Brief Answer:
Need a clinical examination by a general surgeon.

Detailed Answer:
Hi XXXX! Good morning. i am Dr Shareef answering your query.

Please do not be sorry for anything. It is good that you have frankly described your problem to a doctor, which you should do whenever you visit a doctor in your area, which might be required in your case.

From your history, it seems that you have developed either a chronic fissure in ano with an external skin tag ( healed acute fissure with recurrent injuries ) or a full formed hemorrhoids due to passage of hard stool and also due to the pressure of the fetus on the pelvic veins which not infrequently happens during pregnancy which could be diagnosed only by a clinical examination.

If I were your doctor, I would first examine the area clinically, and after confirming that it was a fissure or a hemorroid , would go for some anti inflammatory drug (for your discomfort) along with a proton pump inhibitor, a broad spectrum antibiotic, and a stool softener like lactulose liquid at bed time along with an anti hemorrhoidal cream locally. Add sitz bath to it (sitting on a XXXXXXX warm water filled tub) three to four time a day for five minutes each. I am hopeful that you would get relief with this strategy, but I am afraid it would return if constipation (hard stool) occurs again for you. Therefore, to prevent the constipation, please avoid high protein diet, add a lot of roughage and fresh fruits along with sufficient liquids. Go for a regular exercise programme like a keggel exercises and morning walks.

Usually hemorrhoids occurring during the period of pregnancy goes off of its own once the pressure of the fetus is off from the pelvic veins post delivery. The same prognosis holds good for a fissure as well with a conservative management unless it becomes a chronic fissure. However, considering the long duration post delivery (14 months) and your persisting discomfort so much so that you had to avoid social functions, I feel that some intervention would be required if your discomfort did not subside after trying all the above measures stated by me. And in that case, I would recommend you to visit a general surgeon in your area for a clinical examination of the lesion for a certain diagnosis and further management of your problem.

I hope this information would help you in discussing with your family physician/treating doctor in further management of your problem. Please do not hesitate to ask in case of any further doubts.

Thanks for choosing health care magic to clear doubts on your health problems. Wishing you an early recovery. Dr Shareef

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Brief Answer:
It was a pleasure.

Detailed Answer:
Never mention. It was a pleasure answering your query. If there is no other query, it would be nice if you could please rate the answer. Thanks. Dr Shareef.

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