Anorectal symptoms during pregnancy and postpartum: a prospective cohort study

Dorreman, Yaliva; Roelens, Kristien; Ceelen, Wim; Looze, Danny De

doi:10.1111/codi.14324

Cited by 39 publications

(48 citation statements)

References 18 publications

(45 reference statements)

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“…In a recent study, where anal symptoms and risk factors were evaluated up to 3 months postpartum, two‐thirds (61%) of women had constipation during pregnancy and postpartum. In that study, two‐thirds (68%) of women developed anal symptoms and constipation was major risk factor for anal problems, of which haemorrhoidal complications and anal fissure were the most common 24 . In pregnant women, counselling should be provided, with appropriate advice on how to prevent and treat constipation.…”

Section: Discussionmentioning

confidence: 96%

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Pregnancy, puerperium and perinatal constipation – an observational hybrid survey on pregnant and postpartum women and their age‐matched non‐pregnant controls

Kuronen

Hantunen

Alanne

et al. 2020

BJOG

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Objective To evaluate the prevalence of constipation during pregnancy and early puerperium. Design Observational survey. Setting Secondary and tertiary hospital in Finland. Population Pregnant (n = 474) and postpartum (n = 403) women and a control group of 200 non‐pregnant women who did not give birth in the past year. Methods Women reported bowel function and other gastrointestinal symptoms on a structured questionnaire using an 11‐point numerical rating scale (0 = no symptom, 10 = most severe symptom) and binominal yes/no questions during the second and third trimesters and few days and 1 month after childbirth. Main outcome measure Prevalence of constipation based on the Rome IV criteria. Results The data consist of five cohorts of women: second trimester (n = 264), third trimester (n = 210), after vaginal delivery (n = 200) or caesarean section (n = 203), and a control group (n = 200). The prevalence of constipation was 40% in pregnant women and 52% (P < 0.001) in postpartum women, which was a higher prevalence than that in the control group, where 21% had constipation (P < 0.001). A few days after delivery, the prevalence of constipation was lower after vaginal delivery (47%) than caesarean section (57%, P < 0.039). One month postpartum, the prevalence of constipation was low: 9% after vaginal delivery (P = 0.002 compared with the control group) and 15% after caesarean section. Other gastrointestinal symptoms were common; pregnant women had the highest prevalence (34%) of nausea/vomiting. Conclusion The prevalence of constipation was two‐ to three‐fold higher in pregnant women and a few days after delivery than in non‐pregnant women. During puerperium, bowel function returned to or below that reported in non‐pregnant women. Tweetable abstract Constipation is common in pregnancy and after delivery, but bowel function returns early in puerperium.

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Section: Discussionmentioning

confidence: 96%

“…In that study, two-thirds (68%) of women developed anal symptoms and constipation was major risk factor for anal problems, of which haemorrhoidal complications and anal fissure were the most common. 24 In pregnant women, counselling should be provided, with appropriate advice on how to prevent and treat constipation.…”

Section: Discussionmentioning

confidence: 99%

Pregnancy, puerperium and perinatal constipation – an observational hybrid survey on pregnant and postpartum women and their age‐matched non‐pregnant controls

Kuronen

Hantunen

Alanne

et al. 2020

BJOG

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“…Conceptually similar work has been carried out by another author in which the mean age of AF is 40.13 years. 20 The reason is not well defined. However, muscle tone in the middle age persons are comparatively a higher in tonicity which may oppose the passage of hard stool and will result in the formation of fissure.…”

