Fissure after childbirth

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Fissure after childbirth

Postby NewMomInPain » 11 Oct 2014, 11:01

Hi,

I am new to the forum and am hoping I might be able to get some advice.

I am a 30 year old new mom and I developed a fissure 3 weeks after delivering my son -- due to dehydration from breastfeeding (that is my theory at least.) In the beginning, BM were excruciating and the spasms would last all day; I could barely walk after. That lasted about two months and during that time I saw a CRS who prescribed nifedipine ointment. I used the ointment, took Colace, Metamucil and increased my water intake tremendously and I finally had a two week period where the pain lessened and the bleeding stopped. Then, the cut reopened and the pain returned. Not as much pain as the first time but enough to drive me insane. This continued for a few weeks and then the pain/bleeding stopped again but only for a week. At this point I saw a second CRS and he did Botox injections. I also cut down on the amount I was breastfeeding at this point but have not weaned my son completely. It seemed I was improving and I went another week with no bleeding but still pain. I also have the problem now where all the stuff I am taking to ensure soft stools is causing me go multiple times per day. I honestly don't know what to do. I am debating surgery because I can't live in pain every day, but am concerned about incontinence and future pregnancies/deliveries.

My last effort will be to completely stop breastfeeding. I feel my system is slowed down due to lack of estrogen and isn't allowing me to heal. I had a fissure once before and it cleared up on its own that is why I am so confused now. I eat really well and don't have constipation issues normally -- I was just unaware how much water I would need to intake with breastfeeding.

For background, here is what I've done so far:
-cut out caffeine, alcohol and dairy
-take 2 Colace per day
-take Metamucil twice a day
-CRS prescribed nifedipine ointment which I use religiously
-Botox injection 5 weeks ago
-cut down on breastfeeding but not stopped completely

Have any other new moms had a similar experience? It kills me to stop breastfeeding but I don't know what else to do. This fissure has taken over my life and I'm losing my mind. This has been going on 4+ months and the pain is unbearable.
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Re: Fissure after childbirth

Postby Alyssa » 11 Oct 2014, 17:23

Newmominpain,

I too developed a fissure after delivering my daughter... I never breastfeed though... My fissure healed within 2-3 months but I still continue to suffer from residual chronic post fissure pain.
I too feel like I am losing my mind!
There are other new moms who can also chime in with their experience...
2/14 Fissure developed
3/14 Diagnosed w/ fissure given Nifedipine
4/14 Referred to Pelvic Floor Physical Therapy=Pelvic Floor Dysfunction
5/14 Fissure declared "healed"/chronic anal pain persists
9/5/14 Botox to pelvic floor
9/22 biofeedback
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Re: Fissure after childbirth

Postby jlm1 » 11 Oct 2014, 20:43

Hi there,

So sorry you are suffering. I also have/had a fissure and the pain was just unbearable at times. I also had botox about 3 months ago and the fissure is much better and is healing. I got my fissure from a hard stool (i think) but I also have a 2 year old so I know how hard it is to deal with fissure pain and a little one. This has been like a nightmare for us since it started in May. I've had other complications come up but am hoping that I am on my way to full recovery now.
I don't have much advice for you except to keep up what you are doing. I found sitz baths to help a lot. And hot water bottles. I keep stool very soft and follow a high fiber diet with a ton of water, veggies. I also find magnesium to be helpful but I don;t know about taking that while nursing. I hate to say it but maybe your body will heal better when you do stop nursing? I found botox to help a lot and each week it got better. I would either see your crs again or find another one if you are not happy with the results. Keep in mind that the botox takes a while to really kick in......maybe that is the case with you.
Try not to worry about future pregnancies. Although I totally hear you because I too want to have more children and getting this fissure has actually delayed our plans a bit. Hope you get some serious relief soon. Hang in there!!
fissure May 2014
nitro, diltiazem
botox July
fistula surgery, piece of skin tag removed Oct
fissure declared healed Dec
currently have burning/pain-told it is nerve pain
physical therapy, sitz baths, valium suppositories
hoping I am healing
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Re: Fissure after childbirth

Postby NewMomInPain » 12 Oct 2014, 08:06

Hi Alyssa,

Thanks for the reply. Hopefully we both find some relief soon.
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Re: Fissure after childbirth

Postby NewMomInPain » 12 Oct 2014, 08:16

Hi jlm1,

Thank you so much for the response. I'm glad to hear the Botox is working for you. I guess I have to give it more time. I've heard sitz baths can be really helpful but I'm finding it hard to find the time for them with my five month old. My plan is to fully wean him at 6 months and see if I get better at that point. I'm also thinking maybe I need to back off the Metamucil and let my body function a little on its own. I still plan to keep my water intake up and high fiber foods...we shall see how that goes.

