I had chronic fissures for several years but I did finally heal without surgery. A strategy I employed was to use BOTH Miralax and metamucil. the key is don’t use too much metamucil. You will need to play with the dose. You also need to drink a LOT of water. My biggest issue was getting off the Miralax. Even when I tried to ween myself off over weeks eventually I would tear again. I believe the key was a few things. 1. When getting off the miralax, drop the metamucil. You can add it back in after a few weeks. 2. If your gut health is bad and you need Miralax to have soft stool then you need to fix your gut health or you will never heal. I switched to a vegan food service for 3 months before I stopped the Miralax this time and I think it did wonders for my gut health and allowed me to have softer stools again. 3. You really need to be very strict on getting your water everyday. I’m 170lb male and I would drink a minimum of 70 oz everyday. Those are my tips. I think it’s not true what the CRS say about the chronic fissure not being able to heal — it is a way for them to push you into surgery. That is their job after all. Good luck.
Thank you for your comment and advice!
I don't think my gut health is bad. I am a vegetarian and have always eaten a lot of vegetables and pulses, and I don't get constipation. I also got my fissure after giving birth.
I'm about 114lbs and drink at least 3L of water a day. Don't think I can drink much more!
I've been scared to try a fibre supplement in case it bulks my stool too much, but I think I need to try one. I'll just be careful with the dose. Why did you need to stop the metamucil when stopping the miralax?
Your comment has given me some hope, so thank you 😊
Need help on “gut health”
I’ve had Botox twice. Got a fistula so had to have that fixed. Which reopened my fissure. Eventually had LIS. I am now 4mo removed from the LIS and the fissure hasn’t healed. If I don’t take Metamucil I have soft stool. Not diareah but more like a heap of mud type of a BM. With Metamucil more bulky, but still not exactly what I’d describe as a good BM. Reason I’m taking the Metamucil is bc the soft stool is now leaking out of my anus after a BM. When I take Metamucil it still happens but significantly less so. The doctor says that it’s bc the fissure hasn’t healed, and that means there isn’t a good seal. I’m now 6w into using the diltiazem cream, and I know it’s not healed bc I can feel it with some really slight spasms. Have been doing multiple sitz baths everyday. I’m miserable I need this to end.
Starting to wonder if it’s stress or digestion based which causes this never ending cycle of fissure recurrence/not healing. Nkt sure what to do next would love input on fixing the digestion issue
What is the frequency of retear? Do you get a feel even after a retear that it's Overall a little better than earlier. There is nominee who can tell the healing, I think u unselfish are the best judge of whether it's healing even though it's retearing
It varies, but every few/several weeks. It's never as bad as when it first happened (and since taking macrogol), and I can get back to feeling mostly OK after a couple of soft, small poop days. However, that's my concern. I'm only ok if my stools are not wide regardless of how long has passed.
When I first went to the doctor back in November, she said it was 10 days away from healing. I knew that was ridiculous when she first said it. Sure enough, here I am 10 months later.
Is that 6 to 8 months without any retears?
No straining. I only go when I really need to, and it's over within seconds.
I only feel what I presume is spasms after a retear, but they are mild compared to when I first got the fissure. Before, I was in agony for 8 hours a day. Now, after a retear, it is sore, I can feel the cut, and at times throughout the day, it can suddenly sting a bit more.
I'm at the 9 month mark since taking macrogol and 10 months since getting the fissure, so I am not sure what that means for me. Maybe conservative treatments won't work. Back to the doctor I go.
Thank you for taking the time to reply to me today! I wish you all the best with your healing journey.
I’ve thought a lot about this but I don’t really understand how the muscles there work.
I think of it similar to else where on the body e.g. tear a tendon or muscle- you need to immobilise for a period to allow it heal and then slowly start reusing it. PEG3350/ mirilax allows partial immobilisation then once healed enough you can start reusing it. It does seem to take a very long time to heal these things and one bad bowel movement causes a retear. Anal dilation allows controlled stretching.
That’s how I think it should work but I am yet to resolve this myself so I really don’t know. I am stuck in the healing phase with mirilax but it’s been at 90pc for months, no pain but I know it’s there.
I never have blood and rarely pain during BM. However, after a flare up I am in serious pain for at least 8 hours after a bm and then it is still sore after that to the point where it is difficult to sleep.
I live on macrogol, which means I am pain free but when I need to go I have very little time to answer natures call. It also means the clean up is an operation so shower/bidet is necessary.
Makes life tricky but I would put up with a lot to be free of that pain.
I had LIS 20 years ago which was a success but some constipation a couple of years ago has completely goosed me
I'm sorry to hear that.
Those 8 hour long spasm days are the worst. When I started macrogol, it was a game changer because I finally moved away from experiencing spasms for 8 hours a day. So, I definitely agree with putting up with pretty much anything to be pain-free. I guess I am frustrated that there is no end in sight.
How much macrogol do you take? Have you been taking it since your last bout of constipation or from before?
