Preganyrelated fissure first trim treatment ester
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anal fissure pregnancy treatment first trimester topical lidocaine laxative guidelines
If you mean an anal fissure in the first trimester of pregnancy, start with conservative treatment:
- Keep stool soft: plenty of fluids, fibre, fruit/vegetables. Your obstetric clinician may recommend a pregnancy-safe stool softener or laxative if constipation continues.
- Warm sitz bath for 10-20 minutes, especially after passing stool.
- Avoid straining and avoid opioid pain medicines, which worsen constipation.
- A clinician may advise a short course of topical lidocaine for pain relief.
Do not self-start nitroglycerin (GTN), diltiazem, botulinum injections, or surgery in pregnancy without review by your obstetrician plus a colorectal/general surgeon. Textbook evidence notes that fissure medicines have not been adequately studied in pregnancy, and botulinum toxin is contraindicated in pregnancy. ASCRS fissure advice supports fibre, fluids, stool softening, sitz baths and topical local anesthetic as first-line measures. Yamada's Textbook of Gastroenterology, 7th ed., Anal fissures section.
Seek urgent care if bleeding is heavy, you have fever, a painful lump/swelling, pus, severe abdominal pain, or dizziness. Please confirm whether you mean an anal fissure and how many weeks pregnant you are.
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