Hello,

This is my first post but I've been a forum member since October when I got a pretty painful fissure for the second time in my life. That one healed with diltiazem, procotfoam, comfrey, diet changes, etc. but I'm now 7 months pregnant with a very painful anterior fissure that isn't responding to dilitiazem or nitro. It's been painful for only 2 weeks but I have a large sentinel tag for some reason. Does anyone know if LIS or botox is an option when pregnant? I really don't want to deal with this with a newborn.

Thanks!

Juliana

Oh I feel for you my fissure started 2 weeks after giving birth to my first born then was on an off till my second born it can back when he was 4 weeks old both times I had my fissure with a 1 week old then a 4 week old it is hard but everyone is different nothing has worked for me so I'm getting Botox in 2 days if I was you I would ask my doctor from what I've read online both are safe during pregnancy pregnant woman have surgery all the time an Botox is apparently safe because it's such a low dose are in one area woman get Botox in their faces while pregnant but ask your doctor tell him you want an need it sorted asap they should help you. I really hope this gets sorted for you also the skin tag means it's chronic like mine an mine is also anterior which is less common then posterior don't know why. Good luck hun

Thanks for your response, Missy Moo. Like you, I got my first fissure shortly after having my first child. It is so difficult to take care of yourself when you have a newborn! I hope your Botox works out for you and I'll be looking for any updates you post. I've had a crazy setback with my fissure so I'm going to try to get in with my CRS tomorrow to see what comes next. It's weird but I've had what appears to be a large black blood blister pop up overnight next to my fissure and the whole area seems more swollen. I have no idea what's going on. There's a lot more bleeding now. :-(

Hi that's sounds like a blood blister but ask your doctor about it I had Botox 7 hours ago and so far so good time will tell if it's a permanent fix or not I'm writing my story in the general fissure discussion and it's called just Botox after all. As I thought I was getting a fissurectomy aswel but the surgeon said the fissure/scar tissue was looking good so he didn't want to touch it.

Here the link if you want to see how Botox goes for me after time
fissurectomy-an-botox-t13238.html

I'm 18 weeks pregnant with an anterior AF that hasn't healed in 9 months. I was being treated with diltiazem when I found out I was pregnant, but I haven't been back to the doctor since so I don't know if Botox or LIS is an option. I'm planning to wait until after birth since constipation is a serious issue for me both pre and post pregnancy. I know I won't be able to heal until after birth. The only way I've been able to have painfree bowel movements are with Miralax. I'd prefer not to take any medications, but I have intense pain and bleeding without it. Maybe that can help you until you are able to be treated. Are you planning on a vaginal delivery? I am but I'm terrified of things ripping further. Good luck to you. Hang in there, baby will be here soon.

Allthepain, are you still taking the Diltiazem? My CRS prescribed it and I was hesitant to take it while pregnant but my OB okayed it and said that very little is actually absorbed topically. I’ve been using it pretty faithfully for almost two weeks and I think there’s improvement but who knows.

Good luck on making it through the pregnancy with the fissure. I’ve heard some women have CF’s that heal during pregnancy from the extra blood flow so hoping the best for you. I’ve actually had the pregnancy constipation under good control but am prone to pregnancy hemorrhoids which can lead to a fissure for me. This time I’ve actually got a fissure on the underside of a hemorrhoid. The hem puffs up often and puts extra pressure on the fissure throughout the day. So I am REALLY ready to get this baby out of me needless to say.

Like you I’m also worried about a vaginal delivery. My CRS actually told me I should consider a C-section. But I’m worried about the post-partum constipation from the C-section drugs. It’s like I’m stuck between a rock and a hard place yeesh!

My fissure healed for the last 4 months of my pregnancy then came back with baby was 4 weeks old so I got a 5month break!!! It came back from a soft bm too so maybe the inflammation of child birth caused it who knows I new to avoid it the second time round but still I couldn't prevent it best of luck to you guys the the pregnancies and delivery

Unfortunately, mine hasn't improved at all with pregnancy. I did stop the Diltiazem because I didn't know if it was safe in pregnancy, but I also didn't ask. I also know that it's pretty hopeless to try and actually heal until I finish breastfeeding. I've been managing ok as long as I keep the constipation under control... which is much easier said than done. I still have the excruciating tears and bleeding but I will take Miralax for a while until it "heals" a bit. It's seriously the worse thing I've ever dealt with.

I can't imagine having hemmorhoids along with a fissure. That just seems cruel! Did your CRS say why he recommended a c-section? I need to see what my doctors think about it, but I'm hoping it will be ok. I actually had the fissure after my first baby and it "healed" until I started breastfeeding with the second. Both times it's been triggered by breastfeeding and not giving birth so I'm hoping that's a good sign it won't get worse with labor.

Are you nervous about possibly getting the LIS surgery? My doctor acted like he didn't like to do it in women because he's worried about incontinence later in life. I'm just hoping the cream or botox will work. Ugh, what a miserable issue.

Missy Moo, that's so sad your fissure reoccurred with a soft poo. It does make you wonder if we're just predisposed to fissures as a result of hormonal changes or something and there's not much we can do about it.

Allthepain, I hear you on the struggle to avoid constipation. I have BMs everyday but can't always get them soft enough. I can't seem to gain enough weight with this pregnancy because I'm so afraid to eat too much meat and other things that might make my BMs too hard. It's misery and I can't wait for the pregnancy to be over, which is sad. Although, I'm also worried about breastfeeding causing fissures because I got my first fissure shortly after I had my first daughter. I was constipated with large hard BMs and I totally attribute it to the breastfeeding. When I stopped BFing I stopped having issues with constipation.

So, my CRS said she recommended a C-section because she thought the straining and pressure of vaginal delivery would aggravate the tear and make it more likely that I would need surgery. Since I have an anterior fissure, she said it was always possible I could have a bad vaginal tear that would meet up with the anterior fissure and obviously cause horrific issues. My OB wants me to try to heal up enough to try for the vaginal delivery. I honestly don't know who to trust on this issue.

And I would really like to avoid LIS because I've heard it's not ideal for women and that it may not even be the most effective option for anterior fissures which are often not the result of high resting sphincter pressure. Apparently, the flap surgery is better for fissures with normal resting sphincter pressure. I'm not an expert on this though, it's just something I believe I remember reading.