Chronic Anal Fissure in Pregnancy or While Breastfeeding
Treating a chronic anal fissure in a woman who is pregnant or breastfeeding requires careful consideration of which nonsurgical therapies are appropriate for both mother and infant.
Clinical Situation
Prescription of nonsurgical treatments in female patients with a chronic anal fissure who are pregnant or breastfeeding may be considered with caution.
Treatment Approach
A specific topical therapy — chosen for its established safety profile in pregnancy and lactation — is recommended as first-line treatment, with defined precautions to minimise infant exposure during breastfeeding.
References
DOI: 10.1111/codi.167
Prescription of nonsurgical treatments in female patients with a chronic anal fissure and who are pregnant, or breast feeding may be considered with caution.
The British National Formulary (BNF) states that GTN is not known to be harmful in pregnancy or lactation and has the most data to support its safety.
It should probably therefore be used as first line therapy in these patients.
With all use of topical treatments mothers should be advised to wash hands immediately after use of a topical product to avoid contact of medication with the infant and avoid breastfeeding for 1–2 h after use.
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