I think after awhile your body does get used to same old routine. I know I have to mix it up some here and there to get the results I want.

Miralax is not a stimulant laxative so don't be afraid to add a little. You don't have to take the full capful. Just maybe a tablespoon in some water.

You can also try adding Digestive Advantage which has glucomman fiber which makes the stool softer. It also has probiotics in it too which helps with the consistency.

I also eat All Bran Buds with soy milk every day.

hmmmm. a change in stools is what cause my fissure. I got reallly REALLY dehydrated and constipated on weekend, and viola. It took me a while to get the under control and sufficiently soft to start healing.
I did note that when my sphincter is tighter the stool is harder. I think this is because not everything gets out all at once, and so it sits in my intestines dehydrating. Usually a few doses of MOM work for me.
since I have been paing super attention to keeping the poo soft, here's what I found. Grain fibers do not soften anything for me. The only fiber tha I have found that has been helpful is glucomannan, a yam fiber. I also find that Mineral oil is helpful on a more regular basis. It is an emolient laxative, as opposed to a stimulant laxative. That means that it is not absorbed by tthe intestines and just mixes in with the poo making the poo softer and easier to pass. Miralax is an emolient laxative as well. MOM is an osmotic laxative, which means that it pulls water into the intestines for a softer easier poo.
I've often wondered is fiber should be considered an emolient laxative since it works the same way as mineral oil--the intestines don't absorb it so it just passes through. The trick is finding a fiber that stays soft and not scratchy in the intestines after being dehydrated by the colon...

Thanks Lecia and BG! Happy New Year! Lecia, your daughter is so cute!
I had recalled reading a posting some months ago by Lecia that said it's good to vary softeners, so that your colon doesn't get used to the same thing. So, I had wondered the last few weeks if the constancy of my routine was the problem. Also, because I took some time off work at Christmas, the change in routine may have affected my digestion. My body is sensitive that way.
At any rate, the information you provide is very helpful. The reason I was concerned about Miralax is because someone on the board said their doctor told them they could be on it for 6 weeks. The time limit gave me reason to think it probably affects the motilitiy of the colon, and is addictive. Also, the bottle at the store only read 'laxative', not stool softener like Colace. I bought some anyway, but I just wanted to post before I tried it. I find this board more helpful than the doctor's office, since we are the ones that are dealing with these matters personally.
BG - that's interesting that you saw a relationship between tight sphincter and harder stools. I've been wondering about that myself, since I noticed my sphincter felt like it was in spasm yesterday. I really think it has been in serious spasm for a number of years, in fact, but it didn't affect me as much since I had a watery bowel. Over the years, I've often had to massage my stomach in order to release even water because the muscle was so cramped up. I just never knew about spasm or the possibility of tearing at the time. I think the doctors are right, though, in that they've all told me that the fissure is not the problem - it's my tight sphincter. I think it atrophied from constant watery bms. I'm more concerned about soft bms now than the two fissures themselves. I just don't want any more damage!
Well, your information is thought-provoking. I'll try mixing things up a bit and see what happens. I also went to a woman doctor for a physical (she's my mother's doctor), and she is the most sensitive doctor! She mentioned a stool softener, but I forgot the name. When she calls back, I might run it by the board. Thanks!

Thanks QOP!

I have been on Miralax on and off for 5 years and it has not affected the motility of the colon. I just saw my doctor today and she said it was fine to take long term. Her daughter who was 5 at the time took it for months as well. It says laxative but it doesn't make you go it just helps you go. Aloe vera can also be a mild laxative. I take that every day.

Metamucil works best for me because I am never constipated. It makes my poop fluffy and it never gets even close to be dehydrated in my colon (but again - I go poop 2 times a day, so it might not work for somebody who skips a day or two going potty). It works other way around for me also - if I get diarrhea, it "collects " extra water from the intestines and comes out like little clumps. Since it is fiber it definitely helps with keeping guts in god condition and can even lower cholesterol (now they have little heart printed on the package). I like my Metamucil a lot : )))) !
I tried mineral oil and MOM before and they worked great - but I had to go 5 times a day !!!!! Mineral oil was great lubricant , but it can interfere with oil soluble vitamin absorption (A, E...). Make sure to take multivitamins to compensate.
All the best : ) !