Section: Discussionmentioning

confidence: 99%

Prevalence and Seasonal Pattern of Anal Fissure in Rural Hospital of Nepal

Menyangbo

Bhatta²,

Subedi

2020

J. KIST Med. Coll.

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Introduction: Anal Fissure (AF) is a longitudinal tear in the epithelium of the anoderm within the anal canal. It is associated with symptoms of severe anal pain and rectal bleeding. While searching for literatures on AF prevalence in Nepal, there were hardly any systematic published studies except a few studies that mostly focused in the treatment and outcome of the disease. The objective of the present study is to report on AF prevalence with its seasonal pattern among anorectal disorder patients from this rural part of Nepal. Methods: This was a retrospective cross-sectional study from June 2015 to March 2020 at the Karnali Academy of Health Sciences. The demographic characteristics features of anal fissure were recorded. Cases included all hemorrhoids, perianal abscess and fistula in Ano with a bleeding history. Previous fistulectomy, biopsy-proven tuberculosis and malignancy were excluded. Statistical analysis was performed using SPSS 16. Results: A total of 1768 patients with ano-rectal disorders visited surgical outpatient department OPD) during the study period. Of 1768 patients, 415 patients (23.47%) had anal fissures. The mean age of patients was 29.02±13.58 years. There were 176 male patients (42.4%) and 239 (57.6%) patients were female. The majority (n=148; 35.7%) of patients were in the group 20 to 29 years. Most of the patients with anal fissure visited during winter time (42.7%). Conclusion: Anal fissure is common anorectal problem, with slight female predominance. The majority was found to affect the adolescent group

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“…While the most common disease among these lesions is haemorrhoids, the second disease is anal fissure. [4] The main cause of these lesions has been shown as injury to the anal mucosa due to constipation. In addition to the most common risk factor being constipation, it has been emphasized that the birth weight of the child, the time elapsed during the termination of pregnancy and perianal diseases are also important.…”

Section: Introductionmentioning

confidence: 99%

Do obstetric factors have an effect on success of medical treatment of anal fissure seen in women?

Bolat

Çakmak

2021

Journal of Contemporary Medicine

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The aim of this study is to examine the effect of obstetric factors on the medical treatment success of anal fissure in women. Material and Method:A total of 324 women, who were diagnosed with anal fissure, who applied to the General Surgery outpatient clinic between 2015 and 2020, were included in the study. The patients were divided into two groups; group I (medical treatment was successful) and group II (medical treatment failed -surgery performed). Both groups were compared in terms of age, body mass index (BMI), number of births, delivery type, birth weight, breastfeeding rate, constipation, diarrhea, smoking and anal fissure symptoms.Results: Medical treatment was applied to all of the 324 patients we included in our study, and it was observed that 45.7% of them had successful medical treatment and 54.3% had undergone surgical treatment (lateral internal sphincterotomy) because of unsuccessful medical treatment. It was found that age, BMI, number of births, number of vaginal births, breastfeeding rate, constipation rates were higher in those who failed medical treatment (p<0.05). The number of cesarean sections, birth weight, diarrhea and smoking were found to be similar between the two groups (p>0.05). While gas incontinence was observed in 44.1% of those who underwent surgical treatment, this rate was found to be 1.4% in those who benefited from medical treatment. Conclusion:In our study, it was found that while maternal age, number of births, vaginal delivery and breastfeeding rates had a negative effect on the success of anal fissure medical treatment, cesarean delivery and baby birth weight were not effective.

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Anorectal symptoms during pregnancy and postpartum: a prospective cohort study

Abstract: Two-thirds of pregnant women have anal symptoms during pregnancy and postpartum, especially haemorrhoidal complications and anal fissure. The most important risk factor is constipation. The prevention of constipation in pregnant women is therefore highly recommended.

Cited by 39 publications

References 18 publications

Pregnancy, puerperium and perinatal constipation – an observational hybrid survey on pregnant and postpartum women and their age‐matched non‐pregnant controls

Pregnancy, puerperium and perinatal constipation – an observational hybrid survey on pregnant and postpartum women and their age‐matched non‐pregnant controls

Prevalence and Seasonal Pattern of Anal Fissure in Rural Hospital of Nepal

Do obstetric factors have an effect on success of medical treatment of anal fissure seen in women?

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