I've been doing well lately. Yesterday was the first time i saw blood on my toilet paper for 2 months. All because I tried to lower my dosage of miralax by half. I've been taking a full dose of miralax for 4 months now. For the past 2 months I thought my AF was healed, so I cut my miralax dosage in half and 2 days later my BM's are hard again and I had some mild pain and trace amounts of blood on my toilet paper, so I decided to go back to the full dose and try it again. I told my sister about it, who is a doctor and she warned me against prolonged usage of stuff like miralax cause it prevents your body from pulling water from your bowels when it needs it. My question to you guys is: what's the longest any of you have been taking miralax continuously? I thought I would only have take it for 4 months cause my AF was healed, but I'm back to square 1 again and will have to take it for at least a few months more. But now I'm thinking I might have to take this for the rest of my life. What do you guys think?

My doctor told me at Mayos that I would have to be on Miralax for the rest of my life. He told me that b/4 I even started taking it. I do think the body can learn to rely on it. But I also think it is safe as all my docs have told me that (unlike the stimulant laxatives). Personally, I would prefer to have my digestive system work (and live a normal life) and take Miralax than have an AF!! They give Miralax to babes, so it can't be too harmful. But if you really dislike taking it, you could try to keep increasing your fiber amount as you decrease your Miralax. I read once about doing that. If I can find the link for that, I'll repost it!

I agree with you Cherylk. I also take miralax daily and benefiber. I would much rather have my body working correctly and be able to go on with my life than to have to worry every single time I had the urge to go to the bathroom. I've seen a number of doctors and all of them said miralax is safe to use daily. I tried just using fiber and increasing my liquids but it didn't help me and my fissure got worse. I did that on my own for over 4 months until I was introduced to the miralax. I just wish I would have taken it sooner. I've had the LIS surgery and on the adivse of my doctors I continue to take miralax. I like it because it doesn't have a taste and is completely adjustable. If you get a little stressed out and you start to have a harder stool you can take a little extra and get back on track. Suzy

I, also, which I had taken Miralax sooner, Suzy. I thought I was destined to be forever constipated, which is not a good way to be!!!!!

how much do folks take. i take around 1 and half packets per day, gives me a good formed but soft bm 6/7 day aweek...
movicol 4ever

I take about 1 1/4 packets daily (varies slightly).

here's and update on me: I had blood-free bm's for 2 months, mainly cause I stopped eating any cheese and i take a full dose of miralax daily. However, I have noticed that since my AF healed, it feels like my internal sphincter is permanently tight. I would never be able to pass stools as thick as I was able to a year ago. So i went to the doc and she tried sticking her finger up there, and i told her it was too tight and she jammed it up there and made it bleed for the first time in months :(
She wants do do the crohns disease colonoscopy, but i told her I didn't want to do that because it would make my AF worse, and I know I dont have that disease. So anyway, It has been 2 weeks since that doctor visit. Currently I have no bloody stools, very little pain, a small amount if itching, no spasms, a bottle of nifedipine, and a very tight sphincter. (like passing a bm wider than my index finger would be considered huge)
what should I do? My doc doesn't believe in LIS unless drastic measures. She said she could try botox on me. I could try to get referred to another doctor. or in 10 months I can leave kaiser permanente altogether.

I would try to see another doctor!!

Hey Nebel,
I take about 2/3 to 1 full dose of Miralax a day. I usually adjust it based on what I ate that day. If I ate fruits and veggies all day, then 2/3 of a dose is usually enough. If I ate things containing meat or junkier foods like potato chips, then I go with a full dose. I'm resigned to taking it forever or at least for a long time. I don't care what I have to do to avoid another fissure, whatever works, I'm doing it!
For your case I don't think a referral to another doctor would be a bad idea, but to be honest, I think the options are pretty much limited to nitro/nifedipine/diltiazem, BOTOX, and LIS no matter who you see.
I was a in a similar position as you a few months ago and personally opted for nitro and BOTOX. My original two fissures healed up about 2 months after BOTOX but now I have some other rectal pain (described in my other thread today) and don't know if it's due to a new fissure or a hemorrhoid. For what it's worth, my sphincter remained tight for a while after the acute fissure pain stopped but the tension slowly decreased with time and continued use of nitro.
Anyway I think it's going to be a personal call depending on how much it's bothering you and how you feel about BOTOX versus LIS. If it's real bothersome then most people have gotten much better results from LIS. If it's just a minor nuisance then I don't see what there is to lose by trying BOTOX -- my opinion only, I know others have differing opinions on the matter.
BTW I had a colonoscopy done when my fissure was pretty bad. The colonoscopy was incomplete due to some non fissure related complications, but it didn't bother my fissure very much. So I wouldn't let that stop you from considering doing it just for some peace of mind.

Hi Nebel,

Sounds like you need LIS to permanently relax that horrible muscle, you should see a different doctor and state that it's your body and you want what's right for it/you, only you know how you feel.
In the meantime i'd keep on a strict regime of stool softeners, plenty of water (average 2L p/day) fresh fruit, boiled or steamed veg, bran and definitely no cheese or red meat, basically that's the regime i'm on, as for stool softeners i'm taking Dioctyl capsules 4 times a day and maybe the odd sachet of Macrogol (Movicol), like NG I don't care if i'm taking this stuff forever so long as it's keeping things flowing, consistency is the key