Insight and Advice?

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Insight and Advice?

Postby RumBum » 18 Feb 2017, 16:01

Hi everyone!

I'm new to the forum. So happy this place exists. There's tons of good information here and much needed support. I'm wondering if anyone has any insight or advice on my current healing/re-injury (?) trajectory.

I've had a fissure for about three weeks now. For the first week it went untreated. In the second week I was diagnosed by an NP. I started increasing soluble fiber and taking 100 mg of Colace before bed and upping my water intake. Last week I upped my Colace dose to 150mg per night because my BMs were not really soft enough, especially in the morning (that dreaded hard tip of the stool problem that is very hard to get rid of for me). Three days ago I had two days of blood-free but still rather painful BMs using these conservative measures. So I thought to add in a very small dose of Miralax at night to the mix, hoping it would be the magic that would tip me into the next stage of healing (no blood, less pain). I have been taking 1/2 tsp to 1/4 tsp of Miralax on alternating nights, keeping the 150mg of Colace consistent. This did make my stool even softer. Perhaps too soft and runny because it isn't really sticking together in the toilet, and some of it, especially at the tail end of the BM is so soft that it doesn't form the cylinder shape. But...over these past few days I have also noticed a return of a very small amount of blood. For the first two days it was just a few (15?) little specks, almost like dust or pepper, on the toilet paper. Then this morning it was more like a small drop of blood. So, I'm wondering if the addition of Miralax is a bad idea. While the BMs have been slightly less painful because they're softer, some very light bleeding seems to have returned. I can't be 100% sure that the Miralax caused the changed, but I didn't alter anything else in my regimen.

Do you think that I should stop taking this small dose of Miralax and return to only taking 150mg of Colace?

This might be an impossible question to answer, but is it better to have more pain without blood than less pain with the return of some bleeding, in terms of healing?

For what it's worth, I've also started topical nifedipine 0.2% three times a day. My NP said to only apply it on the outside of the anus.
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Re: Insight and Advice?

Postby Roidsfizzman » 19 Feb 2017, 16:34

Your stool softness is a combination of water intake, exercise, diet and stool softener. There is nothing wrong with taking Miralax if it works of you. Once you get the combination that works for you for getting soft stools that are not runny stick with your program. The stool softness is going to change as your stool water retention will change base on your diet and daily activities. Do not get hung up on the amount of blood if you keep your stools soft, the blood will take care of itself once you heal. Your goal should be to avoid pain and straining.
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Re: Insight and Advice?

Postby RumBum » 20 Feb 2017, 01:15

Thank you for the reply Roidsfizzman! I appreciate your perspective! I hadn't really thought about how exercise could also affect stool consistency.

Getting things right with all this is fascinatingly and frustratingly nuanced and personalized. I cut out that seemingly tiny dose of Miralax last night before bed, and I didn't have any bleeding this morning, as far as I can tell.

I guess I was more concerned about the bleeding because it seemed to be a sure sign of re-injury, whereas pain is a bit more ambiguous.

Thank you again for taking the time. It means a lot!
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