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How to treat cracks in the anus after childbirth

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An anal fissure is a rectal disease in which a defect is observed on the skin and mucous membrane. In this case, there is a constant trauma to the rectum, infection of an open wound, which is accompanied by pain, itching and other unpleasant symptoms.

Reasons for the appearance

An anal fissure after childbirth may have the following prerequisites for occurrence:

  1. During pregnancy, many women have circulatory disorders in the pelvic area. This is due to the fact that the large weight of the uterus with the baby presses on the pelvic arteries and veins. For this reason, many young mothers also suffer from hemorrhoids after childbirth.
  2. Relaxation of the muscles of the pelvic floor amid changes in the level of hormones in the body. Since during pregnancy many women suffer from constipation, then against the background of this, chronic stretching of the rectum and trauma to large and hard feces of the anus are formed.

In addition, anal fissures in women can appear due to natural labor, when the woman in labor is very strained.

To some extent, the manifestations of the anal fissure are similar to hemorrhoids, however, they have their own specific features:

  • a feeling of sharp pain, tingling or soreness at each visit to the restroom,

  • sphincter spasm, which is obtained as a result of circulatory disorders,
  • spotting that can be seen on toilet paper,
  • itching, which is caused by the multiplication of pathogenic bacteria in an open wound, while combing only exacerbates the situation.

To make an accurate diagnosis, it is necessary to undergo a full course of research, since the symptoms of an anal fissure can easily be confused with the manifestation of cancer of the rectum, inflammation of the hemorrhoidal nodes.

Acute form

The disease can occur acutely when the crack appeared abruptly and suddenly. It is always accompanied by sharp pain during the act of defecation, spotting and such unpleasant sensations as a feeling of fullness, burning, pressure. Unfortunately, a pregnant woman is not always able to give this much attention, since during the bearing of a child she encounters many troubles of this nature.

Chronic course

This kind of pathological condition has the appearance of an ulcer, so the symptoms vary slightly:

  • the pain is felt not specifically at the time of defecation, but some time after, and even several hours may pass,
  • marked anus compaction - proliferation of connective tissue and violation of the anatomical structure of the anal sphincter,
  • bleeding that may not occur with every visit to the toilet.

A chronic crack can form if 2 months or more have passed since the appearance of the acute crack without the necessary treatment.

Diagnostics

It is possible to identify an anal fissure after childbirth by the following methods:

  • a survey of the patient in which the proctologist finds out the symptoms that the woman is experiencing,
  • visual inspection of the anus,
  • rectal examination with fingers.

Sometimes a device such as an anoscope or special expansion mirrors are used. All manipulations are performed under local anesthesia, as they can cause pain to the patient.

In addition to visual and physical examinations, blood donation for biochemistry, HIV, analysis of urine and feces, as well as sampling of the material from the ulcer for a biopsy is required.

How to treat an anal fissure after childbirth? It should be remembered that self-medication can only exacerbate the situation, therefore, only a qualified proctologist should deal with the problem. For successful healing, it is necessary to exclude all factors that may prevent this:

  • lead an active lifestyle, avoid prolonged sitting
  • timely eliminate constipation that lasts more than two days,
  • exclude anal sex or use high-quality lubricants,
  • use soft toilet paper and wash off after each visit to the restroom,
  • timely treat diarrhea.

If a crack has already appeared, then these recommendations are not enough, in this case, serious medical treatment is necessary:

  1. Sedentary baths after bowel movements. The water temperature should be comfortable and be 30 degrees. To enhance the effect, a decoction of chamomile, a solution of potassium permanganate, an infusion of oak bark is used.
  2. Ointments that should combine the analgesic and healing effect. It can be such drugs as Emla, Bepanten, Proctozan, Levomekol. Creams must be injected into the anus twice a day after bowel movements and washing.
  3. Suppositories are used as an active form of treatment not only for anal fissures, but also for hemorrhoids. In this case, combined preparations are selected that include painkillers and active substances. It can be such candles - "Relief", "Posterisan", "Aurobin", candles with sea buckthorn oil.

In the presence of chronic constipation, it is recommended to use mild laxative drugs.

