiagnosed as haemorroids and told to relax about it!
could you see a second doctor? did you ask about anoheal? its good you got the ok from the breastfeeding network on the recto cream. don't they have amazing names? am sure they could be called something more subtle! anusol sounds too much like anus hole to be kept in the front of the medicine cabinet!!
i hope the pain gets better soon, and i hope your family are being supportive. x

Thanks for your support guys. Will see how the rectogesic cream goes as it has made a marginal difference over the last few days. Thought I'd investigate the homeopathy and/or anoheal if no change within a couple of weeks. Family v supportive, just wish I could focus fully on my ds rather than keep feeling so up & down and sorry for myself!

well i seem to be bleeding a little bit again. it will be a nightmare if the surgery hasn't worked.
damn damn damn