I have external hemorrhoids and anal fissure. I increased my fiber, so stool is softer now. But, I just feel that I cannot pass my stool without pushing.

I tried squatting, but it still felt stuck. fearing sitting on toilet too long, pushed and my stool went through, but the usual 7 hours of pain follows.

Suggestions? Should I wait longer? More stool softener? Help!!

On a personal level, I find squatting does not help me. I tend to sit upright on the loo and very gradually express the motion ( I cant put it any more dainty than that, so excuse me !! ). Another thing I have done is to get some KY jelly and just rub a little around the anal ring before passing the stool. It may be psychological but it helped me

How long is gradually? I'm concerned that sitting on toilet too long worsening my hemorrhoids. Basically, any longer than 3-4 minutes, and I give up and push. Should I wait longer? What happens if there's BM, but I feel there's still some left? Should I wait or push?

You could try glycerin suppositories to induce a stronger urge, which will require less pushing. Another option is a gentle water enema, to soften things up a bit. Instead of pushing down, sit with your feet on a small footstool, breath in and out deeply, and let your diaphragm do the work. You can also try breathing out into a closed fist. Hope this helps!

Gradually is for about a few minutes. I always think it best to push if I know there is more to express, as I have found that on average I go once per day. I think that if you go multiple times you may well get discomfort and slower healing. its very individualized I know. Glycerine suppositories are a great option

Sliu,

You must get the input right for the output to be right.

Ideally you need to "be rushing to the toilet". Not diahorea but just one step prior to it. As soon as you hit the toilet seat it should just fall out of you. That is what I aim for. Drink loads of water. Try 200ml of prune juice with every meal. Eat about 10 prunes prior to breakfast (tinned ones). Put a dollop of yogurt on the prunes if you don't like the taste.