Good luck with your recovery!
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Re: Fissure after childbirth

Postby Jbl22424 » 12 Oct 2014, 23:57

Wow new mom, we have similar stories... I went through a lot of what you just listed. Fissure at seven weeks postpartum due to constipation while breastfeeding, four months of pain that incrementally got better, felt I had no choice but to wean my son, broke my heart, gave up breastfeeding, then finally went in for Botox with an agreement that my CRS could do LIS if she saw a really bad fissure. She did and I was blissfully pain free in a week. Anyways, yes breastfeeding caused my fissure and made me constipated but giving it up didn't cure me and I regret it massively to this day. In hindsight I wish I had done surgery sooner and kept nursing. I couldn't be convinced of that at the time though. You just never know what the future holds and what is the right decision. I wish you the best of luck in figuring it out. My fissure ruined my first year with my son and my heart breaks for any other new mom that has to go through that.
Developed fissure from constipation due to breastfeeding 7 weeks after delivery (Jan 2014)
Nifedepine
Colace
Magnesium
Miralax - godsend
Nitro - some improvement
LIS (May 2014) - cured for 3 months then setback
Diltiazem
Feeling better for now
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Re: Fissure after childbirth

Postby NewMomInPain » 13 Oct 2014, 06:12

Hi jbl22424,

Wow, we really do (unfortunately) have very similar stories. I'm happy to hear that you had the surgery and it was successful for you. I've met with two CRS and while they haven't said not to do the surgery, they seem to think I'm at a higher risk for incontinence because I've already had a baby and plan to have more. Did your surgeon talk about that with you at all?

Thank you for the info on the breastfeeding too. I've cried so much the past four months not just from fissure pain but from feeling like I have to give up breastfeeding to heal -- and I'm not one to normally cry...

Thanks for your response and I hope you continue to feel better.
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Re: Fissure after childbirth

Postby Jbl22424 » 13 Oct 2014, 23:36

I cried every day for six months till I recovered from surgery. I had massive postpartum depression which manifested because of the fissure trauma. Giving up nursing is so difficult even if you and the baby are ready, it's just the hardest thing if you feel like you have to let it go for reasons outside your control.

I saw three surgeons and all of them said incontinence is not really much of a concern. The risks are low and in comparison your quality of life with a fissure is so drastically inferior to being pain free, they really all were strong proponents of my going forward with it. They had all done a lot of these on women, especially after childbirth. I ended up going with the CRS who I liked the best and she went through all my questions and concerns about this. She said she hadn't had a patient with any incontinence. My cut was conservative and I've had issues since surgery so maybe she is a little too safe but I still don't regret surgery one bit.

Have you tried miralax? A lot of us on here take it. It works far better than colace or Metamucil for me. I actually take a full dose of miralax, 3 colace, magnesium and a little benefiber. I'm not taking any chances these days since I had a relapse three months after surgery... I'll be on this stuff for quite a while.
Developed fissure from constipation due to breastfeeding 7 weeks after delivery (Jan 2014)
Nifedepine
Colace
Magnesium
Miralax - godsend
Nitro - some improvement
LIS (May 2014) - cured for 3 months then setback
Diltiazem
Feeling better for now
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Re: Fissure after childbirth

Postby NewMomInPain » 14 Oct 2014, 08:14

Thanks for information on incontinence. Maybe I need to go back to the two surgeons I've been previously seen and talk with them about the surgery. I just can't imagine going on like this for much longer.

I have not tried Miralax yet although I have read many posts where people use it. Part of me would love to not have to take anything and let my body try to work it out in its own but I don't know how that will go...

I really appreciate all of the information you've given to me.
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Re: Fissure after childbirth

Postby Jbl22424 » 15 Oct 2014, 00:58

I Understand not wanting to be on anything but sometimes we just need a little help. The general medical opinion is that long term miralax is completely benign. I eventually got to the point where I could not go on with my fissure and letting my doctor take the decision for surgery out of my hands was the best thing for me. It's such a tough call. Good luck with finding healing!
Developed fissure from constipation due to breastfeeding 7 weeks after delivery (Jan 2014)
Nifedepine
Colace
Magnesium
Miralax - godsend
Nitro - some improvement
LIS (May 2014) - cured for 3 months then setback
Diltiazem
Feeling better for now
User avatar
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