Anal fissure 2 weeks postpartum

[mzlk]

Hey everyone

Well, I’ve been constipated due to having iron tablets throughout my third trimester, during labour I had loose stools but then went back to constipation a day after birth.

I didn’t get any fissures from pregnancy constipation but I don’t know if childbirth has made my bottom weak/sensitive because I have now developed a fissure!!

I thought it was a one off painful poo but no, it continued and I actually felt a rip and bleed yesterday and since then my 2 bowel movements today have also been painful, first one bled a little less than it did yesterday. And second one didn’t bleed but HURT.

I feel quite upset tbh. I feel like it’s just been one thing after the other since giving birth. My stitches have healed and now my bum is ripped. I’m so so fed up. I want to enjoy our new little addition but I just can’t deal with pain every single day. Every single bowel movement.
It seems as though fissures don’t always heal and that scares me.
I’ve just picked up lactulose which GP prescribed, some kind of ointment (scheriproct) and some suppositories
Any positive stories about postpartum fissures?
Please give me some hope! I feel so down and helpless.

No, the recovery was honestly not half as bad as the pain I'd been through with the fissure itself. Just a massive relief. I also absolutely understand the fear of incontinence. For me I'd say it's slightly easier for a little fart to slip out as it's all very slightly less tense but it's not a problem at all and so worth it as it finally put a stop to my agony. That's anecdata obviously and all the risks have to be weighed up but there comes a point where you just can't or shouldn't really, live with the pain cycles and anxiety that chronic fissures bring anymore. Look into it anyway and all your options.

Hi guys, just a little update from my end. I had a good 5 weeks with no issues but suddenly started getting pains again when going to the toilet! I’ve been for a ‘Mummy MOT’ if you’ve ever heard of them, my employer pays for it which is great. They are a physio and post natal pelvic floor expert.

I spoke to her about my fissure. She assessed my vagina & bum hole, and basically my pelvic floor muscles around my bum and vagina are all over active and now are very tight and tense and this is what is causing my fissure because my muscles around my bum won’t relax so I’m straining.

I’ve got to concentrate on learning how to ‘belly breathe’ in order to relax my pelvic floor muscles and this will hopefully in turn, allow my fissure to heal and it shouldn’t become chronic if I can fix it this way.

I never knew your pelvic floor could become over active after birth I just assumed it would be under active! I’m so pleased I’ve had the opportunity to have this appointment and would really recommend going to your local MummyMOT specialist if your employer pays or if you can justify the cost of it!

That's so interesting. It makes sense that the pelvic floor is intricately involved in the issue. I first had fissures before I'd had DC but I know part of the problem was holding huge amounts of tension in the area. Perhaps pelvic floor physio could have been helpful, before surgical solutions were explored.. Oh well, I hope this idea could be an avenue to explore for others! I agree, everyone should see a physio after giving birth.
I hope you see a huge improvement from the physio!

@CHPC hey how are you doing now since youre mummy MOT. Do you feel theres a difference now in terms of your fissure healing

Hi lovely. Well I went weeks with no issues and then about 5 days ago it was back to horrendous pain and bleeding all over again. I’m booked in at the GP tomorrow morning for the 4th time so I’m going to ask them for a referral to the hospital as I can’t keep living like this! I’ll let you know what they say tomorrow! How are you getting on?

@CHPC heyy thank you for replying. Oh no thats the problem will fissures. They can feel like its all going ok and then out of nowhere a retear happens. Hopefully it will settle soon for you. Might only be superficial retear. Im still the same. Struggling along. For the life of me i cant pass a normal sized stool and its getting me really down.

Update for you. Doctor has prescribed me rectogesic which is specifically for anal fissures to use everyday for up to 8 weeks so fingers crossed this is the beginning of the end! I thought I was going to have a fight on my hands to ask for more help since it was the 4th appointment I’ve had about it but the GP was like right let’s get this sorted. If this doesn’t work they’ll refer me to hospital! If you haven’t tried this cream maybe it’s worth seeing if they’ll prescribe it to you!

@CHPC heyy so glad theyve given you that. They gave me that cream but i couldnt handle the headaches! Just remember to rest after applying it. Not everyone gets the headache side effect. Tbh i dont think i gave this cream enough of a chance. But my main struggle atm is trying to bulk up my stool

@mumof2bambinos have you tried pysillium husk to bulk up your stool?
its really good at bulking stool up.

