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How to deal with difficulty in passing stools while breastfeeding?

Answered by
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Dr. Bhagyesh V. Patel

General Surgeon

Practicing since :1999

Answered : 13165 Questions

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Posted on Wed, 22 Aug 2018 in Lump
Question: I'm breastfeeding mom...
Im feeling difficulty in passing stool, while passing stool I get pain and there will be slite bleeding... I'm facing this issue since 15 days...I can feel some flesh at entrance of anus.... I'm drinking 3 Lt of water and even using Anovate cream still the problem is not solved... I have attached the images for the reference

It's Fissure or Piles
Please guide me What I need to do to solve this and what diet I need to follow
doctor
Answered by Dr. Bhagyesh V. Patel 1 hour later
Brief Answer:
Fissure with external pile. Guidelines in details below.

Detailed Answer:

Hello,

I have evaluated your query thoroughly with all images attached.

* This is more likely to be fissure with external hemorrhoid (sentinel skin tag which is felt as flesh at entrance of anus)
* Primary guidelines for better recovery

Local part care

- Keep the area clean with antiseptic liquid.
- Sitz bath (sitting in a tub filled with lukewarm water 5 minutes each 3 times a day, specially after passing each stool) help great.
- Continue Anovate cream application.
- Avoid sitting on hard surfaces for prolong period.
- Avoid tight undergarments or jeans.

Systemic care

- Continue to drink plenty of liquids.
- Diet should contain high amount of fibers as green leafy veg, organic fresh fruits.
- Avoid all spicy, oily, non-veg, junk foods.
- Intake of bulk forming laxative as Ispaghula husk with a glass of drinking lukewarm water improves healing by soft stools.
- Tab. paracetamol preferably with antacids
- Avoid stress, anxiety.
- Avoid smoking or alcohol consumption (if doing).
- Avoid anal intercourse (if doing).

* Special note
Convey in follow up if taking any of the medicines as iron preparations or else taking right now for post C-section recovery, as those may be causing hard stools with constipation.

Hope this will help you for sure.

Wishing you fine recovery and best motherhood.

Welcome for any further assistance.

Regards,

Take care.
Above answer was peer-reviewed by : Dr. Kampana
doctor
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Follow up: Dr. Bhagyesh V. Patel 2 hours later
Thanks a lot
Yes I'm taking iron and calcium tablets

I have few doubts

* It is necessary to take paracetamol and what antacid I can take

*I need to apply Anovate cream internally or externally

*Can I use dettol as antiseptic

* In no veg is it ok to have fish

* If I follow all the above points then how many days it takes to recover completely and will the extra flesh reduce
doctor
Answered by Dr. Bhagyesh V. Patel 9 minutes later
Brief Answer:
Follow up.

Detailed Answer:

Hello, welcome for the follow up.

* Kindly find herewith all following answers to your further doubts.

1. Paracetamol is for pain relief, if you do not think that you have not substantial amount of pain then you can avoid it, but taking will be helpful to alleviate pain during defecation.

Antacid as Ranitidine is best.

2. Anovate cream has to be applied externally, it gets absorbed inside.

3. You can use Dettol as antiseptic.

4. Fish is not recommended at all at this stage, as it will flare up the issue.

5. The recovery of fissure part and symptoms take around 3 weeks period provided all care in diet, sitz bath are taken properly.
The external skin tag is sentinel pile (in some cases it disappear at varying period of time, in others it remains but does not hurt).

6. If you have constipation or even a bit of hard stool , it is strongly recommended at present to stop taking iron tablet till recovery.

Hope this clears your doubts.

Still any hesitation welcome.

Regards.
Above answer was peer-reviewed by : Dr. Nagamani Ng
doctor
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Follow up: Dr. Bhagyesh V. Patel 2 days later
I'm having 4 Lt of water, leafy vegetables, vegetables ( carrot) and applying Anovate
I'm getting normal stool not hard one and it's not bleeding now but while defecation I feel pain
Is it normal ??
doctor
Answered by Dr. Bhagyesh V. Patel 25 minutes later
Brief Answer:
Follow up.

Detailed Answer:

Hello, welcome.

* While defecation, normal pain remains for the period till there is complete healing of fissure.

* Continue all dietary precautions, sitz bath, keep stools soft, avoid iron tablet for some period; it will definitely heal faster.

Wishing you happy motherhood.

Regards.
Above answer was peer-reviewed by : Dr. Kampana
doctor
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Follow up: Dr. Bhagyesh V. Patel 27 hours later
Thanks a lot ..... Even after taking care of diet, water and isabgol , stool is not soft , I think isabgol is not working... please can u suggest some stool softener
doctor
Answered by Dr. Bhagyesh V. Patel 9 minutes later
Brief Answer:
Follow up.

Detailed Answer:

Hello, welcome,

Need to take syrup Lactulose, dosage management further according to the consistency of the stool.

And how about pain at present.

Regards.
Above answer was peer-reviewed by : Dr. Yogesh D
doctor
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Follow up: Dr. Bhagyesh V. Patel 7 hours later
Since stool is not very soft it's still paining while defecation and after that it pains for 2-3 hrs... are there chances of having internal piles...
doctor
Answered by Dr. Bhagyesh V. Patel 7 hours later
Brief Answer:
Follow up.

Detailed Answer:

Hello, welcome.

* There can be internal piles, but usually you can feel the mass after defecation or during passage of stool coming out when they are of sufficient size to give bleeding.

Secondly usually internal piles do not give pain to much extent unless they are prolapsed outside and not going inside (which is called third stage).

* So in your case, chances are less (though can be confirmed with physical examination of proctoscopy with a consultant surgeon).

Regards.
Above answer was peer-reviewed by : Dr. Nagamani Ng
doctor
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Follow up: Dr. Bhagyesh V. Patel 2 days later
Thanks doctor Along with isabgol daily I'm taking 10 ml of laxative... Now it's better and even pain is less.... How many days i need to continue laxative and do I need to increase its dosage... I have another question... It's been 2 months for my delivery... Sometimes while turning I feel pain in my pelvic bones ... Is it normal
doctor
Answered by Dr. Bhagyesh V. Patel 6 hours later
Brief Answer:
Follow up.

Detailed Answer:

Hello,

Welcome for follow up.

* As pain is better, there is no need to increase the dosage of laxative.

Should continue the same dosage for further 5 - 7 days, later on according to the consistency of stool and pain level, will need to taper it.

* Occasional pelvic bones while turning is likely muscular , need minor physical exercises by now to get better back to rhythm as before pregnancy stage.

Take care.

Dr. Bhagyesh V. Patel, General Surgeon
Above answer was peer-reviewed by : Dr. Yogesh D
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