Miralax, tenderness, and childbirth with a chronic fissure

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Miralax, tenderness, and childbirth with a chronic fissure

Postby brittanyb » 25 Jan 2017, 14:23

Hi everyone! I’ve been struggling with a chronic anal fissure for a little over a year now. About 4 or 5 months ago I got it to a place where it felt very managed—I had recurrences every month or two, but they generally healed up within a day. I worked with a CRS and a pelvic floor physical therapist to basically retrain my body to relax while pooping and to have a bowel movement correctly.

I have a couple of ongoing concerns, though:

1. I started Miralax about a year ago, and that was key in my healing. I started with half a dose, but the stool was not quite soft enough, and I would retear frequently. My physio suggested upping to the full dose, and that plus all the physical techniques she taught me allowed full healing. She told me that I can take Miralax forever, indefinitely, and that it’s more important to keep the stools soft as long as I need to. She told me that the way it works, it does not actually get absorbed by the body, but it goes right into the stool and draws water with it, so my body won’t get addicted or damaged, but I still worry about taking any kind of medication for the long term. Every time I try to taper off of it, my stool gets harder and I have slight pain with bowel movements, so then I go right back to my normal dose.

Has anyone used Miralax longterm? Will it do damage to my digestive system? Has anyone had luck weaning off of Miralax and still keeping stools soft? I already take 400 mg of magnesium citrate and eat a high-fiber, mostly Paleo diet. I take fish oil and eat avocado daily as well.

2. I was breastfeeding when I sustained the fissure, and ever since I stopped breastfeeding and got my normal period cycle back, I’ve noticed more difficult stools and some pain/tenderness with bowel movements (and a general achiness in the anus and pelvic floor all day after that) around the time of my hormonal shifts (right after ovulation, right before/during my period). My physio said this is, unfortunately, normal – these hormonal shifts can make the tissue more tender for a few days, causing pain near the scar tissue. Whenever I have this pain, I expect to see blood, but I never do. I haven’t had bleeding in about 4 months. I guess I’m just trying to learn to not worry about it – I keep thinking it’s the beginning of a recurrence, but then it never bleeds and it gets better a few days later. Maybe this is just my new normal.

Has anyone else experienced this sensitivity/pain/achiness regularly without bleeding? Should I just get used to it? Is there anything I can do to make the scar tissue less sensitive?


3. I am so, so nervous to have a second baby. I got the fissure a few weeks after childbirth due to constipation, but I’m terrified of another pregnancy because I know that can cause more issues and more constipation, and of course, I’m super nervous to push during labor again. I don’t want to NOT have another child simply out of fear, but I also don’t want to live out those first 3-4 months of fissure agony again.

Has anyone given birth with a chronic but managed fissure? Did it open up all over again? I’d love to hear your story of childbirth and what it was like healing the second time around, from birth and from the fissure.

If you’re still with me, thank you so much for reading the longest post ever! I’m so grateful for this community!
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Re: Miralax, tenderness, and childbirth with a chronic fissu

Postby suzyljank » 25 Jan 2017, 20:00

I've been taking miralax for over 3 years now. I will be taking it the rest of my life and I have no problem with that. I've had Hem. surgery, LIS and bilateral advancement flaps done. My last surgery was because of all the scar tissue. That tissue doesn't stretch. Some of the scar tissue was removed and replaced with new skin. It helped and the area stretches more than before but after anal surgery it's important to keep the stool softer and that's what miralax does, most of the time I take a little less than a full dose but sometimes I have to increase it a bit and that's what's nice about it. I take it at bedtime. As far as the scar tissue yes it can be sensitive. I can go a long time where I have no problem and then sometimes it will ache for whatever reason, I don't know. Increasing the miralax help, dilation helps too. I also have PFD and IBS. As far as having another child talk this over with your obgyn I'm sure they can help you.
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Re: Miralax, tenderness, and childbirth with a chronic fissu

Postby brittanyb » 26 Jan 2017, 11:12

Thanks for your reply, suzyljank! I spoke too soon because this morning I had a horrible setback. There was very little pain, similar to the last few days, so I thought nothing of it -- but then I looked in the toilet and there was SO much blood. I'm so discouraged and frustrated. It looks like I will be staying on the Miralax for quite a while after all! Maybe in 10 years I can try to come off it. ;) Thanks very much for your perspective and for sharing your experience! I will look into dilation once this setback settles down.
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Re: Miralax, tenderness, and childbirth with a chronic fissu

Postby Kulisu » 26 Jan 2017, 13:25

I had just started taking Miralax a week and a half ago after normal stool softeners seemed to be losing their effectiveness. It was my life saver. After 2 days it was like night and day the difference. My fissure seemed to heal on its after just a few days of taking it. My problem seems to be that it is making my stools too soft now and I keep having diarrhea. My doctor told me to cut back to 2 times a week instead of everyday and start the softeners back up daily. I should notice the difference either tomorrow or the day after. I'll try to update when I notice any changes.
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