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!

hi myrtle,
yep i still bleed, and sometimes go a couple of weeks without blood and pain and then it starts again. ive also got internal piles since childbirth, so they bleed too. maybe the same for you. but really, really really do go to the doctors, they always say get checked out for anal bleeding, even though it probably is benign.
well, ive had a much better week, and, excitingly, my period came back! my boy is 1 tomorrow so almost exactly a year! its my longshot that having my hormones back to a regular cycle might soothe things.
go to the doctors, and let us know how it goes. its just 5 mins of embarassment.

Hi maebee,
I've booked an appointment for Friday and guess what, that is my birthday - great, lucky me!
I shouldn't be embarrassed really as when I had my 6 week check up after birth and 3rd degree tear they looked at my bum then.
Its frustrating though as i thought it was getting better. The pain is much less now, just stings a bit but there was just more blood than I expected. Back when I first had it the blood was very little but now when it does bleed, there is more blood and less pain!
Happy birthday to your little one
I think when my period came back, the pain lessened a bit so i hope it does for you.

myrtle, it could be piles for you too. i think they bleed more and hurt less!
don't be too dismayed about pain again though, cos the healing of a fissure isn't just linear, it goes up and down as it progresses. so it sounds like you are healing.
what a great birthday treat!

myrtle - happy birthday!
and how did it go at doctors?

Hello,

The Dr had a look and a prod and couldn't see any fissures but she said it could be an internal fissure or pile so has sent me to see surgeon at hospital. She also took blood to check for anaemia. Its a bit scary because I was just hoping she would see a fissure and that would be that. Where was your fissure maebee, was it inside?
She was concerned about the blood too and kept asking me how much, but it is really just a little bit on tissue usually and only one wipe of it and then no more. Sometimes I will have it for a few days and then nothing for a week or so. Is it same for you? Usually the pain comes when it bleeds. I hope its nothing bad. Dr gave me a routine referral so will take a few months.

Hi Myrtle, Hi Maebee

Happy Birthday Myrtle and Happy First Birthday to your little one Maebee! I hope you can both celebrate happily despite these bum issues.

Myrtle, try not to worry yourself. My doc had to have a real go inside to find mine (and boy! did it hurt when he did!)then said, yep, a small (SMALL!!!) posterior fissure. Its possible that your doc was a bit too gentle to really find it. I am sure the surgeon will confirm cos it sounds v similar to mine in terms of bleeding and pain. Hopefully, by that time it will have healed or be much better anyway.

mine wasn't visible or feelable either, had to do a general anesthetic to have a probe deep enough!
i got an urgent referal but it still took 6 weeks. thats cos i was in shocking pain and bawling my eyes out on my rather lovely doctor.
have been good since my period restarted actually, so nearly a week painfree again. its hard to tell if its bleeding though, cos of menstrual blood.
i think i may have asked this, but do either of you suffer any sexual problems as a result of this? i still find penetrative sex very uncomfortable, and my libido still low, and i wonder if its fissure related.

Hi Maebee & Basset,

Thanks for the reassurance, I find this thread a real comfort
Maebee, mine doesn't seem to hurt when we have sex so it has been fine although not much libido but then our DS is not sleeping through yet so we're usually tired.

Can I do a mini survey? My DS had a broad head which didn't help during birth and I'm quite slight, 5ft 3 and 7 and a half stone. Maybe that is why I tore so much at the time, are you both similar? And did you both tear during labour? I had no idea about pushing either and kept pushing when I didn't have a contraction cos DS hearbeat was dropping.

my boy was 8 15 and stuck, so i was pushing for hours and hours to no avail. the midwife kept saying "push out of your bottom". the equivilant of several years worth of constipation problems within a few hours methinks!
im average build, prob more on the stocky side than the thin side, but my lo was big and transverse arrest. i had to be cut to fit in the forceps.

Hello all. Hope you don't mind me barging in on this thread again, but I find it so comforting too. Been on hols & so it's been cold turkey on the mumsnet front! Sorry you're all feeling pants again, but glad to hear your baby is Ok Basset and belated happy birthday to you Myrtle and your little 'un MaeBee.

I thought my bottom was getting better as pain was less (i.e. no clenched teeth & fist moments) and no bleeding for 3 weeks but I strained too much the morning I went on hols (fear of possibility of having to go at airport/on plane!) and I felt fissure all reopen again. Back to very bloody toilet bowl and lots of pain again. Joy.

