Up to one in ten women develops an anal fissure in the weeks after delivery. It is usually mistaken for hemorrhoids, and it heals well when treated as what it is.
In short: Postpartum fissures are often at the front of the anal canal, caused by the pressure of delivery and the constipation of the first weeks. Soft stools, sitz baths and a sphincter-relaxing cream approved by your physician heal most of them without surgery.
Medically reviewed by Dra. Milagros Carla Quinto Cobeña, Cirugía general, especialista en proctología · CMP 53588 · RNE 30074 · Clínica Proctológica de Lima · Updated 2026-11-01
Why it happens after delivery
The baby's head stretches the perineum and the front wall of the anal canal; episiotomy and tears add to it. Then come days of constipation from fear of pain, iron supplements and dehydration. The hard first stools tear the weakened anoderm. Because the tear is anterior, pain may be felt near the vagina and attributed to the stitches.
How to treat it while breastfeeding
Psyllium and water from day one; a stool softener such as polyethylene glycol is compatible with breastfeeding.
Sitz baths also soothe the episiotomy.
Topical nifedipine or diltiazem has minimal systemic absorption; most physicians allow it during breastfeeding, but it must be prescribed. Nitroglycerin is usually avoided because of headaches.
Pelvic floor physiotherapy after week 6 reduces recurrence.
When to see a colorectal surgeon
If pain or bleeding continues beyond 3 weeks, if there is a lump or discharge, or if you notice difficulty holding gas or stool. Obstetric injuries to the sphincter need a specific assessment.
Frequently asked questions
Can I use FISURIN while breastfeeding?
Only with your physician's prescription. Absorption of topical nifedipine and lidocaine is very low, but the decision is individual. Our surgeons assess it in consultation.
This content is educational and does not replace a medical consultation. FISURIN is a magistral (compounded) formula prepared under prescription in an authorized pharmacy; availability and regulatory status vary by country. If you have bleeding that does not stop, fever, or pain that worsens, seek medical care without delay.
