Hi all

I have been reading these forums for several months and it has been a valuable source of advice, thank you!

I have been suffering with an anal fissure for 7 months. The doctor confirmed I have a large fissure recently.

I have been using Lactulose as prescribed, and it does seem to add some moisture to the stools but they're still large enough that the fissure must be re tearing every single time as there is usually quite a bit of blood.

I've just acquired some Movicol-half from the chemist. It seems to simply be half a normal dose (6.9 grams per sachet). Does anyone have any advice on what dose I should start off with? One sachet? I want to achieve stoops soft enough not to cause this damage every time.

I'd also like to offer a big thumbs up for Rectogesic cream by the way. Since I started using it on Friday last week, the spasms which lasted for hours have completely gone. This is itself feels like a miracle, as the pain was debilitating and I was worried about the pain and the effect it would have on my work.

Thanks all!

Hi, start out with a full dose for 3 days, it can take that long to work and then adjust up or down as needed. Some can use less and some need a bit more. The nice thing about movicol is that it's easily adjusted and taking more than the recommended dose won't hurt you. It's also a good sign that you see blood. It means the blood flow down there still exists. My fissure was so bad and I had it so long it no longer bled. It can't heal if there is no blood flow to it. Good luck Suzy

Thank you Suzy. I have tried 2 sachets (1 dose) last night and this morning. I will see what happens with it.

Had the worst pain of my life today for hours after having constipation. I jinxed myself by saying what I did about the rectogesic, I just can't think why it didn't work today. Still a bit in shock from the pain, I was having to stand up while working and even that didn't help much

Praying the movicol works

I know how bad the pain can get. The worst for me was that Charlie horse feeling up the bum. I suffered for 8 years until my doctor told me that it wasn't just the fissure. The reason I was getting fissures and not healing was because I had severe anal stenosis from a hem. Surgery I had many years ago. We had to address that. I had two advancement flaps. It took me a long time to get up the courage to do it but people in this group helped me. It was very painful but not as bad as the pain from the fissure. It's been 2 years since my surgery. I still use miralax and I dilate once a day but I'm so glad I had the surgery. There's always hope. Find out if you have any underplaying reasons why you got a fissure. It might help you. What helped my fissure pain the most was nitro and a warm heating pad. I wish you all the best. Suzy

Again thanks Suzy for the advice.

The Movicol is working fantastically well. Better than I had hoped for really as the stools are ever so soft and not irritating my fissure thus no pain whatsoever and for the first time in months I'm thinking I must be healing.

I suppose my next question would be how on earth do I know when it's healed and when to start trying to come off the Movicol. I am a bit worried about this Lazy Bowel thing I have read in a few other posts.

My idea is to at least keep going with 2 doses per day until Xmas and then maybe halve it from that point and see how it goes. Does that sound reasonable to anyone?

I'm speaking from experience right now. You've had a few surgeries in that area and have scar tissue, that tissue will never go away and will never stretch beyond what it does now. You will probably have to take miralax daily. I tried cutting back on mine, I was down to a little over a teaspoon a day. I did this for quite a while but then I started getting that burning feeling. It took me 2 months to figure out that although my stool wasn't extremely hard it just wasn't soft enough. I'm now taking 3/4 of a regular dose a day and it's much better. Things are still formed just softer. I talked to my surgeon and he told me it will just be a part of my life and I'm alright with that. My daily routine is dilation in the morning and miralax in a cup of tea in the evening. I also have IBS and PFD. I switched around my diet a bit because this spring I had a case of food poisoning and now can no longer eat dairy but I'm doing good, even managed to lose 10 lbs and keep it off. Life can be challenging but we only have one so we have to make the most of it and that's what I'm doing . Good luck Suzy.