Surgical treatment

In rare cases, removal of the anal fissure is possible only surgically. There are such methods of intervention:

  1. Devulsion is a mechanical extension of the anus that helps relieve spasm. Partially solves the problem with constipation, and also speeds up the healing process of the crack.
  2. Cryodestruction - freezing a crack with liquid nitrogen. The operation has some contraindications, and there are also negative aspects in the form of the inability to cover only the affected tissue, as well as the high cost of the procedure.
  3. Sphincterotomy is a classic operation that involves excising an anal fissure along a plane within healthy tissues. The healing time is about 5-6 days, while the wound must be washed twice a day with warm water and treated with Levomekol ointment.

Surgical treatment is not possible during lactation, so a woman will need to wait until it is over or, in case of large damage, refuse to breast-feed.

Causes of Postpartum Fissures

Hemorrhoids and anal fissures after childbirth are far from uncommon. The fact is that during pregnancy, the hormonal background of a woman undergoes changes. Accordingly, the uterus becomes larger, and some organs are displaced.

An enlarged uterus exerts high pressure on the rectum. As a result, hemorrhoidal veins are squeezed, blood flow in the small pelvis is disturbed. Moreover, with an increase in the uterus, ruptures of the rectal mucosa can form.

There are a number of predisposing factors to the development of anal fissures after labor:

  1. Unbalanced diet. Some pregnant women take the expression "eat for two" literally, and significantly increase the number of calories consumed. As a result, constipation appears, and then linear ruptures of the rectal mucosa. “Eating for two” means that a woman needs to consume more vitamins during the period of gestation, and not dramatically increase the calorie intake or include simple carbohydrates in the menu.
  2. Vascular diseases and other intestinal pathologies. If the patient before birth had chronic vascular disease, Crohn’s disease, hemorrhoids, chronic paraproctitis, rectal prolapse, then after labor, the likelihood of rectal cracks increases.
  3. Passive lifestyle. Pregnancy is not a reason to sit all the time and not move. Hiking and yoga will be helpful. They will help strengthen the muscles of the pelvic floor, and prepare the body for childbirth.

If a cesarean section was performed, the likelihood of rectal defects and impaired intestinal motility increases significantly.

Symptoms and alternative methods of treatment

How do rectal fissures manifest themselves if they occur after childbirth? A characteristic symptom is pain in the anal canal, which appears during bowel movements. Moreover, the bowel movement is often accompanied by burning and itching in the anal canal.

If the crack is large, then the pain, itching and burning intensify, and haunt the woman throughout the day. Moreover, the symptoms become more pronounced even due to minor physical exertion.

Often, anal fissures are accompanied by the appearance of bloody discharge from the anus. Moreover, the peculiarity is that with deep damage full rectal bleeding develops. Outwardly, they resemble bleeding that occurs with inflammation of the hemorrhoids.

There are cases that the occurrence of a linear rupture of the rectum is accompanied by an increase in body temperature. Usually this happens either in the acute course of the disease, or in the development of a complication such as purulent paraproctitis. If body temperature rises, you should immediately contact a doctor. Any procrastination is life threatening.

With the symptoms, everything is clear. But how to treat cracks in the anus after childbirth? If a woman has recently given birth, then you can use folk remedies. This should be done very carefully, because the use of any folk remedies can lead to the development of allergic reactions.

Useful enough. With its help, you can make therapeutic lotions. To do this, dip gauze in sea buckthorn oil, and then attach it to the anus for 15-20 minutes. Repeat this procedure several times a day.

If there is no sea buckthorn oil, then for lotions you can use coconut, castor or linseed oil. Also, baths are a very useful treatment method. In warm sessile baths, you can add potassium permanganate, a decoction of chamomile or a decoction of calendula.

If there are no postpartum complications, then you can introduce rectally homemade suppositories from raw potatoes or lard.

Conservative treatment of pathology

If the birth of a child has led to the formation of cracks in the rectum, then a woman needs to use certain medications. The drugs are selected exclusively by the attending physician, since during lactation some drugs are strictly contraindicated.

To eliminate cracks, anti-inflammatory ointments and suppositories, which have a pronounced regenerative effect, are used. The safest medicines are Relif suppositories, Vishnevsky ointment, candles with sea buckthorn oil, Natalsid suppositories.

