I've used this forum a lot for it's search feature ever since I first developed my fissure a little over three years ago.
I'm now pregnant (2nd trimester, almost 20 weeks), and was searching a lot for how to handle my fissure with pregnancy, but just found a lot of people in similar positions to me--looking for ideas to survive pregnancy with a fissure, but no real answers.
Now that I'm almost 20 weeks in, and surviving, I wanted to share how I've gotten through it to hopefully help someone else.
So a bit of background, I developed my fissure after my first pregnancy about 3 and a half years ago. Last September I finally got it under control and thought I was finished with the issue, only to get pregnant and have it flare up again. I wanted to share things I tried and what worked, to maybe save someone else the aggravation and fear that can come with pregnancy.
Everything I'll write about in here was approved by my OB, but you should speak to your own OB to see what they're comfortable with.
So here's a list of things to consider. Also some things that didn't work for me (but might work for you).
Diet: This sort of worked for me. I cut out bread, rice, and pasta before I got pregnant which got me to be more regular. I became very strict with it once I was pregnant, but it didn't always keep me going.
Prenatals: Talk to your OB about prenatals without iron. Iron stopped me up so bad during the first few weeks and, I think, were the root of my fissure reopening. When it got really bad, I stopped taking prenatals and just took folic acid and DHA separately. I then slowly worked them back in with a more friendly prenatal that included iron (lower dose and more natural form). There are also vitamins without iron, but ask your OB about them.
Prunes and Prune Juice: I tried this for a few weeks. A glass a day or a couple of prunes. Worked the first few days, then stopped working, even when I tried upping the dosage. Since it tasted gross anyway, I eventually gave up using it.
Coffee: Someone suggested trying a black decaf coffee once a day. It worked the first time. After that, it never worked. I hate coffee anyway, so I stopped drinking it.
Milk of Magnesia: This works. But most OBs want you to limit how often you take it. I started saving it for days I did have bread, rice, or pasta to keep things moving. I've been able to stop using it completely.
Glycerin Suppositories: I bought a package of these and use them if I ever don't poop in a day. They're safe for occasional use and there's no waiting around to see if it works. They tend to work in about ten minutes.
Kiwis: When the prunes failed, I moved on to kiwis. They're much more delicious anyway. They have also worked well for me. I just buy them precut and eat a couple of pieces everyday.
Flax Seed: I mix it into my smoothies or oatmeal so I get a little bit everyday. This has worked well for me to.
Magnesium: I take one magnesium vitamin every night (250 mg). It's just the regular vitamin I got at Shopper's Drug Mart. This started working for me the very next day from when I started. I take one pill every night.
Colace: One pill every day. Do not skip it. Do not forget it. Double up the dose if one of your poops feels a bit too hard. It's super helpful.
So to sum it up, this is my daily routine now:
-Smoothie or oatmeal with flax seed in the morning.
-A couple of slices of kiwi.
-(I take my prenatal at this point)
-Magnesium pill after dinner.
-Colace before I go to bed.
I haven't had a flare up since I started this routine. I even ate 5 slices of pizza yesterday, and still had a normal movement this morning, as usual. (I wouldn't recommend eating whatever you want, whenever you want, but I now seem to be ok with the occasional indulgence).
I don't promise my routine will work for everyone, but I wish I'd known about some of these things before I got pregnant, so I might've avoided the flare up that I had about 6 weeks ago.
I'll update the thread if I ever have any other complications or issues that come up, but if I don't, you can safely assume that this routine worked for the rest of my pregnancy.