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I Have Delievered A Baby Through Caesariann On 26 July.
Question: I have delievered a baby through caesariann on 26 july. After 10 days, i was diagnosed with internal piles, anal fissures and centinel piles. Initially doctor advised surgery since the situation was severe. But then undergone 2 sittings of laser treatment by piles specialist. After that., outside and inside piles have considerably reduces in size but fissures still persist. While passing stool, i feel lot of pain. Doctor has advised diltigesic and placentric ointment to apply inside the rectum 3 times a day along with sitz bath. Its been 15 days since i m doing it. No relief yet. Can u please suggest me further course of action.
Brief Answer:
Details of additional care below.
Detailed Answer:
Hi Priyalgarg24,
Thank you for the query. I have read it &understood your concern.
Your doctor has advised all the line of action properly...the symptoms should have healed by now. In my view, the following are the things .. solving the problem more effectively.
- Addition of a stool softener( like cremaffine over the counter ) ... which would ease the daily defecation &also avoid continuous straining for stools &also reduce daily stress to the part ....which is not allowing healing.
- Application of the ointment(Proctosedyl ) before & after passing stools & after each Schitz bath
-Avoiding spicy&irritative food
-Treatmentment of infection at the piles' site or in intestines by adding suitable antibiotic ( to be decided after local check-up /after stool examination )..in addition too anti-inflammatory pills you are already taking.
*The fissure would heal with the added care under treating doctor's guidance.
* In case of no response with all the above care... a minor surgical procedure under anesthesia (Anal fialation) should be done .
Please consult an anorectal surgeon for such interference.
I hope that answers your query. Any follow up query is welcome.
Thank you.
Details of additional care below.
Detailed Answer:
Hi Priyalgarg24,
Thank you for the query. I have read it &understood your concern.
Your doctor has advised all the line of action properly...the symptoms should have healed by now. In my view, the following are the things .. solving the problem more effectively.
- Addition of a stool softener( like cremaffine over the counter ) ... which would ease the daily defecation &also avoid continuous straining for stools &also reduce daily stress to the part ....which is not allowing healing.
- Application of the ointment(Proctosedyl ) before & after passing stools & after each Schitz bath
-Avoiding spicy&irritative food
-Treatmentment of infection at the piles' site or in intestines by adding suitable antibiotic ( to be decided after local check-up /after stool examination )..in addition too anti-inflammatory pills you are already taking.
*The fissure would heal with the added care under treating doctor's guidance.
* In case of no response with all the above care... a minor surgical procedure under anesthesia (Anal fialation) should be done .
Please consult an anorectal surgeon for such interference.
I hope that answers your query. Any follow up query is welcome.
Thank you.
Above answer was peer-reviewed by :
Dr. Prasad
Thanks for ypur valuable advice. As you have suggested anal dilation surgery as the last option. Being a mother, i have to constantly feed my baby. How long will this surgery take to complete recovery and will it create any problem in feeding. Does this surgery ensure complete cure? I have been told that Lateral internal sphincterotomy is better option these days. Plz give your opinion about it
Brief Answer:
Detailed answer below.
Detailed Answer:
Hi Priyalgarg24,
Reaceived your follow up query....understood your concern.
The problem you have is is due to too much straining for the stools... where anus is injured to form a crack ..that is fissure.Because of the stress to the area there is reflex spasm of anal sphincter muscle.. causing narrowing of anal passage &painful defecation... infection & inflammation in the fissure cause constant pain.
The surgical treatment is aimed at relaxation/widening of the anus.
*The Anal dialatation is a sort of non invasive surgery where surgeon under aseptic precaustions &anaesthesia manually stretches the anal canal(applying optimum force) .. when only few muscle fibers give way to cause relaxation of anal canal.
This procedure does not need any after care except using anal dialaters(if advised) & hygiene of the anal &perineal region along with affirming smooth stools(by lifestyle changes/stool smootheners)... so post operative period is as good as normal life...&result is seen within couple of days.
But sometimes due to overstretching.... fecal incontinence &fltulence were observed... which was due to weak perinium of the patient&over pressure during surgery.
*To combat this... the new version of the surgery ..the Laterral internal spinctorectomy was introduced.. in which lateral muscle fibers of the sphincter on both sides are insised & stitches applied to anal mucosa.
At the cost of cautious care hyginically &restrictions in sitting movements for few days with possibility of infection of the wound... anal dialatation is achieved by cutting the fibers at safer place.so results can be assessed after 8-10 days of postoperative phase.
** In your case breast feeding is the point of your major concern.... from that point of view simple dialatation of anus would be better.( But breast feeding can be given In lying position/position comfortable to you.Even expressed milk can be given to baby in case of need)
** In my view you should consult an anorectal surgeon.He will assess your perineal &general health &advise you whatever is good for you.Be prepared to accept his view &cooperate for surgery.
I hope that satisfies you.Any follow up query is welcome.
Thanksh
Detailed answer below.
Detailed Answer:
Hi Priyalgarg24,
Reaceived your follow up query....understood your concern.
The problem you have is is due to too much straining for the stools... where anus is injured to form a crack ..that is fissure.Because of the stress to the area there is reflex spasm of anal sphincter muscle.. causing narrowing of anal passage &painful defecation... infection & inflammation in the fissure cause constant pain.
The surgical treatment is aimed at relaxation/widening of the anus.
*The Anal dialatation is a sort of non invasive surgery where surgeon under aseptic precaustions &anaesthesia manually stretches the anal canal(applying optimum force) .. when only few muscle fibers give way to cause relaxation of anal canal.
This procedure does not need any after care except using anal dialaters(if advised) & hygiene of the anal &perineal region along with affirming smooth stools(by lifestyle changes/stool smootheners)... so post operative period is as good as normal life...&result is seen within couple of days.
But sometimes due to overstretching.... fecal incontinence &fltulence were observed... which was due to weak perinium of the patient&over pressure during surgery.
*To combat this... the new version of the surgery ..the Laterral internal spinctorectomy was introduced.. in which lateral muscle fibers of the sphincter on both sides are insised & stitches applied to anal mucosa.
At the cost of cautious care hyginically &restrictions in sitting movements for few days with possibility of infection of the wound... anal dialatation is achieved by cutting the fibers at safer place.so results can be assessed after 8-10 days of postoperative phase.
** In your case breast feeding is the point of your major concern.... from that point of view simple dialatation of anus would be better.( But breast feeding can be given In lying position/position comfortable to you.Even expressed milk can be given to baby in case of need)
** In my view you should consult an anorectal surgeon.He will assess your perineal &general health &advise you whatever is good for you.Be prepared to accept his view &cooperate for surgery.
I hope that satisfies you.Any follow up query is welcome.
Thanksh
Note: For further inquiries on surgery procedure and its risks or complications book an appointment now
Above answer was peer-reviewed by :
Dr. Remy Koshy
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