In addition to the use of rectal ointments and suppositories, the patient needs:

  • Normalize intestinal motility. If the anus crack is accompanied by constipation, then laxatives are prescribed to the woman.
  • Do not use hard toilet paper. After the act of defecation, it is better to wash the anus with warm water.
  • Avoid anal intercourse, especially for those cases when a cesarean section was performed.
  • Follow the rules of intimate hygiene.
  • For acute pain, take painkillers or antispasmodics.
  • Balanced to eat. the rectum is an integral part of treatment. A properly constructed diet will normalize intestinal motility, get rid of constipation or diarrhea.

If a woman develops rectal bleeding, then phlebotropic drugs may be prescribed.

When conservative treatment does not help, therapy may be performed using radical surgical procedures or minimally invasive techniques. To get rid of the pathology can be used:

  1. Excision of a rectal fissure. The procedure is performed under local anesthesia in one session. During the operation, the surgeon excises the defect with one block and leaves the wound open. After excision, you need to undergo a long rehabilitation course.
  2. Laser Therapy Laser removal is a painless procedure that takes no more than 1 hour. Laser therapy is effective, and does not require a long course of rehabilitation.
  3. Cryodestruction. This procedure involves freezing a rectal defect with liquid nitrogen. Cryodestruction is a fairly effective technique, but it is often difficult to put into practice.

If a woman is going to give birth, then it is best to be observed by a proctologist, eat right and spend more time in the fresh air. Subject to these simple rules, the risk of cracking can be minimized.

In the process of bearing a child in a pregnant woman, blood circulation in the pelvic area is disturbed. This leads to stagnation and the formation of hemorrhoidal nodes. As a result, a woman may develop an anal fissure after childbirth. Treatment must be carried out in a timely manner, you should not postpone a visit to the doctor, otherwise the disease will take a chronic form, which can only be treated surgically.

Anal fissure is a fairly common disease among women in labor. The ailment begins its development during pregnancy. During labor and after the birth of a child, it worsens. The development of the disease contributes to a number of reasons:

Pregnant women are far from always able to avoid the formation of anal fissures in the anus after childbirth. The risk of developing an ailment among pregnant women and women who have given birth is high, even with prophylaxis. But with timely action, the disease is easily treated. The neglected variant of the disease can be eliminated only with the help of surgical intervention.

How is the disease manifested?

Anal fissure has a characteristic clinical picture. The disease makes itself felt already at the initial stage of development. Symptoms of the disease:

  • the appearance of sharp throbbing pain during bowel movements,
  • spotting from the anus, which with the development of the disease turns into heavy bleeding,
  • itching and.

Unpleasant symptoms make the woman uncomfortable. At the first signs of the disease, consult a doctor. Early diagnosis and timely treatment improve the prognosis of the disease. A proctologist is involved in the treatment of diseases of this kind.

This disease should be distinguished from hemorrhoids or other lesions of the rectum. The diagnosis is made by the doctor on the basis of an external examination.

Before starting treatment, you will need to conduct a diagnosis. The diagnosis is made based on the results of the examination and on the basis of patient complaints. In some cases, resort to the procedure of anoscopy.

If the diagnosis is confirmed, the doctor will advise the woman how to treat the disease. The main therapeutic goals:

  • eliminate pain,
  • relieve spasm
  • stop the inflammatory process,
  • prevent constipation,
  • crack healing.

In accordance with the objectives, the proctologist selects drugs for. It will require complex therapy, consisting of drugs mainly for external use and additional therapy.

Not all funds are approved for use by nursing mothers. Therefore, the selection of drugs should be approached with caution and entrusted to the doctor. Self-medication carries a danger not only for a woman, but for her child.

Drug therapy

An anal fissure is treated with medications, most of which are for external use. The therapeutic course includes the following drugs:

  • for wound healing and prevention of infection, rectal suppositories or Posterisan ointment are used,
  • Natalside will help relieve inflammation and stop bleeding,
  • Bepanten and other pantothenic acid-based products improve metabolism, speeding up the healing process,
  • itching and pain passes under the influence of Ultraproct candles,
  • Relieve swelling and reduce pain by ointments or suppositories Procto-glivenol,
  • candles, which include propolis and sea buckthorn oil, help well.

It is important to consider that not all medicines are suitable for nursing mothers. Take medication only as directed by your doctor. If an allergic reaction occurs, the use of the drug should be stopped and consult a doctor for adjusting the course of therapy.