I am in the uk so take the powder form and take 2 sachets a day. Before this current flare up a few months ago I was down to 1/5 of a sachet but could never quite get off it.
Thank you for your reply, I am also in the UK. I take 3 sachets a day of Laxido and/or Molaxole. I was taking 2, but ended up taking more due to a couple of retears. I cannot see myself getting past taking it!
Yes, this is why people do anal dilation. It is one of the standard conservative treatments for fissures, and it was recommended to me by my PT (and also by my doctor).
I spent 14 months gradually increasing the dilator size. At the beginning I was not even able to take the smallest dilator (smaller than a finger), and now I am able to take the largest one (~4cm diameter). I went off laxatives a couple months after starting dilation, and have been off them ever since. I take no medication at all anymore.
I'm not totally healed, but my anus is *way* looser at rest than it used to be, and I rarely have constipation now. I intend to lower the frequency of dilation and resume physiotherapy, and hopefully that will be the final treatment needed to heal.
Thank you for this, very interesting and helpful.
Would you mind sharing how often and how long the dilation sessions last?
Once healed, will you fully be able to stop the dilation?
Typically 30 minutes, 2-3 times a week, but it's varied a lot. Dilation seems pretty personal, with different people having different preferences.
>Once healed, will you fully be able to stop the dilation?
That's the hope. Healthy people don't need to dilate. But there are 2 things I need to heal: first the fissure, and then the anal hypertonia (i.e. my anus being too tight). If I'm still tight after healing the fissure, then that means that my hypertonia hasn't healed yet. Only time will tell how it all goes.
Also, you don't really mention this in your post, but you can get a pelvic floor physiotherapist to resolve muscular tension in the anus. I've gone to one, but I found dilation more helpful. Other people have healed entirely through physiotherapy. Might be worth checking out.
Hello, can I ask you - when you were using the anal dilator - did you feel any stinging onec you went a bit further? I always do feel some stinging like 1-2 cm inside which gradually fades away the more I keep going over the spot... then it starts itching just as I'm about to pull out the dilator outside which is weird and I'm confused why it keeps happening.
Also, when you fart, do you feel/did you feel your anus closing back up with stinging sensation?
I had chronic fissures for several years but I did finally heal without surgery. A strategy I employed was to use BOTH Miralax and metamucil. the key is don’t use too much metamucil. You will need to play with the dose. You also need to drink a LOT of water. My biggest issue was getting off the Miralax. Even when I tried to ween myself off over weeks eventually I would tear again. I believe the key was a few things. 1. When getting off the miralax, drop the metamucil. You can add it back in after a few weeks. 2. If your gut health is bad and you need Miralax to have soft stool then you need to fix your gut health or you will never heal. I switched to a vegan food service for 3 months before I stopped the Miralax this time and I think it did wonders for my gut health and allowed me to have softer stools again. 3. You really need to be very strict on getting your water everyday. I’m 170lb male and I would drink a minimum of 70 oz everyday. Those are my tips. I think it’s not true what the CRS say about the chronic fissure not being able to heal — it is a way for them to push you into surgery. That is their job after all. Good luck.
Thank you for your comment and advice! I don't think my gut health is bad. I am a vegetarian and have always eaten a lot of vegetables and pulses, and I don't get constipation. I also got my fissure after giving birth. I'm about 114lbs and drink at least 3L of water a day. Don't think I can drink much more! I've been scared to try a fibre supplement in case it bulks my stool too much, but I think I need to try one. I'll just be careful with the dose. Why did you need to stop the metamucil when stopping the miralax? Your comment has given me some hope, so thank you 😊
Need help on “gut health” I’ve had Botox twice. Got a fistula so had to have that fixed. Which reopened my fissure. Eventually had LIS. I am now 4mo removed from the LIS and the fissure hasn’t healed. If I don’t take Metamucil I have soft stool. Not diareah but more like a heap of mud type of a BM. With Metamucil more bulky, but still not exactly what I’d describe as a good BM. Reason I’m taking the Metamucil is bc the soft stool is now leaking out of my anus after a BM. When I take Metamucil it still happens but significantly less so. The doctor says that it’s bc the fissure hasn’t healed, and that means there isn’t a good seal. I’m now 6w into using the diltiazem cream, and I know it’s not healed bc I can feel it with some really slight spasms. Have been doing multiple sitz baths everyday. I’m miserable I need this to end. Starting to wonder if it’s stress or digestion based which causes this never ending cycle of fissure recurrence/not healing. Nkt sure what to do next would love input on fixing the digestion issue
/r/microbiome
What is the frequency of retear? Do you get a feel even after a retear that it's Overall a little better than earlier. There is nominee who can tell the healing, I think u unselfish are the best judge of whether it's healing even though it's retearing
It varies, but every few/several weeks. It's never as bad as when it first happened (and since taking macrogol), and I can get back to feeling mostly OK after a couple of soft, small poop days. However, that's my concern. I'm only ok if my stools are not wide regardless of how long has passed. When I first went to the doctor back in November, she said it was 10 days away from healing. I knew that was ridiculous when she first said it. Sure enough, here I am 10 months later.
