Hi all
I have a post childbirth fissure, my first child was born in January and the fissure presented a few weeks later. I have never had one before and after a month of daily pooing pain I think my fissure is actually getting worse. I am trying to Breastfeed however after a BM I find it painful to sit down for a number of hours post BM. Lately I have had blood on my toilet tissue as well, when previously I didn't. I am reluctant to go out just in case I need to 'go' and I will not visit my family as it requires an overnight stay. I really want to get my life back and start enjoying being a new mum. My partner is also keen to resume our bedroom activities but I just cannot come at it given the constant dull pain in my butt. My obgyn has given me a referal to a rectal surgeon however they cannot see me until the end of May - the thought of waiting with such pain and such effect on my daily life, has me in tears.
I am doing all the recommended things, laxatives, Metimucial, Fruit, Veg, Bran, Wipes instead of toilet paper, sitz baths daily, even trying some breast milk on the fissure (they do say Breast milk has great healing qualities).
Just finding this forum shows me that I may be on the very start of my fissure battle, which depresses me greatly. I would be interested to know what are the signs of a fissure starting to heal or alternatively the sign's it is getting worse.
Thanks.

Hey there, sorry to hear about your troubles, especially when you've got a new baby in the house :( It does sound like the fissure is getting worse if you're seeing blood and feeling longer-lasting pain. The pain could be a muscle spasm or simply due to aggravation of the open wound. The pattern of pain from my own fissure has changed several times now.
End of May is definitely quite a wait to see a colorectal surgeon... It sounds like you're on the right track with a high fiber diet and laxatives (what kind?). Have you asked your current doctor about any of the first line treatment topical ointments? I mean stuff like 0.2% nitroglycerin, 0.2% nifedipine, or 2% diltiazem? I'm not sure where you're from but I'm guessing maybe Australia based on time zone? We don't get these ointments ready-made here in the States but I think the nitroglycerin formulation is available pre-made as Rectogesic over there. I don't know what implications these drugs have when it comes to breastfeeding but they are often used to treat fissures. The earlier you start treating it, the better, taking mine casually early on was a grave error on my part, if I'd been more careful in the beginning I strongly believe it would have been in the rearview already.
It's getting late over here so I've got to hit the sack for the night, but if it would help at all, I do have a copy of Thomas Hale's well known book "Medications And Mother's Milk" (because my wife and had twins last year) and would be happy to look those drugs up in it tomorrow if it would help. It won't substitute for real medical advice of course but might give an idea of which ones are even worth asking your physician about.
The folks here are a great bunch and real knowledgeable and I'm sure they'll be able to give you a hand with some pointers soon. Hang in there :)

Hi ouchie,
You're in the right place for help and advice and we're pretty much all in the same boat, like NG says, you need to try the first line of attack, ask your GP about nitro and nifedipine if your lucky then these ointments will help, in mine and NG's case we are on the final part of the (j o u r n e y) as far as topical treatments go, we are using Diltiazem and if this doesn't work then we are going under the knife!
Diet plays a crucial part in your fissures activity and healing, most of us here are on a strict high fibre diet with plenty of water, mainly to achieve the correct consistency of BM, I can see your already using laxatives, you should try and get Movicol (Miralax) or Docusate sodium for softening the stools, i've noticed you haven't mentioned water, water is also essential for the bowel and will make the stools soft, all of these things will help you for the meantime until you get the required treatment, as NG says the folks on here are great and will help you whenever they can.
Best of luck! :D

Thanks guys.
Nice detective work NeuropathicGuy, I am in Australia and rectogesic is available OTC here. I am using the rectogesic wipes and they do soothe as the packet says! Also using something called HemoClin (http://www.hemoclin.com/) which helps lubricate to ease out the BM. Its also available OTC here in Oz. I am taking Coloxal with Senna, they give me a bit of a gut ache therefore I am only taking one a day, just before bed. I did take 3 tabs once, but I ended having 5 BM that next day - very bad day.
StevePain, I did forget to mention water, but yes I am consuming about 2 litres a day. They say Breastfeeding dehydrates the body so I am extra careful about making sure I get plenty of water.
Strangely enough today I had a BM without blood, and only minor pain, not sure if perhaps it is getting better or just had a good day?

Ouchie, I love Aussies, so I will try to relate my story soon for you. My husband and I were supposed to take a month long trip to Australia and NZ 3 years ago, but we had to cancel because of my butt issues!! (sitting on a 16 hour flight to Australia is not good for a sore butt!!)

Hi Ouchie,
I was going through the same experience you are... I just had my baby in Jan. and also developed a fissure a couple of weeks later. I was having a really hard time sitting still to nurse, so I did some research and talked to my lactation consultant. I found something called a Moby wrap. It's like a really long piece of fabric that you can wrap around your body in different ways to hold the baby. There are a couple of ways to use the wrap and nurse while moving around. I bought the wrap and had some success with it. Since then my fissure has been on the mend, so I haven't needed it for that reason but it's nice for other positions. I would highly recommend looking into the wrap if things don't get better soon. At least then you aren't tied down to a chair in pain!

Hey ouchie,
What part of Oz? My wife and I visited there about 2 years ago, took the popular tourist route through Sydney, then Cairns/Port Douglas, and then the Red Centre. We had a great time.
I would second Steve's suggestion about considering Movicol (Miralax here in the States). I'm not sure what it's called down under but the ingredient in it is polyethylene glycol 3350. It's an osmotic laxative and I personally found it to be far more gentle and effective than docusate sodium (Coloxyl). Actually a lot of us here have found some relief from Miralax. I looked into its effect on breast milk back when my wife was nursing (she got hemorrhoids post-partum) and seem to recall that there isn't any as it simply passes through the body and into the colon (double check this if you do try it of course).
As for having a BM today with no blood and just minor pain, that's good news of course, but as many of us here can attest to, there can be many ups and downs when it comes to fissures. I'd say to take it as a good sign but not *too* good, you know? Be diligent about watching what you eat (veggie soup works great for me), taking laxatives, drinking TONS of water, and using the Rectogesic and hopefully your upward trend will continue :)

After a bad weekend, painful BM's followed 8 hours of continued pain, I have managed to beg for an appointment asap and got one tomorrow. Have chatted to a couple of friends and works out they had post childbirth fissures, luckily for them they cleared up after a couple of weeks, I am at my wits end and not able to enjoy an being a new mother, so I am hoping the appointment tomorrow can help me with some options so I can get my life back.
Hey NG I am from Geelong, which is about an hour from Melbourne in Victoria. If you have heard of the Great Ocean Road or Bells Beach, its not too far from there.
Cherylk, now that you are healed have you rescheduled your NZ & Oz?

No, ouchie, but I have been taking some shorter trips and also took a 5 day cruise to the Western Caribbean last October. My mother has trouble thinking about me taking such a long trip to NZ and Australia, and I am gradually working up to a longer flight which would be necessary to go that far away from the US. I hope you feel better soon and have a good appointment tomorrow. Is your health system there similar to the one they have in the UK???????

Hey ouchie,
Yup I know the Great Ocean Road. A friend of mine actually just moved from San Francisco to Melbourne last year. He grew up in Hawaii, spent his young adult years in California, and absolutely loves it in Melbourne :)
So how did your appointment go? Were you able to find out anything or get any kind of new plan in place? Hope it went alright.