How to speed up recovery

To cure the disease as quickly as possible, you must follow the rules. A woman should:

  • prevent constipation, for this, proper nutrition is organized, if necessary, you need to take a laxative in the form of suppositories,
  • after each bowel movement to conduct hygiene of the anus, it is advisable to rinse it with warm water,
  • do not use hard toilet paper,
  • follow a diet, include fermented milk products in the diet,
  • lead an active lifestyle, you need movement, daily walks in order to prevent congestion in the pelvic area.

Traditional treatment can be supplemented with traditional medicine. Useful baths and compresses made from medicinal herbs: chamomile, St. John's wort, sage, oak bark. Procedures with herbs are done before treatment with ointments and suppositories.

Anal fissures are successfully treated at the initial stage. Do not bring the disease to a chronic form. In this case, only the operation will save.

This video talks about an anal fissure after childbirth:

One of the most common complications during childbirth is tears during childbirth of the soft tissues of the birth canal, which include the cervix, vagina, perineum and external genitalia. Why is this happening and can stitches be avoided? In fact, it is impossible to single out any one reason for the breaks. But some of them can be influenced.

First of all, it is necessary to remember that only healthy tissues have sufficient elasticity and extensibility. Inflamed tissue is fragile and swollen, therefore, with any mechanical action, it does not stretch, but breaks. So, any inflammation of the genitals on the eve can lead to ruptures during childbirth. Therefore, about a month before the birth, every woman should undergo an examination and pass a smear on the microflora. If inflammation is detected, treatment is definitely prescribed with subsequent monitoring of its effectiveness. Another reason for the decrease in tissue elasticity is previous injuries (scar tissue does not contain elastic fibers and therefore is practically inextensible). So, if a perineal incision was performed in previous births, as a rule, in subsequent births one can also do without it.

Rapid childbirth, the lack of coordinated work of a woman and a midwife, the large size of the child, or the incorrect insertion of the pre-existing part of the fetus is another reason for breaks in childbirth. In ideal births, the fetus moves along the birth canal gradually and the tissues of the future mother's body have time to adapt to the increasing pressure, they stretch each time more and more. If the body does not have time to adapt, then this leads to a violation of blood supply and the occurrence of swelling of the tissues of the birth canal, which inevitably ends with a rupture.

Sutures after childbirth: repairing tears and incisions

All birth canal injuries are subject to mandatory treatment. It begins when examining the birth canal immediately after separation of the placenta. For suturing small cervical ruptures, analgesia is not required, since there are no pain receptors in the cervix. If a very deep gap is found (which is rare), the woman is immersed in general anesthesia to examine the uterine cavity for the depth of the gap. Cervical tears are sutured with absorbable material.

After examining the cervix, the walls of the vagina are examined. If there are few breaks during childbirth and they are not deep, then local anesthesia will be enough - the wound edges are cut off with painkillers. In deep and multiple ruptures, general anesthesia is used. If epidural anesthesia was used in childbirth, then when suturing, the anesthetist adds an analgesic to an existing catheter. Tears in the walls of the vagina are sutured with absorbable sutures that do not need to be removed.

Small cracks of the external genitalia often do not require suturing, since they heal quickly, but this part of the birth canal is very well supplied with blood, therefore, if the cracks are accompanied by bleeding, they must be sutured after childbirth. Damage to the external genitalia is very painful, so medical manipulations in this area often require general anesthesia. Sutures are superimposed with very thin absorbable threads that do not need to be removed.

At the end of the postpartum examination, the integrity of the perineum is restored. Currently, sutures after childbirth are more often applied by absorbable suture material and do not require removal, less often there are nodular non-absorbable sutures.

A separate case of suturing during childbirth is sutures after cesarean section. Previously, with a caesarean section, the abdomen was cut in the middle “from the navel to the pubis” and interrupted sutures were applied. Now they are making a small incision along the pubic hairline. Most often, a special continuous cosmetic suture is applied, less often - nodal sutures or metal staples. Sutures after cesarean section are removed on the 7-9th day. With proper care, one year after the operation, a white scar remains as thin as a thread, which is easily covered even by bikini bottoms.

Postpartum suture healing

Of course, all young mothers are concerned about the question, how many sutures heal after childbirth? So, this process depends on the size of the damage, proper care, the general condition of the body, methods and materials used when suturing. When using natural or synthetic absorbable materials, wound healing takes place within 10-14 days, the sutures resolve in about a month. When using metal brackets and non-absorbable material, they are removed after childbirth on average on the 5th day in the hospital, before discharge. In this case, wound healing will be longer - from 2 weeks to 1 month.

