Anal Fissure - might me TMI for some :)

[Yael]

Hey everyone,

I developed an anal fissure after birth, which is basically a tear in the anus, so when you poo you tear more, and end up bleeding and being in quite a lot of pain afterwards (not being able to sit down for 10 mins afterwards).

Anyway, when I went to my 6 week checkup by obs told me to use glycerol trinitrate gel to get rid of it - only bad side is the gel dilates all the blood vessels in your body - especially in your head, so you get these killer headaches 15 mins after using the gel

Anyway, I would take panadine 20 mins before, and only use 1/2 the gel, but i would still roll on the floor crying with icepacks on my head from the headaches...

It said use 3times a day for 1 week, i only used it once a day for 4 days before i said no more... Luckily it had seemed to be enough, and with a lot of metamucil the pain from it subsided...

Anyway, its been back for the past few month, i'm not sure whether it was inevitable because i dont think it 100% cleared up the last time, or because I haven't been fantastic about the metamucil...anyway, after weeks of this again i['m back up to the not being able to sit down afterwards, quite a lot of blood when i go, and dreading (and hence putting off as long as possible), going to the toilet...

Finally, yesterday I said enough was enough, and got a referral to a colo-rectal surgeon about seeing what my options were for surgury on it..

Luckily they had an opening this Thursday, so I won't have to wait long to find out.

Just wondering if anyone else has had this, what they did if they couldn't tolerate the gel, etc??

Also, are they caused by pregnancy or the type of delievery you had (i.e. vaccuum etc), or even the type of pushing (my baby was posterior so i was told to push for like 1 hr even though i had no urge to, and also ended up with a prolapse)??

If i do have surgery, will it come back if I have more children? Can you get pregnant straight away after having surgery, or do you need to wait a while to let things heal 100% there???

Anyway, hope somebody can help me!

Thanks,
Yael

[Danni]

Hey, A lot of people get fissures without pregnancy or childbirth etc.

Most of the time they will go away by themselves providing they dont get strained. In saying that, you need to try and get your feaces as soft as possible.

eating a lot of fibre will help with this and dried fruits especially.

i hope it goes away soon for you

[BellyBelly]

I had that after Marisa's birth, it was a nightmare and painful! Check what surgery involves, from memory some will make a small cut to relax the muscle so it's less painful but that apparently has a high chance of some incontinence later in life. You can take drugs, but it's no good when breastfeeding. It was a no win situation with me and I just lived with it until it got better - it took AGES. I think it was a dose of gastro that helped fix it as there wasn't much pressure

[{sarah}]

Hey Yael, I don't know too much about it but one of the mums at my mum's group had the surgery and it has been perfect ever since. Hers was caused by the way she was pushing when she had her son, not sure on the exact details though. As for another birth causing it to happen again, I suppose it could depending on the way the birth went....

Sorry, not much help there was I?! *hugs* to you anyway & I hope it's all fixed up soon.

[BellyBelly]

Another thing it is caused from is straining to go to the toilet in general, which is common after the birth with constipation due to the hormones still keeping your digestive system soft and supple.

[Yael]

Thanks for all the responses everyone!

It's just really been getting me down lately, every time i feel like i need to go to the toilet i dread it..

I've tried making the stools as soft as possible (hence the copious amounts of metamucil), but even that isn't perfect (although a lot more bearable), but if i ever go a few days without and it goes even slightly more normal it hurts like all hell! I didn't realise just going to the toilet could hurt so much... and its been 6 months of it, thats the bad part

I try and wait until the last possible moment, so i don't have to push either (sorry, its really gross i know!), and then i don't strain.. if i eve have to strain and push, the pain is so bad!

I'm going to just see what surgery involves, but if it means being incontinent later in life, i think i would rather the pain.. i mean wetting yourself is one thing, but that would be just disgusting!

Kelly, how long did it take yours to clear up? Did u try the gel also??

I wonder if it is the way i pushed, or it could be i was terribly consipated after birth and had to beg them for 5 days for suppositories.. maybe i left it to long?? I don't know, but i just want it over with!

Anyhoo.... gosh i never knew there were all these wonderful things about having children.. probably a good thing they don't tell people beforehand or they would never go through with it (but then i look at DA and think its all worth it)

Yael

[DoulaRelle]

Yael,

My girlfriend suffers from them and she swears by daily salt baths to help heal the area. Could be worth a shot!

[Yael]

Hey all,

Will just post what I did in the Jan Baby Buddies thread

Well, I just got back from the surgeon...

He doesn't think surgery is the best option fo me... also apparently bf keeps these things around longer due to the hormones, so i might just have to wait until i finish (althoguh he said i should keep bf as long as possible, so i was very impressed with that)... Although I'm planning on basically just having a cycle of bf-preg-bf-preg kinda thing. He wasn't sure 100% what caused it, although it might have been from the pushing in labour, but he did say it wasn't a given that i would end up with one again once i have another baby..

So, my options... must have metamucil at least once a day. Can either try the gel agai (which gives VERY VERY VERY VERY VERY VERY VERY bad headaches - sorry did i say how bad they were??? never had anything this bad in my life.. i just sat there with an icepack on my head for 1 hr crying from the pain... and need somebody else to be around to look after DA)..

