I don't like taking medication. I try to minimize it as much as I can.
I'm really really worried about taking laxatives long term. I've used miralax before, and while it works, I need to take it every day for it to stay effective. Does anybody know how often you can take it before your body becomes accustomed to it, and you start needing a higher dose? Does anybody have experience with taking it long-term? I'm already taking cocalase and it's just not cutting it.
Enemas work when I'm in a huge amount of pain. If there is any fecal material in my bowls while I'm having problems, I have @$$-pain. I use an enema with distilled warm water, and small amount of yogurt (acidophilus and bifidus) to keep the bacteria in my gut from washing out. I try to avoid enemas unless I'm in a LOT of pain, and it's in the middle of the night or something. Still, I've been doing them about once a week lately. This isn't healthy because I don't want to make the muscles in my colon "lazy" and need an enema to go to the bathroom all the time.
I've read something about juice fasting when you have anal fissures in order to clear out everything in your gut and "Re-set" it when you are having temporary constipation. I don't want to do an eight-day juice fast. I'd like to do a two day juice fast so that I can just clear everything out. Then slowly add food in, hopefully constipation free this time. Has anybody tried this? would it be a waste of time?
And finally, anal dilation makes sense, in theory to me. Can anybody post a link about how to do it specifically for my problem. I have no plans to make recreational use of my newly dilated anus, but I'm having trouble finding anything but links to sites for recreational use.

Oh, and don't worry. I plan on running all of this by my doctor before I try it. I just want to avoid wasting my doctor's time, so I'd like your opinion.

Hi there,
Don't know much about fasting, so hopefully someone else will help you with that.
Miralax, if it worked for you, I would continue. According to present research, it is okay to use for life. However, research has not gone on for 30 years or so, and the packaging recommends it to be used only for a week (I think it is just a week, though am open to correction). GI doctors and CRSs say you can use it for life. I would take the chance, especially if it relieves your pain. I have been taking MofM for about six years, in a small dose. I took a quarter of a Colace last night, by the way, and am suffering for it today. Pain at about 3/10. Not nice.
There is a good enema with natural products in it with the name of Fleet Naturals. I used that before my sigmoidoscopy and they said they had never seen such a clean sigmoid colon... I actually tried one again yesterday, however, and did not like this because of the pointy top and my shaky hand. Not a good mix. So, no more enemas for me. unless desperation sets in.
Anal dilation, which I am a few others are doing, there are some links on here which are worth reading. Hope they help:
http://anal-fissure.org/t4261-self-dilation?highlight=dilation
http://anal-fissure.org/t4552-true-stories-of-self-dilation?highlight=dilation
http://anal-fissure.org/t4086-standardized-anal-dilation?highlight=dilation
http://anal-fissure.org/t4737-pneumatic-balloon-dilation-and-skin-tag-removal-1-week-ago?highlight=dilation
This person in the link above had the procedure done at the Cleveland Clinic in April this year.
http://anal-fissure.org/t4104-my-standardized-anal-dilatation-this-morning
Written by wecc. Very good post, as are others under his name to get an idea of what he went through.
This is the link to all his posts:
http://anal-fissure.org/st/wecc