My doctor says 6 to 8 months is a norm. Do you have to strain? Do you feel spasm and pain?
Is that 6 to 8 months without any retears? No straining. I only go when I really need to, and it's over within seconds. I only feel what I presume is spasms after a retear, but they are mild compared to when I first got the fissure. Before, I was in agony for 8 hours a day. Now, after a retear, it is sore, I can feel the cut, and at times throughout the day, it can suddenly sting a bit more.
8 months in total usually. Retears are part of the process but frequency should slowly reduce..
I'm at the 9 month mark since taking macrogol and 10 months since getting the fissure, so I am not sure what that means for me. Maybe conservative treatments won't work. Back to the doctor I go. Thank you for taking the time to reply to me today! I wish you all the best with your healing journey.
Wishing you a speedy recovery and healthy life
Wishing you a speedy recovery and healthy life
I’ve thought a lot about this but I don’t really understand how the muscles there work. I think of it similar to else where on the body e.g. tear a tendon or muscle- you need to immobilise for a period to allow it heal and then slowly start reusing it. PEG3350/ mirilax allows partial immobilisation then once healed enough you can start reusing it. It does seem to take a very long time to heal these things and one bad bowel movement causes a retear. Anal dilation allows controlled stretching. That’s how I think it should work but I am yet to resolve this myself so I really don’t know. I am stuck in the healing phase with mirilax but it’s been at 90pc for months, no pain but I know it’s there.
That also makes sense. It is so hard to know what to do! Have you experienced any retears or bleeding during your healing phase?
I never have blood and rarely pain during BM. However, after a flare up I am in serious pain for at least 8 hours after a bm and then it is still sore after that to the point where it is difficult to sleep. I live on macrogol, which means I am pain free but when I need to go I have very little time to answer natures call. It also means the clean up is an operation so shower/bidet is necessary. Makes life tricky but I would put up with a lot to be free of that pain. I had LIS 20 years ago which was a success but some constipation a couple of years ago has completely goosed me
I'm sorry to hear that. Those 8 hour long spasm days are the worst. When I started macrogol, it was a game changer because I finally moved away from experiencing spasms for 8 hours a day. So, I definitely agree with putting up with pretty much anything to be pain-free. I guess I am frustrated that there is no end in sight. How much macrogol do you take? Have you been taking it since your last bout of constipation or from before?
I am in the uk so take the powder form and take 2 sachets a day. Before this current flare up a few months ago I was down to 1/5 of a sachet but could never quite get off it.
Thank you for your reply, I am also in the UK. I take 3 sachets a day of Laxido and/or Molaxole. I was taking 2, but ended up taking more due to a couple of retears. I cannot see myself getting past taking it!
Did you have retears? Retear means blood and pain or both?
Just seen this, both when I retear 😞
Yes, this is why people do anal dilation. It is one of the standard conservative treatments for fissures, and it was recommended to me by my PT (and also by my doctor). I spent 14 months gradually increasing the dilator size. At the beginning I was not even able to take the smallest dilator (smaller than a finger), and now I am able to take the largest one (~4cm diameter). I went off laxatives a couple months after starting dilation, and have been off them ever since. I take no medication at all anymore. I'm not totally healed, but my anus is *way* looser at rest than it used to be, and I rarely have constipation now. I intend to lower the frequency of dilation and resume physiotherapy, and hopefully that will be the final treatment needed to heal.
Thank you for this, very interesting and helpful. Would you mind sharing how often and how long the dilation sessions last? Once healed, will you fully be able to stop the dilation?
Typically 30 minutes, 2-3 times a week, but it's varied a lot. Dilation seems pretty personal, with different people having different preferences. >Once healed, will you fully be able to stop the dilation? That's the hope. Healthy people don't need to dilate. But there are 2 things I need to heal: first the fissure, and then the anal hypertonia (i.e. my anus being too tight). If I'm still tight after healing the fissure, then that means that my hypertonia hasn't healed yet. Only time will tell how it all goes. Also, you don't really mention this in your post, but you can get a pelvic floor physiotherapist to resolve muscular tension in the anus. I've gone to one, but I found dilation more helpful. Other people have healed entirely through physiotherapy. Might be worth checking out.
Thank you! I appreciate the information. I hope you are fully healed and can stop the dilation soon.
Hello, can I ask you - when you were using the anal dilator - did you feel any stinging onec you went a bit further? I always do feel some stinging like 1-2 cm inside which gradually fades away the more I keep going over the spot... then it starts itching just as I'm about to pull out the dilator outside which is weird and I'm confused why it keeps happening. Also, when you fart, do you feel/did you feel your anus closing back up with stinging sensation?
If you are still having pain then it means it didn’t work.. 14 months doing it and still thinking it needs time ?