I've had an anal fissure for about two months. I think I am finally on the road to healing. The road was very difficult, with at least three re-tears and a lot of pain and anxiety.
I wanted to share a key insight that came about in my case.
Most of the "patient education" materials that I got from my colorectal surgeon emphasized the importance of a high fiber diet, among other things. They also primarily gave examples of *insoluble* fiber, when talking about fiber. After a fair amount of experimentation and work with physical therapist who were skilled with dietary matters, we made a key discovery. Primary reliance upon insoluble fiber is precisely the *wrong* thing to do. Insoluble fiber bulks up my stool and increases its diameter, which increases the risk of passing stool that re-tears my AF. Soluble fiber, by contrast, does not bulk up stool, but instead makes it softer, soupier, and more gelatinous. Once we realized I was inappropriately and dominantly emphasizing insoluble fiber, I switched to primarily eating beans, pears, oats, etc., instead of whole wheat bread, bran cereal, etc. The change was dramatic. It became so much easier and less painful to pass stool associated with a dominant emphasis on soluble fiber.
Perhaps each of our bodies is so idiosyncratic that my personal learning may not apply to others. However, if our bodies generally treat soluble fiber in the same way, I would highly recommend that everyone who is trying to heal his or her AF move away from insoluble fiber and use a more balanced mix of soluble and insoluble, or try what I did... a move to primary emphasis on soluble fiber. I hope this may help my fellow sufferers, in case it applies to your body as well.

I so agree with you. I use Psyllium as my lax/softener which is soluble. I was warned about too much fiber on this board. Too bulky hurt. I googled a list of soluble fiber food and went in that direction and found that did the trick. I have the double whammy of no gluten or dairy (IBS) so my list is really short. Ate a cookie yesterday and I am paying for it today. Here is a link to one of the list I use. http://www.healthhype.com/list-of-high-fiber-foods-soluble-and-insoluble-fiber-chart.html

Sterlingbird and prospero.
I notice prunes are on the soluble list...
I'm going to print that out and put it on the fridge.
Thanks!
-Tanya

I also use soluble fibre. Found that that worked best for me. And I do not eat too much, but that is my way of doing things. Good luck with your healing! Sounds like you're on the right road.

Thanks Prospero.. Makes sense.. God bless u all

Thank you! I have a bad habbit of snacking on cereal, have for years. I have also however always and oly eaten super high fiber cereal. Surprisingly this is the first time I've read that its the inoluable type, this explains a fair bit perhaps why when I'm stressed (and potentially killing a whole pakc of cereal in a day) my AF suddenly acts up. Tomorow I'm off on a soluble fibre shopping binge :)
Though from looking online it looks that pasta and white wheat are good solble fibre sources, that goes against everything ive been doing and thiking the past few weeks...

There's a pasta made by catelli, called 'smart pasta'. It has soluble fiber added so it's pretty high in fiber.
Tanya

sterlingbird wrote:I so agree with you. I use Psyllium as my lax/softener which is soluble. I was warned about too much fiber on this board. Too bulky hurt. I googled a list of soluble fiber food and went in that direction and found that did the trick. I have the double whammy of no gluten or dairy (IBS) so my list is really short. Ate a cookie yesterday and I am paying for it today. Here is a link to one of the list I use. http://www.healthhype.com/list-of-high-fiber-foods-soluble-and-insoluble-fiber-chart.html

I can't have gluten either, also have diabetes to contend with. I practically live on plain cooked beans of all types. The diabetic portions are helpful. With my earlier fissures I didn't have to watch portions and I ate way too much fibre of all kinds ( you know, if a little bit is good, more is better :) ) and then between frequent bowel movements followed by sitz baths, I spent a good part of the day camping out in the bathroom! The smaller portions of everything is definitely beneficial.

sterlingbird wrote:I so agree with you. I use Psyllium as my lax/softener which is soluble. I was warned about too much fiber on this board. Too bulky hurt. I googled a list of soluble fiber food and went in that direction and found that did the trick. I have the double whammy of no gluten or dairy (IBS) so my list is really short. Ate a cookie yesterday and I am paying for it today. Here is a link to one of the list I use. http://www.healthhype.com/list-of-high-fiber-foods-soluble-and-insoluble-fiber-chart.html

I can't have gluten either, also have diabetes to contend with. I practically live on plain cooked beans of all types. The diabetic portions are helpful. With my earlier fissures I didn't have to watch portions and I ate way too much fibre of all kinds ( you know, if a little bit is good, more is better :) ) and then between frequent bowel movements followed by sitz baths, I spent a good part of the day camping out in the bathroom! The smaller portions of everything is definitely beneficial.

I was going to start a new topic ,but this makes sense and works for me too, advised by my Doctor and through trial and error with my diet. Its the placementt of the soluble over the insoluble foods..
Please see below..
This is what I find through my Doctor and my trial and error works for me...Not necessarily increasing soluble over insoluble, but placement.
What I mean is eating the soluble food item first., example, a simple 5 minute plain oatmeal first then follow with a insoluble food, I usually take a little while to digest then follow with the rest of my meal.
Soluble fibre isn’t found in the foods we most readily think of as fibrous (such as raw greens or vegetables). Instead, it’s most predominant in starchy foods, including oats, barley, sweet potatoes, winter squashes, and white breads.(careful with the white breads)
Other sources are:
Rice
Pasta (white, not whole grain)(I mix white rice or white pasta with brown pasta or rice.)
Soy
Quinoa
Corn meal
Carrots
Turnips
Rutabagas
Parsnips
Beets
Avocados
Bananas
(a) getting soluble fibre at each meal
(b) eating soluble fibre before insoluble fibre
(c) avoiding excess insoluble fibre
P.s I usually take a little break, after eating the soluble food , then I follow with the insoluble foods.
Please try it, it could work for you too. Print it out.