In answer to your question Myrtle I'm 5ft 6 and a couple of stone overweight () but my DS was large (10lb 2oz). I had 3rd degree tear but didn't really 'discover' fissure until after my stiches had healed and still felt enormous pain when going to toilet. I'm sure childbirth caused it.

Glad you raise the sex issue MaeBee. (Have you mentioned your discomfort re penetrative sex to the doctor & if so, what did they say?) Although I only had DS 13 weeks ago, the thought of anything or anyone down there fills me with such fear of pain that I'm sure it's not healthy. We tried, if you call it that, last week but I was in tears before my husband even touched me, just in anticipation. I'm getting quite paranoid that I might have developed a sex phobia due to all the pain I've suffered down below. Have another check up (no doubt involving examination) at gyne clinic in a couple of weeks and absolutely dreading it. xx

miffymoo: i think those fears of pain are all really normal after childbirth. 13 weeks is still very short a time after giving birth. we have just managed full penetration (a year later) but its still not comfortable. but i can orgasm as normal again now, and im fine with cunnilingus or clitoral stuff (tmi? or helpful?!) a friend of mine only started to orgasm again after stopping breastfeeding. my sex drive seems to slowly be getting better now my period is back. at least, i managed non-penetrative sex last night that i actually enjoyed rather than just felt relieved i'd managed it!
i need to go back to the doctor and get checked out to see if ive been stiched too tight, but i keep putting it off. you know what it's like, its so invasive and i just want to be left alone!
my bum has been good this last week though.
miffymoo: are you on any cream? again, im a real advocate of that anoheal stuff. it really helps me but its expensive and not commonly prescribed so you may have to push for it.

Poor you Miffy I've found recently that if I relax like you're meant to do in labour and not tense up with the pain, it is ok and generally doesn't bleed but if I forget and get tense and hold my breath then the pain is sharp and there is usually blood.
I was ok today, no pain, no blood, long may it continue.
I'm dreading my blood test results this week, I don't feel anaemic but what if I am, I'll start worrying again.
Maebee, glad that things are easing a bit for you

I too am a sufferer of the evil anal fissure, it's so good to hear other's advice/experiences, it really is something that you don't hear about usually, and I thought it was just me for a while! I was wondering whether anyone had been prescribed or had heard of Glyceral Trinitrate ointment? Has anyone used it? Any good? I know it's the same stuff that's used for angina sufferers ( opens up the blood vessels I think?) GP had just examined me when she prescribed it and it was such incredible agony that I wasnt really listening to what she said . I do remember her saying that it can give you nasty headaches, and as i suffer fro migrane anyway I've been a bit nervous about it. i think further down the thread someone mentioned something similar.. thanks guys..

lakelover - GTN is very similar to Diliatzem, except it can have terrible headaches as a side effect. Diliatzem (Anoheal) works the same way but doesn't give you headaches. i would really push for that if you can. its only in Phase 3 so officially i think only hospitals generally prescribe it but you can get it from your doctor too. i did.
sorry to hear you are joining us on this thread. its not the jolliest is it!!

Thanks guys. I'll brave it soon again I guess and try to relax... (ha!).

Lakelover, I've been on Rectogesic, which is GTN, for the last 7 weeks. It hasn't given me a headache (which surprised me as I tend to be hypersensitive to most things) other than occasionally a minor headrush when I stand up after initially applying. It seems to be quite good, although sadly I don't think there's an easy cure for fissures. It certainly helped stop the dreadful spasming that I used to get for hours after going to the toilet. Although I've been a bit one step forward and two back with my bum, it's never been quite as bad as it was before I started using the cream so I'm sticking with it for the time being.

Thanks so much miffymoo and maebee - great to get some personal opinions on this - I think I'll give the GTN a go ( a headache cant be worse than this pain!!) Just as an aside - so fed up with GPs who insist on examining internally when it hurts like HELL! I know what's wrong with me, and seriously, how much can they tell by shoving their finger ( KY or not) up your a*se??? Thanks so much for your advice! I think this thread is about the only comfort I get from the dratted bum!! PS Have horrific piles too since DS born - both things together a a real blast! Any good pile remedies out there? xx

i sympathise with the piles too. after never having suffered anything like that i get it all now. sometimes it can be hard to tell with the blood and the pain whats what.
i too find this thread a great help, just knowing others are in the same boat i guess.
lakelover and miffymoo: although i have had mine for a year now (a year!) can i reassure you the pain is nothing like as bad as in the beginning. its become liveable with. i don't know how much is just getting used to it (like a diabetic who has to inject every day i guess) and how much is it healing. but it is loads better, nothing like the hours and hours of pain i was in every day. now its mild rather than monstrous!
i certainly notice the difference if i don't drink enough water or eat too much hard fat. like cheese
do you two suffer constipation too? cos with me, my stools are actually really soft, more like diarrohea, maybe cos i eat so much fruit and other fibrous foods?

