I have a question about stool width. Based on the recommendation of my CRS, I have been taking Miralax (1/2 dose) and Benefiber (9g) daily for the past several weeks, in addition to other high fiber foods. This combination has made my stool soft but formed (like the consistency of toothpaste). Due to the fissure, however, my anus is really tight. When I have a bowel movement now, the stool is much thinner than it used to be (maybe 1/2" wide or less). Obviously, this has made it much easier to have a bowel movement (no straining!). I assume this is because the soft stool is conforming to the tightness of my sphincter muscles. Has anyone else experienced this? Is this ideal for a fissure sufferer? Or should I try to make the stool more bulky even if it means I have to strain to have a bowel movement?

Thanks in advance for any advice, by the way!

How very odd, I came here today to post about this very issue after earlier after work (and holding it in for age) had the first pain free BM in 3 weeks. It was for lack of a better word, large. I recently started eating more and more fibre and taking supplements too, but I was expecting to be ripped asunder. I’m starting to think that it’s more the process than the end consistency of the stool. I’ve been chewing everything so much my jaw aches a bit, chugging water and eating lots of fruit and fiber, I’d have though I’d have been in agony but nothing, It’s the opposite of what common wisdom would think.
I’ve also been recently wondering if a lot of the stinging / itching symptoms may be caused by contamination in the wound, mainly not helped by us all making sure our stools have the consistency closest to toothpaste. As soon as I changed to high fibre including insoluble my stools became much larger, and with (not really a nice way to put this) less runny texture there was nothing to get into the wound as easy and I went from having to lie in bed for a few hours to being able to sit down at work for 8 hours In less than a week!
I’d say there’s something to bulking up the size and trying to get used to it once you’ve started to heal, defiantly. If you hope to ever have a normal diet you’ll have to face it at some point. Though depending on how far along you are healing it could cause a lot of pain if its still very painful to pass anything, unless I’m right about the consistency, I which case irritation could bring on spazams causing more problems and giving people a thought of pain which then triggers the muscles to clench even more. But this is all conjecture, it’s impossible to do research on such things, which is why I’m uncommonly open about such thing trying to find others experiences and come to some form of conclusion to aid in recovery.
I will say something definate though, you should never have to strain, even with AF, if it's not coming out of its own volition then you need to change something in your diet/habbits.

You know I agree with rallire in that bulked but soft is the way to go for me too.
When I get more sore, it is because there isn't an even texture to my BM. It doesn't seem to bother it that it stretches to accomodate the BM. It's a gentle stretch if the Stool is soft.
I live as much in fear of the squirts as I do consitpation.
what a life! :)
-Tanya

My problem is that my anus is so tight it won't stretch for a larger (wider) stool, which means I have to strain to have a BM unless the stool is smaller (1/2" wide or so).
Anybody else have this same issue?

Yes, that's why I started the self dilation and I use a couple of oz water to soften things up about 20 min before I go.

Baba, how has the self dilation worked for you so far? Any advice you can give me on what to do and what not to do?
Also, what do you mean you use a couple of ounces of water to soften things up? Do you use a water enema?

Yes, I have a little bulb enema, available at the drug store. I fill it with warm water (usually twice) and then wait for the water to do it's job before I try to go. I've been using this for years when I have a fissure to heal.
The self dilation I've only been doing for about 2 weeks, it's slow progress, but I believe it is working. The fissure is healing and I have less spasm pain.
BTW when the anus is really tight it is helpful to gently massage the sphincter with a well lubricated finger.

Thanks for the advice! Maybe we can compare notes occassionally on our progress with the self dilation. I have an appointment with my CRS tomorrow so I'm going to discuss it with him.

I know this is an old topic, but I've been doing some researching around on this topic, and also through my own horrors with fissures I'm beginning to rethink the bulky stool issue. I used to believe the surgeons who all recommend bulking up and softening the stool. But I'm not so sure about that any more, or even sure doctors know what's best.
We tend to assume all this fiber and bulk is better because we don't want hard stools, but with shoving more fiber in us, something isn't making sense... Stools get bigger, require more stretching and more tearing of the anus. Doctors will sometimes point to native cultures who eat diets high in fiber who don't have anorectal problems. But what they may not know is that in those cultures the digestive system has been living off a whole foods diet without processed foods like Westerners eat, and bowel movements on these high fiber diets by these natives have been described as very long and very thin and very soft, not the bulky stools we are told to aim for.
I recently came across these quotes from TL Cleave's The Saccharine Disease in describing the stools of high fiber eating natives...
"these are passed twice a day and are extended like a ribbon of toothpaste some 15 inches long, and of the diameter of a middle finger."
"if there is no unnatural stasis present the consistency will be soft and the diameter not appreciably greater than that of the middle finger."
thissfissurecankissmybutt was asking if the stool is narrow because of tight muscles. Maybe not. Maybe the stool is just narrow because it is soft enough to get through the anal passage, conforming to its diameter, which is supposed to be narrow. I don't really know. But all I know is this. When I've managed by some miracle to be able to have my stools come out soft and narrow, rather than bulky, I've had far more success with natural healing of my fissures. My problem continues to be getting this to occur on any kind of consistent basis without diarrhea.