Anal Fissures…..a pain in the butt.

Anal fissures. A postnatal pain in the butt. Literally 💩😑

So, I generally like to chat about the stuff that we don’t usually talk about (this is part of why I consider myself to be socially awkward and don’t enjoy parties) and one of those things are postnatal (occasionally they also occur antenatally) anal fissures.

Mostly, when there is pain (and often bleeding) when pooping, we assume it is due to piles……but often, it’s actually anal fissures that cause the issue. An anal fissure is a tear in the thin moist tissue around the anus, called the anal mucosa.

Very common after giving birth, and yes, also after having a Caesarean section. They are usually small, BUT THEY PACK A PUNCH when it comes to pain. Horrid.

If you are experiencing sharp (often quite severe) pain during bowel movements that lingers afterwards, with some fresh bleeding and sometimes small skin tag type growths around your anus, you are likely suffering from an anal fissure.

Occasionally the can give you the gift of rectal muscle spasms too! (If you are unsure, and you are experiencing bleeding/pain/unusual growths, confirm with your GP of course).

Fissures are a MAJOR pain in the butt……they really add some spice to the already challenging postnatal period, during which, quite honestly, you could have done without this bothersome side effect from giving birth. So what can you do?

💩 keep your poo as soft as possible. Harder bigger poop, more potential for tears, and less potential for healing if already torn. How you achieve this is relatively unimportant. Hydration, movement, fibre, good diet, and/or medication such as lactulose, movicol all help.

💩 optimal positioning during bowel movements is super helpful. Elevate your feet to imitate a squat….this relaxes your puborectalis muscle and straightens out the curve in your colon, putting less pressure on your anus….hence less likelihood for tears to occur, and more chance for them to heal in the long run.

💩 go for a poop when you feel the urge. Don’t delay. Sit and relax. Let it slide out. Breathe.

💩 if you already have a fissure, and you get the cold sweats just thinking about poop and anticipate the pain acutely, do all of the above, and potentially add in some gentle counter pressure on your perineum during bowel movements….that can give a sense of control. Also, birthy breathing to can help you relax your pelvic floor and make opening your bowels easier.

💩 there are also medical ways to manage a fissure that is hard to heal. Chronic fissure are no joke…..please don’t be embarrassed to see your GP and don’t be fobbed off by being told that this is simply a temporary postnatal issue. It might be, but you still deserve to access help. Glyceryl trinitrate ointment is a treatment option that is open to you, even if breastfeeding, amongst others (including surgical repair if necessary).

Hopefully this will help a little and bring a bit more awareness to this super common and incredibly unpleasant issue we tend to stay quiet about 🤐🙄