Maebee - I dont really suffer with constipation either - but I think it's more the horror of being constipated that stops it ( lactulose, water fruit and veg etc) however, back when ds was born 15 months ago my GP prescribed me with Codydramol when I had mastitis - and I was too sleep deprived and in pain to think about the consequences of taking them - of course they blocked me up completely, and going to the loo for the first time after 4 days of not being able to go was AGONY! He was the first GP to do the internal bottom exam after I had ds, and actually said to me as I cried out in pain 'oh it cant be that bad! You've just had a baby'!! Needless to say I havnt seen him since! Anyway - like everyone on the thread here, my pain seems to come and go, having a bad period at the moment. Maebee - do you still get the pain even when stools soft? I do, but not quite as bad. PS Only since I've come to Mumsnet have I been able to properly self diagnose and get this new cream from a different GP - so a big thank you to you all for your frankness and honesty - what a help! xx

I guess piles must go with the fun of fissures cos I have them too! Since the fissure I've kind of ignored the piles but I don't think they help. Also, like you both I don't suffer from constipation & never really have, but I ensure I religiously take psyllium husks every day to keep it all soft - and when it's soft its painful enough!

Lakelover - Aren't some GPs just so pants, I can't believe the comments they occasionally come out with & how unsympathetic they can be so I'm glad you've finally got somewhere. I was told by one that there's a debate in the medical world over whether there is such a thing as a fissure or not. I couldn't believe my ears & can bet a million quid that that particular doc had never suffered with one! Anyway, not sure if you've used any of these creams before but I found having to insert my finger up my bum to apply the cream was a real shock and v uncomfortable initially until it started to heal. I wrap my finger in a single layer of clingfilm first (as the GTN is absorbed by the part of the body it comes in contact with so best not to have it on your finger), ensure there's a big dollop on the end of my finger and kind of use it as a lube to help ease your finger in. Sitting on the loo, bending forward helps too. I can't tell you what an expert I've become at finding my bum hole in one go! Rather graphic I know, but just in case your new to the whole experience!

good job we're no longer shy about being explicit! you do have to get the cream up there. sometimes it hurt so much i had to take a slug of whisky first (only once or twice!) but now it doesn't really hurt at all, nothing more than a wince. squatting on the floor was my position of choice!
lakelover - yep, still hurts when stools are soft, but, like miffymoo, not as bad. and i go for a week without pain before it kicks in again.
basset - you doing ok there? i hope pregnancy isn't making things worse anally.

Hello,
Got blood test results today and they were normal so that was great
Like you Maebee, after a year my pain is quite mild too and I can go days without any pain and then I'll get a twinge again but it is liveable with now. I'm more concerned about the blood now as its still bleeding a little bit maybe once a week - how about everyone else?

Hi ladies - thanks so much for the advice - and dont worry about being explicit, it's great to hear the first hand experiences of poor sufferers like me! I still have a bit of blood about 2 or 3 times a month like you Myrtle, and when I have less pain I still have the bleeding, but not to the same extent. Have started to dread seeing GP about it. Miffy - yes some of the people I've seen certainly have been utter pants, so unsympathetic and the evil finger shoving!!!! Arrrgghhh! Think I might have to hunt down a GP who actually HAS a fissure! We are thinking of trying for another baby after Christmas, but am seriously worried about the whole thing kicking off again.. makes me feel quite sad, because although its a small price to pay for the joy of having my baby, I know it will be on my mind the WHOLE time I'm pregnant (if I'm lucky enought get up the duff of course...), and I'll be so scared about the pushing again this time, and I'm sure my labour will be affected. Sorry - am completely rambling on.... xx

Glad your bloodtests came back clear Myrtle.

Good luck with the trying Lakelover. I have already decided that when we try for no 2 I'm going to have an elective c-section. I've even cleared it with my midwife! There is no way on earth I will have another if I have to go through what I did first time round again. Like you the whole situation makes me really sad and that the joy of having another would be taken over with worry - no make that petrified - about the birth .

Didn't mean to sound so doom & gloom in my last posting. Probably haven't helped you feel any more positive about it - my apologies! x

am lucky that none of my doctors/specialists have tried to put their finger up, just checked on the outside!
keep thinking about that doctor saying fissures were debated in the medical profession!?! i have NEVER heard that before and ive spent far too many hours searching about them on the internet!