Hi
I am so glad to have found this group, I am at my wits end with this fissure!
I had my beautiful baby boy ten weeks ago and i have been so poorly ever since, initially due to an infection (episiotomy) then thought I had recovered and could start enjoying motherhood - wrong! I developed what I assumed were piles from hell about five weeks after the birth, so useds lots of anusol. Then one day the pain was so bad (I told my doctor I would honestly rather give birth than go to the toilet) I realised that no piles could cause that kind of agony so I went to the doctor who diagnosed the fissure and prescribed rectogesic, and told me i would be better in a week - of all the lies i have ever been told, this is the worst!!! during this time i was constipated so BMs were dry and hard so it made sense I had zero chance of healing quickly. Over the past 4 weeks I have used rectogesic, stool softeners, lots of water and fibre - and things seem to have improved steadily, like the pain went from a 10 to a 0, then yesterdayI made the msitake of going 1 day and night without rectogesic and bam - it's back, I'd rate the pain as about a 6 at the time, 8 immediately after, then 5 for next 15 mins or so. There is also a little blood which there wasn't before. The other thing is, I was told by my gp to try and do some pelvic floor exercises and I did a couple of sets yesterday - I am certain this has undone all the healing of the fissure.
I think what I need to know is:
do little setbacks happen like this during healing - or am I just stuck like this?
how long have people used rectogesic for?
how long can i take stool softeners for before they lose effect?
are pelvic floor exercises a no-no, like i think they are?
i would really appreciate any thoughts, I am pretty fed up with all this! :(

Hey tigerlily,
Yes, setbacks are almost inevitable. But so long as each is less awful than the previous one... well so far so good.
I wouldn't do pelvic floor exercises while healing, IMO.
You want to relax down there, not tone things up.
Are the kegels because of the episiotomy?
I had an episiotomy from a forceps delivery, and it got infected, and the stitches undid long before they should have. Anyways, nobody mentioned anything about kegels to me.
Don't lose heart yet. Keep using the stool softeners and fiber and drinking lots of water. More soluble fiber is better than more insoluble.
I think using stool softeners is safer in the long term than using laxatives. You could ask your doctor to be sure. All they do is add water to your stool as it moves through your intestines. you can get some of this benefit from taking magnesium supplements as well.
You might think of seeing a specialist. That would be a CRS (colorectal surgeon in North America, or a Proctologist in the UK). Sometimes it takes a while to get an appointment so if you are worried, you could get the ball rolling early on a referral.
Did your doc say when to call back if things didn't improve?
-Tanya

Thanks for the reply! Sometimes just knowing someone else has had the same thing really helps :) the joys of forceps deliveries! and the infections that no-one warns you about...ugh! how log did it take for you to feel vaguely normal, in that department?! I feel like I never will again!
Yes the doctor said to do kegels as I just feel like my pelvic floor feels like its going to drop out sometimes... this is my first baby so I am wondering, is that just normal in the months after giving birth? But I guess I will just have to feel a bit heavy for a while, getting rid of this evil fissure is my priority.
I think I amgoing to pay for a private consultation with a specialist, as my own gp must have no clue with fissures to tell me i am fine to stop the rectogesic after a few pain free days, and to get on with the kegels - I cannot trust him at all.
Anyway I am back on the rectogesic and crossing my fingers. Thanks for your help :D

Tigerlily,
It took my episiotomy almost 4 months to heal. It was awful. It's part of the reason I only have one child to be honest.
Why not try walking instead of kegels. It gets the blood moving down there, without pulling too directly on those tissues.
I don't remember a feeling of fullness. Maybe somewhat. This was almost a decade ago, so fortunately the memory does fade! :D
I remember getting some muscle spasms and aches as the connections healed up.
It takes the skin where the fissure heals a long time to regain it's strength and resiliency. Months to over a year.
Personally, when I am healed, I plan to stay the course for a few months before I lighten up on the prune juice etc.
I think a private specialist sounds like a good idea too. If you can afford it, it will probably be worth it. IMO
my pleasure. Just paying it forward, for all the good advice and commiserating I've gotten here as well. :D
-Tanya

Hi tigerlily,
My situation is pretty similar to yours. With regard to the pelvic floor feeling like it's going to fall out, yep that's a pretty normal consequence of having a baby. Mine slowly improved with time, and yes it's totally impractical to do kegels with a fissure its just way too painful! I am now post LIS and am seeing a women's health physiotherapist - she says we don't want to get my pelvic floor too strong before we have sorted out the muscle problems related to the fissure - in effect because I have been "guarding" my butt (due to the pain) by tensing up just about every muscle from waist to knee, I have to re-train everything to relax.
And if you can go private I'd do it, my GP had dealt with fissures but hadn't many patients with really severe probs so was a bit out of his depth. Throw everything you can into getting good advice and getting it sorted!
The other thing I think might play a role in our fissures is the scar tissue from the episiotomy - this is usually a lot less elastic than it should be. My physio advised me to work on massaging it to make sure adhesions don't form (where the damaged muscle sticks together). I know I could never have touched the area before surgery, but depending on your personal pain level it could be something to consider.
How are you getting on now, it's been a while since you posted...hope this means things are looking up. :)