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?

[quote="aparadigm
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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.
I found this very helpful as well and practice it when I'm at home. I bought 2 plastic stools from Ikea, placed them by the sides of the toilet and that provides me nice steady foundation.

What the body needs is nutrients, and if an area is tense - think of a tourniquet, blood flow carrying them is restricted so poor nutrition necessary for healthy skin, muscle of the anal, or any area, is reduced. I'm trying "good" honey as a food source from the outside - and I think it could work around the anus. Application on going to bed would give long time to work. May stop itching. On me healed up a bad cut + bandaid or two over a few days, and use on any sore - mozzie bite etc. All the best, Piles!
And for me, ease of "going", is helped with a second mug of tea with breakfast. I'm to have a flap op. for a bungled haemorrhoid-ectomy next month. Rectum no longer functions and scar tissue means the anus won't open or close from half an inch. But treatment in Australia for the over 65's is free! Just a 2mth wait

paradigm
yes, I agree with you that there is something here to be considered about fiber, especially insoluble fiber. How it makes sense to jam ourselves full of fiber and make bigger stools escapes me. Yes, being regular is important and having stools that are easy to pass with no straining is critical too. But the anal canal is narrow by design and it just makes little sense to me to fill the diet with indigestible food that just makes stool huge. The previous commenter mentioned nutrients needed for healing. This is very true. If a diet is so heavy on indigestible food, is it really providing enough nutrients for the body to heal?
I don't know and don't have any answers really. But clearly more and more fiber isn't a cure for fissures or none of us would be here.

Eating a diet that is high in fiber has many potential health benefits. Eating high-fiber foods helps you stay fuller longer, keeps you regular, and boosts colon health.
Beyond Diet

I think the benefit of fiber and creating larger stools is that although the stool is larger, part of that additional bulk is in the length, which causes the anus to have to open less wide in order to pass it.
Further, the stools are less dense, which means it can "give" as it is being passed, reducing the strain on the fissure.
Having said that, I think it's important to go easy on insoluble fiber. I've had a couple of bad setbacks when I was eating a lot of insoluble fiber. I seem to do much better making sure I get a bit more soluble.

aparadigm:
I agree with you. The more fiber I took the bulkier my stools got, which was definitely not a good thing. My CRS told me I could reduce my fiber intake and increase my Miralax dosage. My stools are now soft and unformed, like melted ice cream. Initially, I was concerned about anal stenosis. I was afraid that the soft stools would cause my anus to get used to a less bulky stool, but my CRS said not to worry about it. Of course, everybody is different, so a soft bulky stool might be best for some people.

Interesting that you bring this, aparadigm... I'm going to my CRS today and have this exact conversation.
I've been in a 30g fiber/day diet. My stools are soft, but I'm having 3 BIG BMs per day, while my normal is 1 big. Part of the problem is that one of these BIG BMs is in the middle of hte night, which is really hurting my sleep. So I was going to ask to reduce my fiber intake by 1/3. The things I eat are half/half soluble and insoluble and all this fiber is adding a lot of bulk to my stools which, I believe, is preventing me from reaching the last 10% of the recovery.

thisfissurecankissmybutt wrote:aparadigm:
I agree with you. The more fiber I took the bulkier my stools got, which was definitely not a good thing. My CRS told me I could reduce my fiber intake and increase my Miralax dosage. My stools are now soft and unformed, like melted ice cream. Initially, I was concerned about anal stenosis. I was afraid that the soft stools would cause my anus to get used to a less bulky stool, but my CRS said not to worry about it. Of course, everybody is different, so a soft bulky stool might be best for some people.

Hello,
i am trying my best for my stool to get the unformed, melted ice cream so this punk ass AF can finally heal. This Morning my stool started coming out formed (witch hurt my AF & caused pain & blood streaks) but then my stool became like melted ice cream. AM I CLOSE, i want the melted ice cream in the beginning.
my waters intake (3.5 liters) a day
my Diet is:
Breakfast:2 eggs 1 egg white & Cabbage. (full tea spoon Miralax w/ water)
Lunch: Organic Garbanzo beans & cooked spinach *olive oil
Dinner:Tilapia, lentils beans, hand full brown rice, steamed brussels sprouts & Zucchini *olive oil
Snack: 4 Dried Prunes
Thanks so much for your help,
J

Have you thought about increasing your daily dose of Miralax?