Thanks for the advice, Fissulyna. My first CRS put me on Metamucil, but it seemed to make my stools hard. I was straining so much that I was afraid of really hurting the area. I drank a lot of water, too. Plus, it often gave me about eight bms a day. The first day or so it worked beautifully, but then it caused a lot of problems. The CRS didn't believe me and dismissed me, but my second CRS totally understood. I'm thankful for your input on mineral oil. I knew it wasn't as good for you like fish or flax oil, but I couldn't remember why. I still might try it because I think it's better than straining. As long as I don't overdo it. I can't understand how my evacuation could be so difficult when I always go at least two times per day. It's not like my digestion is sluggish where I'm not going for a few days. That's never the case, in fact. Again, thanks!

metamucal and other fiber supplements never worked for me...they always seemed to make me more constipated and my BMs were much harder! MOM has been the only thing that's given me some pain relief. unfortunately it makes my BMs liquidy and a little grainy, not soft and fluffy as everyone says they should be. i don't mind, as it doesn't hurt to go but i worry about the area becoming so unaccustomed to normal-sized poos that i'll never be able to go normally w/o tearing the fissure again. i'm too scared to stop taking MOM for even one day...
Lecia - how does miralax affect your BMs? does it make them "soft and fluffy" or liquidy? Is it the same type of laxative as MOM? i'm considering rotating between the 2, along with taking my stool softeners.

Miralax has the same kind of result as MOM-kind of watery but I don't think it is as strong as the MOM. It has a more subtle effect. You can play around with the dosing. As with MOM, I wouldn't take the full dose at first.

Thanks for the input, Lecia. I tried Mirolax this weekend, but there was no effect yet. I've literally been straining every bowel movement for 3 - 4 weeks about now. I'm really afraid of the situation, and of doing more or other kinds of damage. I plan to try Milk of Magnesia tonight. I really need some strong, immediate, effective intervention right now, so that things right themselves. I'm afraid the stool softeners might be causing the hard stools, since I have been using them consistently since September when I relapsed into pain. I never weaned myself from them for fear of all that pain again. The CRS had told me to switch from Colace to Surfak, and I was up from 200 mg of Colace to 240 daily with Surfak. I've never heard of anyone using Surfak on this board, and the doctor who did my physical a week and a half ago told me that she wouldn't recommend being on it for long. She said it's used for people who mainly have diarrhea. Why would the CRS put me on Surfak, then? I did tell him I had a watery bowel until the fissure, but I now couldn't induce that situation again if I tried. If the MOM doesn't work, I'm going to try mineral oil. I'm desperate!
How ironic that a year ago, a friend asked me if I ever had constipation, and I looked at her like she had two heads. I was even told to eat more cheese to stop myself up (I've never been much of a cheese eater).
Questions: 1) The directions on the mineral oil say not to take the oil with meals, but to take it at bedtime. Is it okay if I've been drinking a lot of water up until that time? Do I take it straight from spoon? Will it affect cholesterol (I know flax and fish oil are good oils, and don't raise the "bad" cholesterol. I just don't want any other problems.) 2) I need to look up All Bran Buds online. Is this found in the cereal section, or is it a snack? 3) Would a gastroenterologist be of use? I'm thinking a colonoscopy might be warranted. But, it may be fissure-related, IBS-related, or stool softener-related. There are no other digestive symptoms.
I need help! Thanks

Questions: 1) The directions on the mineral oil say not to take the oil with meals, but to take it at bedtime. Is it okay if I've been drinking a lot of water up until that time? Do I take it straight from spoon? Will it affect cholesterol (I know flax and fish oil are good oils, and don't raise the "bad" cholesterol. I just don't want any other problems.) 2) I need to look up All Bran Buds online. Is this found in the cereal section, or is it a snack? 3) Would a gastroenterologist be of use? I'm thinking a colonoscopy might be warranted. But, it may be fissure-related, IBS-related, or stool softener-related. There are no other digestive symptoms.
You can take the mineral oil straight, and I don't think the water will affect it (?).
All Bran Buds is a Cereal, in the cereal section of the grocery store.
What dietary steps have you taken for the constipation, e.g. fibrous veggies and fruit and maybe even some prunes/prune juice?