Stitches in the vagina and on the cervix

Self-absorbable sutures in the vagina and on the cervix do not need special care. You do not need to process and remove them, you just need to ensure complete peace and purity. Postpartum excretion is an ideal substrate for the growth of pathogenic bacteria. Therefore, during the first three weeks after birth, it is necessary to carefully follow the rules of personal hygiene so that the infection does not get into the genital tract. Wash your hands thoroughly with soap before each visit to the toilet and change of pad. After the toilet, remove the old gasket from front to back. Wash your crotch with warm water and soap. The direction of movement and the stream of water should always be from the genitals to the rectum. After washing the genitals, it is necessary to dry them dry with a napkin or a well-absorbing towel. Such a towel, like underwear, must be changed when contaminated with secretions immediately, and daily - if all this remains clean in appearance. Even if you do not feel the urge to urinate, be sure to go to the toilet every 3-4 hours. But take a bath first

Why do cracks appear

Anal fissure is a fairly common disease among women in labor. The ailment begins its development during pregnancy. During labor and after the birth of a child, it worsens. The development of the disease contributes to a number of reasons:

  • violation of blood circulation in the pelvic area during pregnancy, arteries and veins are compressed under the weight of the uterus,
  • a change in the hormonal background leads to weakening of the muscles of the rectum and anus, as a result of which the rectum is stretched, hard feces, passing through it, injure the mucous tissues of the anus, this causes cracks,
  • pregnant women are not recommended to lift weights, this can also lead to injury to the anus,
  • untreated hemorrhoids leads to such consequences,
  • in the presence of vascular diseases of the pelvis, the risk of anal fissure is very high,
  • labor can cause injury to the anus,
  • after childbirth, it is necessary to properly prepare for the first act of defecation and take laxatives, if you neglect this, cracks may appear in the anus.

Pregnant women are far from always able to avoid the formation of anal fissures in the anus after childbirth. The risk of developing an ailment among pregnant women and women who have given birth is high, even with prophylaxis. But with timely action, the disease is easily treated. The neglected variant of the disease can be eliminated only with the help of surgical intervention.

Complicated condition

An anal fissure after childbirth can be aggravated by such chronic conditions:

  • heavy bleeding from the rectum, which over time can cause anemia,
  • pectenosis is a condition in which the muscle tissue of the sphincter of the connective tissue is replaced, as a result of such changes, the ability to naturally excrete feces is significantly reduced and coprostasis occurs,
  • Papaproctitis is an infectious inflammation that is characterized by throbbing pain in the anus, fever, fever, and general weakness.

In rare cases, malignancy of a chronic ulcer is noted.

To quickly heal the anal fissure after childbirth, you must adhere to a special diet that will relieve constipation, diarrhea and bloating - this is necessary for the speedy healing of the defect. She completely forbids such foods:

  • canned food
  • alcoholic drinks
  • spicy and salty dishes,
  • carbonated drinks,
  • milk,
  • smoked meats
  • sweets.

To improve intestinal motility, it is recommended to consume more foods that contain fiber, such as fruits, vegetables, whole grain bread, cereals. Sour-milk products, dried apricots, prunes also have a positive effect on the gastrointestinal tract.

It is important to observe the drinking regime and consume a large amount of liquid - 2 liters of clean water without gas per day. Also allowed the use of fruit and berry compotes, natural juices in small quantities.

Prevention

Anal fissures after childbirth are a type of disease that is easier to prevent than to treat, so proctologists recommend that you follow these tips for prevention:

  1. Perform monitoring of the gastrointestinal tract. To do this, it is recommended to eat properly and balanced, and to exclude the possibility of dysbiosis, it is recommended to regularly eat fermented milk products.
  2. The use of high-quality soft toilet paper is necessary to eliminate external irritants of the anus.

Unfortunately, even with strict adherence to the above rules, an anal fissure can occur during pregnancy. Reviews note that about 30% of women giving birth face a similar problem. However, even if it was not possible to prevent the appearance of pathology, then every effort should be made to solve the problem at the initial stage, until it turned into a chronic ulcer.

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