Causes and Treatment of Postpartum Anal Fissures and Hemorrhoids

Nausea, varicose veins, carpal tunnel, constipation, and the little kicks can be a bit uncomfortable for a postpartum mother. But, no one prepares a new mother for the hellish experience that they may pass through due to anal fissures or hemorrhoids.

“Aren’t hemorrhoids the same as anal fissures?” You might wonder. The answer is that they’re not. Their symptoms might be so similar, but they are two entirely different issues. Let me break this down for you.

What are Hemorrhoids?

Hemorrhoids are a condition where the veins in the rectum and anus swell, making it hard for you to pass stool.

What is the connection between childbirth and hemorrhoids, since hemorrhoids affect the anus and rectum?

To answer this, let’s look at the causes of postpartum hemorrhoids.

What Causes Postpartum Hemorrhoids?

During pregnancy, the veins in the anus and rectum expand simultaneously. Since the anal and rectal areas are elastic and expand, the veins also stretch and expand.

The blood vessels in these regions weaken so much that they cannot, making it hard for them to contract in sync with the rectal tissues. As such, they are left looking like the image below.

There are two types of hemorrhoids:

1.      External Hemorrhoids

External hemorrhoids are highly sensitive and develop on the outer tissue of the anus. In some cases, blood clots might form on the anal outer tissue, making you experience excruciating pain.

Preliminary research argues that the contributing factors to external hemorrhoids are:

• Chronic diarrhea
• Straining when pooping
• Constipation

Since the anal region gets delicate after delivery, you are likely to experience excruciating pain if you develop constipation or diarrhea.

2.      Internal Hemorrhoids

Internal hemorrhoids are less sensitive and develop in the lower part of the rectum. You might never even know that you have hemorrhoids if they grow on the inside. However, in some instances, you might see blood in your poop. This occurs if the hemorrhoids have been triggered by diet or stomach upsets. In rare cases, the hemorrhoids might protrude so much that they fall to the anus, becoming so painful.

What are the Symptoms of Hemorrhoids?

You might ask yourself, “How can I know if I have hemorrhoids?”

If you are suffering from hemorrhoids, you will have these symptoms:

• A hard tender lump or swelling around the anal orifice.
• Regular or random pain in the anus.
• Blood in the stool.
• Pain when passing stool.
• Itching of the anus.

What are Anal Fissures?

Now, here is what you have been waiting for or never known about anal fissures. An anal fissure is a condition that is caused by trauma on the inner lining of your anus.

How can trauma cause anal fissure? You might ask yourself.

What Causes Anal Fissures?

Tight sphincter muscles, diarrhea, or constant constipation cause the anal tissues to tear, creating “fissures”. The fissures cause excruciating pain which might leave you not only with tears but sweat too.

Sitting down, walking, laughing, and pooping all trigger the rectal muscles to spasm. This reduces blood flow to the injured area, harming you more.

The most common symptoms of anal fissures are:

• Bright red blood on the stool.
• Severe pain during bowel movements.

What are the differences between Hemorrhoids and Anal Fissures?

These are the major differences between hemorrhoids and anal fissures.

Hemorrhoids	Anal Fissures
The pain lasts throughout the day.	The pain is only experienced during bowel movements.
They can be treated using a non-invasive procedure.	They do not require any surgery; stool softeners and a high-fiber diet are enough.
They are caused by swelling of veins in the anus& rectum.	They are small tears on the anus.

 How to Treat Hemorrhoids and Anal Fissures

Most doctors recommend conservative approach treatment options, including, but not limited to, at-home care. Although the two conditions are different, their symptoms are similar.

As such, the doctor might recommend these treatments.

A.      Conservative Treatment

Conservative treatment is the first choice for most new mothers struggling with hemorrhoids or anal fissures. The treatment might include the use of:

• Creams- Creams and ointments suppress muscle spasms, and reduce itching, helping you recover quickly.
• Tucks pads- Tucks pads are infused with irritation suppressors to help in managing fissures.
• Sitz Bath- You warm water and sit on it for several minutes each day to relax the tissues.  With time, the pain goes away and the tissues around the rectum and anus relax.

If the conservative treatment does not work, your doctor might recommend a surgical procedure to manage hemorrhoids.

These are the most common surgical procedures that the GYN/OB or gastroenterologist will recommend:

B.      Cutting off blood supply for level one and two hemorrhoids.

In this case, OB/GYN, or gastroenterologist uses SapiMed ligator to apply elastic bands to the hemorrhoid, cutting off blood supply. After a few days, the hemorrhoid falls off.

C.      Intensive Surgical Procedure for levels three and four

In this case, the surgeon will use a NeoLaser to break down the veins supplying blood to the hemorrhoid, making the tissue fall off.

Bottom Line

Hemorrhoids and fissures are a nightmare to new mothers and they cause untold suffering. You should not let them weigh you down.

 Taking soft meals, drinking at least eight glasses of water daily, and avoiding straining too much in the toilet are the best ways to avoid anal fissures.

Should you suspect you have hemorrhoids or anal fissures, visit a healthcare practitioner soonest possible.