Or, there is some indication that a botox injection there might stop the muscle spasming enough to let it heal... but, it isn't a guarantee, and most health funds wont cover it, so although his and the anesthetist fee will be covered, i might still be $500 out of pocket for the actual botox.. They are trying to find out from my health fund whether they will cover me, and also my inlaws are pharmacists, so they are trying to find out how much they can get it for...

But, i'm not sure what to do..

I hate living this way, and can't use the cream again, but its a lot of money (and ther are risks with any surgery), for something that might not work...

DH thinks i should do it, even for $500, but he hates seeing my in pain

I saw the pain isn't so bad that it is going to kill me or anything, its just horrible each time i go... I don't know what to do, whether just go with the metamucil and see how things go or what??

what would you guys do if you were in my position??? We have the money, but it was our savings for things around the house... i just feel guilty using the money just for something that isn't going to benefit anyone but me!

Oh, and now i feel like i have none of my diginity left... This was the only place in my body i haven't had proded and poked, and now thats gone.. But the guy was very nice and did it in a respectful way, but it was still horrible...

Gosh i hate my body some times, eczma everyone, breastfeeding issues and now this! And i have a prolapse, but i'm just ignoring that for the moment until i focus on making my bum feel better...

But i'm def. not stopping bf any earlier, after all the pain and problems i went through to get to this stage! And i would rather be in pain than to stop DA getting what he needs.

Anyway, must go, any suggestions on what you would do in my situation would be greatly appreciated! (i'll still make up my own mind, i just want to get some other perspectives on the problem)

Yael

[*Rae*]

I know it's a lge amount of money but i think if it's going to stop the pain, dicomfort and help reduce some of ur body issues i personally would do it. I think it's a very admirable thing u are doing to keep up the b/f of DA - u r a wonderful, giving mother to maintain that despite all the difficulties u r having with ur body right now. So i don't think u should feel guilty about spending that money to help u feel better about urself. Best wishes Yael - hope things brighten up for u

[Miss Kitten]

I've had this. My dr told me to go to the chemist and get this - Proctosedyl - its a gel. It costs about $15, its over the counter so no prescription required. I swear it works. Mine cleared up in about 2 days.

[Yael]

Hi Kate,

Ive tried Proctosedyl, and Rectogesic. I think Proctosedyl is mainly for haemarroids, and therefore wont fix an anal fissure as they are different problems.. It did help 1 haemarroid I did have though.

Rectogesic is for anal fissure, but as the active ingredient is gylcerol trinitrate, it dilates the blood vessles in your body, giving extreme headaches in almost all cases... Although the surgeon said if i use it long term the headaches should subside, personally, i'm not going to put myself though!

Thanks for the advice though, i appreciate anything at the moment..

And Rae, thanks for the support... I just don't know what to do... even if its not about the money (DH wants me to do it so i'm not in pain), there are risks with any surgery and anesthetic, so i'm also not sure if that is the right thing.. especially when there are no guarantees with it working..

I know it sounds simple just to try and fix up my diet and take metamucil all the time, but i find it really hard and DA is a terrible sleeper (i think i have to face the truth), and even then that wont fix the problem, it might just allieviate a little of the discomfort...

Although i did hear that an anal fissure is suppose to be one of the 3rd most painful conditions (i'm not sure if they meant in general or just bowel issues) you can have..

Kelly - how long did yours take to clear up??

Yael

[Amity]

I had a fissure after I had Alex, and he was a c/s. It was just SO painful.

What I found helped, was heaps and heaps and heaps of water, like 3L a day, more if bf, as well as at least 2 apples and 2 bananas a day. No dairy or yogurt or icecream, because they tend to make the stools harder. Definitely metamucil. Nothing that "binds you up" if you know what I mean, just stuff to make it all soft.

It took me about 6 months to finally get rid of it. With DS #2, I asked the anaesthetist for laxatives before I even had the c/s, because I'd had the fissure with DS #1. He gave me them no problems. Apparently it's quite common, because your body doesn't really eat or drink properly for up to 72 hours during labour, birth and recovery, so what is actually in the anus gets very hard and dry, and that's what causes the fissure when you eventually go to do #2s.

Best wishes.

[Fi]

I'm not sure what I have. Its something that bleeds every so often doing #2s. Hurts like snot!!

Mine took ages to clear up after Jenna - it would have been 2 months or so? Since then I've ruptured it again maybe 3 times (and one is at the moment) so even sitting on the toilet hurts

I think its great what the surgeon said, I would personally do everything I could diet wise to correct the problem before resorting to surgery where the consequences could be incontinence!!!!

Good luck,
Fi

[Yael]

Hey everyone,

Well, saw my surgeon again yesterday - and good news! I've been trying really hard nad its beginning to heal by itself. No bleeding anymore, just some pain and stinging for a few hours afterwards... So once i'm at the comfortable stage i need to keep up the fiber for about a month (althogh he says i should keep taking it forever, but i don't need to be so good about it like not every day)..

And so no botox injections at this stage... But if it does break down again, then i can do it quickly before it gets horrible! And he said there is no guarantee that this will happen with the next one! Yah!!

But he told me to be careful about going to the toilet after the birth, and take lots of fibre, stool softeners and suppositories if i need to.. dont let it go a few days (5 in my case after crying to a midwife to please listen to me and help me) cos that can make it worse!

I'm just bringing my own next time and bypassing the nurses altogether!

Thanks for all your support though!

Yael