I'd like to hear everyone's opinion on fiber in terms of treating fissures.
I know most everyone and their doctor recommends an increase in fiber to help with fissures. Personally, I am now skeptical. I'm age 28, male..I received my fissure close to 2 months ago (2 months of pain) after a change to a high fiber diet (Which likely was highly insoluble since it was potatoes, corn chips etc) that resulted in large hard stools with significant straining. Before this, I was relatively low fiber and high fat and had not had a fissure for 4 years. With this latest fissure I was told to increase fiber. So I increased. The more I increased, the more bulkier my stools, the more painful the bowel movements and retears were constant. I had to start stool softeners. This led to the feeling like it would never go away and it was very stressful to me and it got so painful that I was shaking in fear before a BM and in pain after the BM.
I started doing research and there actually are opposing beliefs to a high overall fiber diet for help in recovering from fissures and for preventing future fissures. One school of opinion is that a high soluble fiber diet is necessary instead of a diet high in insoluble as that makes for looser, softer stools. Another school of opinion is that a diet low in fiber and higher in fat is preferable (Fiber Menace book and other places, paleo etc).
And I keep seeing posts of people who are now having to take stool softeners everyday and have to keep eating more and more fiber and it seems like its a body addiction. If they stop they will have new fissures as their body now cannot have an easy soft stool without these fiber supplements and softeners. But what if it's not necessary?
Right now, I am taking a stool softener pill every morning as I heal just for reassurance because I don't want to go through this any longer..., and thankfully the fissure is healing and the pain is going away. I am also consuming more fat and less fiber overall and my BM's are now smaller, easier, softer, wetter and no blood on the baby wipes and the BM frequency is less giving more time for the fissure to heal without friction. This does not prove anything but makes you wonder. I just wonder if I will have the issue that I will have to take these pills everyday now or risk re-tearing. I wonder if a diet higher in fat and with carbs coming from majority soluble fiber sources is better. It's said that fats help coat the intestines and allow for easier BM's and soluble fiber + good water intake makes for softer easier passing stools which would make fissure formation from BM's highly unlikely as well as help in the healing/pain from current fissures.
I wonder if the high fiber (especially insoluble) line of thinking is about as useful as my gastro doctor who told me years ago that diet doesn't matter when it comes to crohn's disease. In other words, an old idea that's just plain wrong and counterproductive in the long run.
Finally, I will say that squatting during a BM instead of sitting has helped as well and I will be doing this in the future from now on as well.
Thoughts?