Hello and macrogol question

number of marcogol sachets

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Hello and macrogol question

Postby peppermint » 26 May 2022, 02:21

Hi
Wondered if anyone could offer some advice?
Been suffering with fissures on and off for 10 years or so, but fairly mildly, so no big deal. But the last 18 months have been off the scale bad with the whole tearing, healing, re-tearing cycle and PAIN. Essentially it never got healed properly in the first place and so you come off the meds thinking it's healed as no pain/blood etc, but actually it's too soon to come off the meds.
Doing all the usual things, diet, drinking, exercise, squatty potty, fibregel. You know the drill.
So finally saw a colorectal bloke who pointed out I really needed to be on the GTN for much longer than the 8 weeks. So I'm back on that, with the option of moving onto a different cream if I feel it's not working.
He also isn't a fan of bulking fibre anymore, as makes poo bigger to pass, so no more fibregel. Just as an aside, I've never been constipated, I'm a fairly regular 1/2 times a day sort of person with no straining.
So he switches me from fibregel to a macrogol.
Now my question is this: how many sachets do people take of this to achieve "soft" poo?
I started on 1 and it did nothing, in fact I'd say it made going "sluggish". So I upped to 2, one morning, 1 evening. Still not really doing what I imagined. I mean things are soft-ish, but what is soft enough? Given I am not constipated, is 3 a day too many?
It's really stressful trying to working out what is best as I just want to heal, and right now when going to the loo I'm bleeding and there's a bit of pain (nothing compared to when it's fully blown bad, that is off the scale painful), so it's managable discomfort. But I'm conscious of it not healing if i don't get the macrogol/poo softness thing right.
Ok, I've written a lot.
Thanks for taking the time to read.
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Re: Hello and macrogol question

Postby dmcff » 26 May 2022, 08:05

Welcome to the forum.

Did the CRS examine you for the source of the bleeding? Did you have any scans - CT, MRI?

Some people have success with GTN cream and ointment, but many find that they cause problems and actually irritate the area, especially if taken for an extended period of time.

Macrogol and fybogel can work as stool softeners, but there are others, like lactulose, that may be more effective. You might want to use the forum search, as this is a subject that has often been discussed here.

Regarding how many sachets of macrogol to take: it varies from person to person, so it's impossible to give a fixed number. I would recommend talking it over with your CRS.

Hope you feel better soon.
2014 Anal fissure
2015 CAT, EUA, sigmoidoscopy, 2 MRI
2016 Pain severe then moderate to low
2017 Moderate pain
2018 Physical therapy, pain management
2019-20 Living with it
2021 Still AF
2022 Therapy, meditation
2023 Onward, up
2024 CT scan
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Re: Hello and macrogol question

Postby peppermint » 26 May 2022, 12:25

Appreciate the reply.
Yeh, he could see the fissure and that it wasn't healed. GTN has worked for me before, but I'm conscious it may not be like that this time. Fingers crossed.

I was curious to know what level of macrogol others found worked for them. I know it's different for everyone, but wondered if others had needed more to maintain softness.
Could be this particular one doesn't work for me and another might be better. Will see how the weekend goes.
Every bowel movement is like an injury so I'm desperate to get dosage right.

It's a great stress!

Thanks again.
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