Hey everyone. I'm new to this forum and I am completely desperate.
I'm a 27 y/o female who has had some GI issues over the past couple of years. I had an anal fissure a few years ago, however, it was resolved without incident. Recently (over the past 6-8 months), I've been having EXTREMELY hard stools when I first have a BM - it is so painful and I usually pass blood with it.. as the BM progresses, however, the stool softens quite a lot such that it is not painful beyond the first 5 minutes (it seriously takes me this long to get it out). The post-BM pain lasts for hours and is so bad that I sometimes find it difficult to sit. I did speak to my doctor a few months ago, and she recommended a dulcolax suppository (to resolve the hard stool that is close to the rectum), as well as Docusate sodium (stool softener). I have trouble with dulcolax because it makes me need to have a BM almost as soon as I put it in. Even if I do hold it for 15 mins, the stool is still very hard and very painful to pass.
I have a relatively good diet - I eat a lot of vegetables and fruit. I also drink a lot of water. I eat foods high in fibre (fibre one cereal, all bran, etc. etc.). I am currently trying some ayurvedic medicine from India (as recommended by an ayurvedic doctor), but this is just to resolve a hemorrhoid, and I don't think it will resolve what is causing the hemorrhoid.
I'm on my last legs here. I'm in so much pain and I am afraid that these hard stools will result in an impaction.
PLEASE HELP ME.

Hey there,
Sorry to hear you are in so much pain. Many of us here use miralax for a stool softener. I started using it after my LIS and it's never let me down.
I used docusate sodium and didn't have very good results. The dulcolax suppository was one of those explosive laxatives for me. I wouldn't use that with a fissure unless I got constipated.
I had the same problem with what seemed to be hard tip stools when I had my fissure. I'm not sure if it was really hard or if it was just the muscle was so tense in the beginning of the bm?!
It sounds like you are eating well. I had problems figuring out what not to eat. Nuts, chips, sharp foods caused much more pain and retears for me. For some dairy can cause harder stools. I avoided all milk and cheese during my fissure except yogurt.
The best advice I can give you is to give the miralax a try and to avoid anything that can make the stools harder as well as keeping up with your water and diet.
Hope this helps and things get better soon:)

For me, docusate was good. It keeps my stool soft with no side effect and easy to take or carry with me. You just need 2 or 3 days until you see its effect.
I tried miralax but it gave me bad bloating so i had to give up on it.
I think some woks for someone but not always to every one.

alpha, No doubt what works for one doesn't work for all. It definitely varies from person to person what will work.
It's surely worth a try:)
I thought I read you were having constipation issues and taking MOM ? Are you taking docusate sodium with the MOM?

Hi all. Thank you for your input. Today was the first "good" day in a long time. I put good in quotations because it's all relative.
I'm not sure what the change was. It's possible the docusate is taking effect. I also had a giant glass of water instead of eating my bfast right away, and decided to squat instead of sitting on the toilet to reduce pressure.
I noticed two things: no bleeding and a much faster, although still painful BM.
I appreciate your input, Dawn and alpha. I am always open to more, if you have any further suggestions.

Welcome Rap - I'm sorry you have to be here! What you describe with BMs is very familiar on this forum. It is frustrating because sometimes taking more stool softeners gets rid of the initial hard stuff, but makes the rest way too loose and watery. The only things that solved that problem for me was Miralax. But Alpha and Dawn are right - what works for one person may not work for another person. That's part of what's so frustrating!
I definitely sympathize. But once you figure out which stool softeners work and in what dosages, things should improve. I hope you find a solution very soon!

Hi Guys;
I have been suffering from anal fissure for the last 2 months. I underwent anal dilation and the pain has reduced. But, now the tip of the stool is hard. I am currently on some ayurvedic laxatives. Shall i try Movicol or magnesium supplements? What dosage should i take and for how long. PLEASE HELP..

This sounds like me a year ago -- the dreaded hard plug that kept me from healing. The harder stool followed by the softer stool. This still happens to me from time to time if I am not careful.

Like others have said magnesium and miralax would be good to try. You want everything to be soft. You can figure out dosage (follow what is recommended on label for miralax and for milk of magnesia, or you cant go wrong with taking 900-1000 mg of magnesium but you will get diarrhea, which sux but is better than hard stool...I take 600-700 mg these days)...dosage also varies based on person and diet -- but as you heal a soft, almost mushy consistency will be helpful. I took so much magnesium I was pooping liquid for a while but I finally got the dosage right and now my poops are almost always formed but SOFT.

Also, I make sure I dont get dehyrdated. I dont drink a ton of water but enough where I usually have to go #1 at least once every 3 hours while I am awake.

I also make sure I have a BM at least once after noon (I always go in the am). This way when I go in the am the poop hasnt been sitting in my colon all day getting hard. I use glycerin suppositories (dipped in vaseline) in the evening if I have to, but taking metamucil 2 x a day has actually helped keep me regularly going once in the afternoon ... it sounds like you are already taking dulcolax suppositories. The suppository might sting a little but it's better than fissure pain.

It also sounds like you are squatting which seems to help; I also found a squatty potty helpful (gravity takes care of it, no pushing needed!)

I am surprised your doctor did not give you any ointment -- like nitroglycerin ointment. This will help accelerate healing if you can get an rx for it.

Good luck and keep us posted on your recovery.

One thing that helped me is "splitting" my colace. Instead of one 100mg pill, I take two 50mg pills: one in the morning and the other late in the afternoon. One-half of an avocado every lunch also seemed to help (because of the magnesium?).