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Gave birth last June. 4th week after while passing stool, felt a tear and sharp pain comes after. When I feel around that area, realised there was a bulge near perineal and there is a skintag dangling

Till now, whenever I went toilet for big business, it gives me the sharp pain and it can last 3 hours or more. I have not went for my 6th week post checkup, as I am quite scared for the doctor to check that area. As for the skintag, i wanted to remove but scared of the pain as well as I can remember how they removed it for my first pregnancy. Is there any way for the skin tag to dropped and is there any cream to subside the bulge/swollen area?
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Dr. Jit F L
Space Doctor
Doctor
1 Streak Score Doctors are able to put a streak together by performing an activity everyday
Hello. From your description you are most likely suffering an anal fissure. This may happen due to hard or large calibre stools, which is common after childbirth. The fissure may or may not be beside the skin tag you mentioned. 
Most anal fissures are treated with medication first. Surgery is uncommon and reserved for those who do not respond to conservative management.
Treatment involves softening your stools, lubricating your anus to ease the passage of stools as well as reducing pain during and after bowel movement. These aims are achieved by ensuring you are well hydrated (drink enough water to be able to pass clear or light yellow urine), have a diet high in fiber and fruits (at least 50% of your diet should be plant-based, with a minimum of 1 serving of fruit/day) and able to exercise regularly (continue your post-delivery Kegel's pelvic floor exercise daily and try to engage in low-impact exercise twice a week). It can be difficult to do these things as you are also busy looking after your newborn. In many cases, you are unable to perform the tasks above or continue to suffer hard stools despite it. If you do not get better within a few days, please consult your family doctor or a colorectal specialist to get medications that can help the fissure heal quickly.
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Dr. Adnaan S
Space Doctor
Doctor
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Hi @Asilamallymkun. Thank you for your question!

Based on your description it does sound like you possibly may have an anal fissure with an associated skin tag. As such, you should not be applying any over the counter medications without consulting a doctor first. I would advise you to see your doctor as soon as possible for management. Most of these conditions are self resolving and the mainstay of management involves (a) management of pain and (b) Changes to diet/stool calibre. 

While waiting for your appointment, i would suggest you start the following
1. High fiber diets
2. Over the counter stool softeners e.g. lactulose
3. Sitz bath - (sitting in a warm bath for at least 20 minutes 3 times a day) 
     > This primarily promotes anal relaxation and allows faster healing

Your doctor may prescribe you with topical antibiotics/topical analgesic medication to help relieve the pain. 

If you do develop worsening pain/increasing swelling over the perianal area/Incontinence/High fever, please do consult a doctor ASAP as these can be signs of a serious infection. 

Hope this helps! 
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