Seeking Advice Concerning a Chronic Post-partum Anal Fissure

Updated on March 21, 2014
B.P. asks from Canton, GA
7 answers

Hello all -- I am desperately seeking any advice/information that you may have concerning chronic anal fissures. I gave birth to my first child in July 2013 and developed an anal fissure shortly thereafter. I had a vaginal birth, but with the assistance of an epidural. I had a difficult time during bowel movements after his birth, as things were a bit too hard to pass, leading to the beginning of my fissure problems. What started as mild difficulty with a little blood during bowel movements escalated into searing pain and hours of painful spasms after a few months. I finally visited a GI doctor in Jan. (I know, I waited too long), and was given nitroglycerin ointment to assist the muscle in relaxing so that the fissure could heal. Things did seem to improve, I no longer have the horrible spasms, but I still experience painful and bloody bowel movements. The severity of the pain varies. I have completely changed my diet over the last few months. I eat no meat or dairy, and I consume tons of fiber and water. I also take stool softeners everyday(I attribute my improvement to this more so than the nitroglycerin ointment.) So, it has been about 8 months and I suppose it is safe to say that my fissure is chronic, not acute. I have also attempted to use homeopathic treatments that I have read about, such as olive oil. At this point I am beginning to think about more drastic options, like surgery. I revisit the GI doctor in late April and I would like some suggestions on what to discuss. A friend of mine had success with a botox injection into the internal sphincter muscle, and I was wondering if anyone else had experienced success with this? I believe it is a less serious procedure than having a sphincterotomy. I want to have more children, but the thought of experiencing this again for an even more extended period of time is frightening and somewhat devastating. Success stories from similar experiences are welcome. Please help.

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B.C.

answers from Norfolk on

There are support groups for this;
This site might have more information for you:

http://anal-fissure.org/success-stories-only-f10.html

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J.B.

answers from Boston on

Ouch! This sounds miserable. I would call your ob-gyn and see if she or he has any advice. She or he may be a good resource for talking about options with and whether or not they typically see ones like yours heal or if surgery really is the best option. I know that she or he isn't a GI doc, but they do see this pretty routinely and can probably give you some good feedback.

A good friend had surgery for her fissure a few years ago. The recovery was pretty rough and she ended up having some follow up procedures done but once it healed, it healed and she's been fine since.

I second the advice on fiber below...one key in increasing fiber is to increase by no more than 5 grams daily. Too much too soon can cause constipation and difficult movements. Magnesium citrate taken once or twice a day can be very helpful, as can soaking in Epsom salts (which contain magnesium).

I hope you get some better answers from others who have had the same problem. Best of luck to you!

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P.K.

answers from New York on

See a rectal surgeon not a GI doctor. They have a lot more up their sleeve.

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C.O.

answers from Washington DC on

Welcome to mamapedia!

Congratulations on your first baby!!

I'm sorry you have had so many problems since the birth of your baby. When you went to the GI doctor - did he/she order a colonoscopy? They should have.

You need to see a nutritionist. You need to find out if you have IBS or a gluten allergy...so I would see an allergist as well.

You might be consuming TOO MUCH fiber..yep, you can consume too much and it will have the opposite affect. drink the water. Watch your diet - cut back on processed foods, see if you can cut gluten out of your diet.

I've NEVER had botox - of ANY kind. So I wouldn't know if that worked or not. I would definitely talk to a GI doctor who has experience with doing these...

good luck!

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M.R.

answers from Seattle on

I had a similar problem, an anal fissure post-partum, complicated by a terrible history of other sorts, but I opted for several sessions with a 're-boweling' RN. That was at the MAYO clinic in Scottsdale and the wonderfully trained and kind and sympathetic registered nurse with many interesting electrodes helped me to retrain my bowel habits. As I wonder if you are terrified to allow a BM to pass naturally given the recent pain.

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O.O.

answers from Los Angeles on

I think if this is a chronic condition, you're smart to revisit the surgery option.
If ask about success rates, % of "normalcy" after surgery, recovery time, lifting limitations, driving restrictions after surgery, etc.
All the best!

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J.C.

answers from Anchorage on

I have been dealing with this issue as well. The cream is working well enough, if I have more issues I will think about the shot, but I would only do the surgery as a last resort.

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