I'm glad to have discovered this forum, it is helpful to read through and find some ways to manage the pain. This is the first time I've dealt with an anal fissure, I've had it for about three weeks now and it's the most painful thing I've dealt with. I've given birth twice, once completely naturally and I would go through that again any day to avoid this daily pain. I'm not sure how this even happened, though I suspect it has something to do with pregnancy as it occurred shortly after my daughter was born. I was constipated during pregnancy here and there so perhaps that is what started it? I always get lots of fibre as I'm a vegetarian (started eating chicken and fish just a few months ago...) and I drink loads of water. I'm very regular currently and am not having problem with constipation or anything atm though it still feels like I am passing shards of glass or razor blades each morning and there is always bleeding. I am thankful the stool has been relatively easy to pass (aside from the pain). I saw my Doctor and she prescribed nitro ointment which I just began using yesterday. I don't know if it will help or not, but at least it's a start. I am currently breastfeeding so am trying to drink lots of water as that also requires a lot of water. I was worried about using the nitro while nursing, but my Dr. and the pharmacist said it was okay. Has anyone dealt with this? I am trying to wait for at least an hour or two after applying the ointment to nurse. Anyways, I just wanted to introduce myself and say I am thankful to find this forum.

Hi Jen!
I got my fissure the exact same way you did, but not until after having my third daughter. Lots of women here have similar tales of woe :( . I've wondered forever what exactly is it about pregnancy/birth that sets these things off? Several women here even had AF's occur after c-sections, so I don't think it's entirely caused by the trauma of vaginal deliveries. Very mysterious. I was breastfeeding too; maybe it's easier to get dehydrated than you think while BF'ing?
Unlike you, though, I didn't get treatment right away for my AF, because it healed up pretty fast on its own. But then it came back later and turned into a chronic situation that eventually required surgery (five years on).
You, however, stand a great chance of getting rid of this thing with just the ointment alone, because if you've only had the fissure a short time, it isn't chronic yet. Statistically the ointments are much more helpful for acute fissures than chronic ones. Drinking a lot of water is also great, and it sounds like your diet is really good. Miralax is the only other thing I could suggest to you, it's helped a lot of us around here, and it is much more effective than the Colace that the doctors usually recommend.
There is currently another thread going in the general discussion forum about the meds while nursing, and it seems that nitro is considered the safest. I remember feeling very paranoid about taking meds too, back when I was nursing, but you MUST take care of you. I would suggest applying the ointment both before and after BM's as much as possible.
Best wishes!

Welcome, Jen, this forum gets me thru each painful day I hope it helps u like it helped me. A heating pad helps with the all day burn, if u have it, also ibuprofen with extra strength robaxacet, pharmacy brand, although I'm not sure about using them during nursing, ask your doc, but they definately take the edge off. Since your AF is fairly new, there is a GOOD chance the ointment will work for you. If, like many of us here, it becomes chronic, then u will b looking at Botox, or maybe LIS. I've had mine over a year, it occured when my daughter was close to two, like you, I wasn't having constipation, I was regular, but I think due to continuing hemmeroid issues it made things tender down there and I used to eat ALOT of popcorn, which is the evil enemy of all AF sufferers. Pain managment has become my career along with taking care of my kids. This is the place to find support, advice, and relief from the feeling that u r alone in this and can't talk to anyone. Only someone who's had an AF can understand the pain. I hope you r quick to heal and relief comes without too much trouble. We r here to help!

Thank you both for your replies! While I wouldn't wish this on anyone it's nice to know there are others out there who understand. It's also really great to hear that there is a chance the ointment will help as I have not had the problem for too long. I wouldn't doubt for a second many women have this problem after pregnancy... it's amazing the things that happen to your body after pregnancy! Thank you both.... the support is much appreciated. I will check out the threads regarding breastfeeding as well for some more information.

Hi Jen,
I got my first AF after DD1 was born by emergency CS. That lasted 10months and in the end I had Botox, which worked for me. This time, I got my AF after DD2 was born (VBAC) and she's now 8months old!
I'm a current Bfing mum too, and I swear that (in addition to the AF) means we have to drink reservoirs of water each day. Seriously, I want to knock out any professional that suggests I aim for 8 glasses a day. Only 8??? I drank that many before I was a mum (I only really drink water), and with the thirst that comes with BFing and needing BMs to be soft means i'm constantly drinking water.
I definitely recommend Movicol/Laxido (it probably has different names in Canada/US). Having tried Lactulose, fibrogel, and another that I can't remember the name, this is certainly the best. I've only been using it for nearly 2 weeks, and the difference is amazing - I didn't realise how much pain I was in (as 'agony' isn't quantifiable)! Initially I was given rectogesic (the nitro ointment) but it was giving me headaches, so as of yesterday I'm now trying diltiazem cream.
As PP have said, hopefully you've caught yours early enough that the ointment and laxative combo will work. And congrats on your latest LO. :-)

Hi Jen,
Sorry you're suffering as well - but we have friends here who understand and add valuable suggestions...
If your stools are easy to pass then a softener or laxative might not be so important, however if it helps, then like others, I've found a PEG or macrogol version (e.g. Laxido, Movicol, Miralax) a bit better than a Lactulose or a Ispaghula (e.g. Fybogel) version
I'd also be hopeful that the nitro will help - especially if you've caught it early and it's your first AF - the GTN (nitro) certainly seemed to have helped me first time around, and the success rate is reported as high. I am no expert at all, but I can't see GTN being any concern for a nursing mother - the chemical nitro groups (that relax the muscle) are reactive (that's why it's an explosive!) so I can't imagine it getting much further...
When your AF does heal you may want to just be a tad more wary of constipation, so that you don't get another (this advice comes direct from the do-as-I-say and not do-as-I-did department!).
Hot pads and warm baths also ease the pain - and make no mistake, as everyone here knows, AF can be excruciating. I've not had a lot of pain relief from analgesic tablets. But I have tried lidocaine and that does help a bit - it's a mild local anaesthetic that my doctor prescribed. Fibre, water and exercise are all helpful we're told, and your diet looks good (and nothing too hard-edged, rough or similar may well help).
So good luck - I'm hopeful you'll be through it sooner rather than later.

If you are in Canada, look for restoralax or the cheaper version, lax a day. Same as miralax. The bleeding stopped immediately for me and none since, over a month now.

Hi Jen - I'm so sorry that you are suffering! There are many mums here who are or were in the same boat and who have healed, so I hope you can take some comfort from the positive stories here. I see you've already recieved lots of great advice from folks, so I'll just say 'welcome' and offer my sympathy and support. I really hope the ointments fix you right up very quickly!

sorry to hear you are in the same boat as well.
I have been told that breastfeeding sets off a hormone thats prevents the fissure from healing. But i am still breastfeeding and still not healed after 5months post LIS. I dont know how much study is done on this but 3doctors have all told me the same thing. of coz been a mum u also put ur kids first and keep bf.
hope you are starting to feel better