Hi all,
I’m the mother of three, my first child I had to have an emergency episiotomy and my second was over 9 lbs and I’m a small woman. So, I’ve had pelvic issues that seem to be getting worse. After the birth of my first child I said the hemorrhoids were worse than the episiotomy! I’ve suffered a them fairly constantly since then.

So, I noticed two months ago some burning after a bm. Hemorrhoid cream also burned. Then I noticed a tiny bit of blood on tp. Not mixed in with any thing it was actually after wiping too much. That freaked me out.’it happened about a week later again (all these on larger bms) and I got a mirror to look and could see what looks like a paper cut at 12 o clock. Happened once more and saw the exact same thing. So it is clear to me that was where the blood was from, not somewhere higher up. I had started a low carb diet before this which changed my bms a bit, not constipated but harder.

Anyway I addressed at my last gyn appt that I have a rather large rectocele. The biggest issue has been needing to push on the vaginal wall at times for a bm. Not all the time, but during harder consistency. As that was the only problem the doctor did not think doing anything further was appropriate as the surgery can cause other issues.

So, I’m making another appointment w the gyn as it seems my issues may stem from the rectocele, and the little bit of bleeding i had has sent me to hysteria. I have added fiber to my diet, but I’ll be honest and say there are times when the looser BMs cause issues bc there is more wiping involved, which hurts. The fissure is not unbearable. It burns and stings right after a large bm, but it stops within five minutes or so. My bigger fear is that there is something worse, like anal cancer. It may sound extreme, but I obviously need to get off the internet!! Any reassurance, and experience w rectocele and a fissure would be appreciated. Thanks!

So sorry you are dealing with this. Pregnancy can really do a number on women's bodies. I would consult with a colorectal specialist, or a urogynecologist. They will be more well versed with rectocele issues.

I have a moderate rectocele and also have to splint to have a BM. I've found that leaning forward and using a squatty potty eliminates pelvic floor pain from a BM most days. Also, dont wipe with dry TP. Switch to a bidet and only clean with wet TP, that should help a lot with the discomfort.

A fissure at 12 o'clock is often associated with lower anal pressure, which is something to ask your doctor. LIS is usually not recommended in that case.

Good luck and I hope you will heal very soon.

Thanks for your reply. It seems from reading that anterior fissures have a strong correlation with birth trauma (I had a third degree laceration, followed by an episiotomy. I remember before leaving the hospital my ob taking a mirror to
Show me because as he said, things were going to look much different).
I don’t see my ob again until the beginning of December. It doesn’t seem urgent I guess, except for the anxiety about the bleeding, which has only happened twice I. A very very tiny amount on the tp. Before this I attributed the burning to hemorrhoids. Now I just have myself all worked up about maybe I have anal cancer or something more sinister since it’s always said rectal bleeding is so serious. However, I did see w my own eyes the spot of the bleeding both times, and it looked like a paper cut at 12 o clock. Anyhow,’I have my physical w my primary next week and am thinking about addressing it there although w all the pelvic floor issues I’m quite sure my obgyn is the correct place to address again . I was referred to a urogyn before who I hated for incontinence.
The pain isn’t awful, doesn’t happen every bm just those that are large or particularly on the harder side. I am just more anxious now than anything else!