@mzlk i bought some tablet forms and i dont think they did anything. Is there any you can maybe recommend. I just want to bulk my stool a bit so i can see if i can pass the stool. Thank you for any help xx

Ahh
Just to get a clearer picture, are you taking anything that’s making them thin?
what’s your diet like?

@mzlk my diet is really shit. I struggle to eat fruit and veg so ive always had a low fibre diet but never suffered constipation. This fissure only happened because of childbirth.always had normal stools and then when i started taking laxido the stools became soft and thin. Possibly because i wasnt taking enough fibre with them.

I had one after the birth of my first. They are eye wateringly painful, so massive sympathies. I found a hot bath after going to the loo helped the pain and kept the area clean. You need a stronger laxative than lactose, ask for movicol. That’s what helped me to heal.

@Groutyonehereagain thank you so much. Il ask the gp for movicol as i was taking laxido before. Is it the same thing. I thought it was? If you dont mind me asking how long did it take you to heal. Ive been suffering with this for so long

I’d say stop faking any laxatives if you are taking them
also maybe tell the gp that your stools have been thin for a while now? I think it’s something that needs to be looked into

my fissure has only just started healing 8 months postpartum

im not doing anything for it, I just kinda learnt to ignore it. I dealt with the pain whilst on the toilet and carried on with my day. At first this was difficult because I had such bad anxiety about the fissure!
But as soon as I “forgot” about it - I felt so much better mentally and physically!

The tensing up that we do when anticipating pain is a key part of the cycle of the fissure not healing up so it makes complete sense that relaxing helps though it can be difficult..

@mzlk i think your approach is the best way. If i could go back i wouldnt have touched the laxatives as i didnt need them. The fissure was caused by childbirth. Never really suffered constipation. I eased off the laxatives a little a while back and my stool started bulking up a tad bit but then i was scared i would have a hard stool

I stopped taking laxatives and stool softeners to try and allow things to fix naturally, and now I’ve been taking the rectogesic everyday I feel pretty much back to normal, although I don’t think going to the toilet post birth will ever be the same again for me, there is no pain and no bleeding so fingers crossed rectogesic is fixing the fissure. I know you said you’ve tried it before but maybe worth giving another go, I’ve not had a single headache or side effect luckily, I do use it before I go to bed so if I did get a headache I’d sleep it off. Honestly it’s worked wonders for me!

@CHPC im so scared to fully come off them. How long were u off them before you saw the change to your stools. I think i will try that cream again as i didnt give it enough of a chance

I came off them 2 weeks after I started taking it and noticed my stools were softer and I’ve just not allowed myself to get constipated again so I’ve been off them since April now

Thank you for replying. So pleased to hear that its working for you. Think im going to wean off the softeners and try and eat a healthy diet to avoid constipation. Will use rectogesic tonight. My real battle is getting the stools back to normal

@CHPC heyy just wondering have you healed now. Im still battling with this damn fissure and now aparantly i have am internal haemorroid

@Chlobob27 just wondering if youve had botox yet. Im looking at this to hopefully heal

@mumof2bambinos no, I didn't have botox. In the end it healed on its own, but it took year's. I had my first son in June 2020. It hurt at every bowel movement until June 2021, when I fell pregnant with my 2nd son. I was then pain free for 9 months, until the fissure re opened after giving birth to him. It didn't always hurt when going to the loo, but the pain would come on after going and it would last hours. Sitting really hurt. My last bad flare up was Nov 2022 and I had another flare up at the start of this year. Thing's settled down after that. I do get the odd twinge now and then, but I make sure to increase my fluid in take when that happens. You need to keep your stools soft. Drink plenty. Take a stool softener. I take Lactulose 2x day. I also use a foot stool that puts me in a squating position. It means unless I'm constipated, because I haven't drank enough, I don't have to push at all. I take the stool with me if I'm staying away from home. I do think it's really helped in preventing me tearing again.

Fybrogel is your friend. One or 2 sachets a day until the constipation stops then 1 sachet a day to keep you regular. Also fresh orange juice with bits loosens me up. If the fissure doesn't clear up go to your GP.