by NeuropathicGuy » 22 Feb 2010, 13:53
Hey Nebel,
I take about 2/3 to 1 full dose of Miralax a day. I usually adjust it based on what I ate that day. If I ate fruits and veggies all day, then 2/3 of a dose is usually enough. If I ate things containing meat or junkier foods like potato chips, then I go with a full dose. I'm resigned to taking it forever or at least for a long time. I don't care what I have to do to avoid another fissure, whatever works, I'm doing it!
For your case I don't think a referral to another doctor would be a bad idea, but to be honest, I think the options are pretty much limited to nitro/nifedipine/diltiazem, BOTOX, and LIS no matter who you see.
I was a in a similar position as you a few months ago and personally opted for nitro and BOTOX. My original two fissures healed up about 2 months after BOTOX but now I have some other rectal pain (described in my other thread today) and don't know if it's due to a new fissure or a hemorrhoid. For what it's worth, my sphincter remained tight for a while after the acute fissure pain stopped but the tension slowly decreased with time and continued use of nitro.
Anyway I think it's going to be a personal call depending on how much it's bothering you and how you feel about BOTOX versus LIS. If it's real bothersome then most people have gotten much better results from LIS. If it's just a minor nuisance then I don't see what there is to lose by trying BOTOX -- my opinion only, I know others have differing opinions on the matter.
BTW I had a colonoscopy done when my fissure was pretty bad. The colonoscopy was incomplete due to some non fissure related complications, but it didn't bother my fissure very much. So I wouldn't let that stop you from considering doing it just for some peace of mind.