Owmybum - that’s really frustrating. Hang in there I’m sure we will both be back on track soon.
I’m gong the right way again this week very slowly though bit less sob each day. Please may it continue.

I did a search on "stress" to learn if it could have any influence on hard stools or going too often, etc, and came across this discussion thread. It has been heartening to read all the posts, not for easy solutions, but for the support offered to each other during such difficult times caused by fissures. It has helped me tremendously to realize that while not the cause, stress can play a role in tool many bowel movements, tight sphincter, or even hard stools. I obsess over each BM, and have too many, which prior to about a month ago was not having so many.

I had a very bad anterior fissure over a year ago, and after six weeks of rectiv the CRS said he couldn't see the fissure that stretched on the outside but he did not want to probe into the anus for fear of stretching what could be a healing fissure on the inside, and again he didn't do a full digital exam several months later and then my GP about six months later also didn't want to bother anything and said we could wait for the next six months checkup before doing a full digital exam. Of course, I then started stressing about prostate cancer and potential for anal cancer, but all the blood work was normal -- PSA, Metabolic Panel, etc., but that still made me stress. I was actually doing fairly well until about a month ago when a soft yet bulky bm caused pain in the very same anterior area as the fissure and it's been off and on since. I thought I was recovering until a couple of days ago -- had veggie tacos and the next day produced too many bm's and while soft enough they have been dry and hurt coming out. I thought I was doing all the right things, plenty of water, veggies, low fat and the like. I usually have salad and protein for dinner, oranges and zero fat yogurt for breakfast and no lunch, just a mid-day fruit and plenty of water. It should be flowing nicely, but instead they've been dry. Last night I had broccoli, mashed butternut squash and 1/2 chicken breast with two pieces of grilled polenta with one tomato (on the polenta). Today's BM was the most complete, been lots of small ones the past few days, but today seemed to be the best in terms of softness, consistency, and size and so far only have gone twice. My point is, my bm's should be flowing and not painful, but the area of the fissure (not sure if I re-opened it) remains sore. So, after reading through this discussion, I'm thinking that my high level of stress may be adding to the issue of hard stools and frequent b-movements. I take one docusate sodium with dinner every night, and have been doing so for over a year, not sure it is doing anything, but I'm terrified to stop in case it is helping and the stools get even harder without it.

The soreness around the area of the fissure, and the need to keep it perfectly clean, which has other issues, is bothersome and so is the fact that one bad BM can set the whole thing off. My wife and I pretty much eat the same thing and she will also mention that her stools are hard but thankfully she has never had any issues. Want to do something to turn this around once and for all, but just not sure anymore. To help with b-movements, since yesterday, I've put some vaseline up there when I have to go to ease passing, it seems to help somewhat. Of course, I'm worrying about what vaseline can do to anal area, too. Will have to stay on good course eating well and after CRS visit tomorrow hoping he can help, no much faith he can, maybe he will give me some ointment or confirm a fissure has returned or not, just hoping not something systematically sinister. In all of this, stress is clearly not helping, so thanks to everyone for sharing. It has actually helped me reduce stress, as I'm trying to actively relax, and even if temporarily, I feel the tension leaving my body. Thanks again and positive thoughts to everyone for smooth healing. I hope for a day when we can just go to the bathroom anywhere without fear of pain. Best wishes.

From my point of view, stress is the cause of hard stools and tight sphincter. This is clearly my case.
On the other hand why do you avoid fats? These are healthy and help tremendously with motility. Without fats the stool just stays in the colon and becomes dry and hard.

I thought adding more fats was good, too, and since the winter had been eating more meats, particular a Greek sausage (Locanico) several times a week and more cheeses and thought it helped with smoother bm's. However, when doing my annual check up, my cholesterol numbers which have been good over the years, were high (Overall was 205, HDL 42, LDL 131, Trig 161) and the GP wanted to put me on a statin right away. I had gained about 20 lbs since last year, which is not a good thing to do at 62, but also refused the statins and have been losing weight and excluding many fats. I've lost 13 lbs since early June and want to lose another 22 to get down to 180 and then stay there and I believe that will bring my weight and cholesterol numbers to where they should be without additional meds. So, that was a long story, but now trying to figure out how to integrate good fats into my diet without adverse effects. I usually eat an avocado every day and we have salmon at least three times per week and we use lots of olive oil in cooking, salads, and on vegetables, but doesn't seem to have the same effect. How to integrate the healthy fats into my diet seems to be a big challenge and I've not been very successful! Thanks for your help.

Tried to edit my previous post but couldn't for some reason. After writing it, and thinking about including more fats into the diet for softer/smoother stools, was thinking that maybe olive oil could help. I did a quick search and found several links about drinking one tablespoon of olive oil in the morning as a way to help. Has anyone tried drinking more olive oil as a way to deal with hard/dry stools? Was thinking to try it out tomorrow morning. Thanks again.

I believe you took a wise decision in staying out of statins. I seem to remember they create issues with arthritis and also are no good for our microbiome.
Related to olive oil there are people here who say it works. I only use it in salads so cannot comment on its efficacy.
Good luck in finding the best way to lose weight and keeping stools soft, I am sure there is a way.

Davimos- it’s so frustrating all this balancing, the fissure is priority but fixing it can knock onto other issues. My stomach for example seems bloated and rounded all the time in last few months and I believe it is due to change in diet to help fissure to heal.
I have heard of others taking olive oil by mouth to aid stool smoothness. But tried it but you could try is olive oil ok for your cholesterol levels or is “any” oil bad for your readings?

Thanks for your reply SueMac. From what I've read, Olive oil does not have cholesterol, and as a fat have to be careful not to overdo daily calorie count, but it is supposed to be help the good cholesterol (HDL) and lower the bad cholesterol (LDL). I've been eating about 1550 calories a day so think it will be ok. Today was the second day of taking a tablespoon and a half of olive oil in morning. BM this morning was very soft, but it was bulky and did hurt a bit coming out, but pain is not continuing after bm. I'm going to the doctor today, dreading the digital exam, so will see what happens. If it is the fissure re-opened then hoping to get Rectiv, it made me light headed last year but seemed to work. Only problem, this is a different CRS then last year -- the other one move to another area -- and this one told me at the last visit that he uses nifedipine, but I've read it is not as effective as the nitro ointment and the only side effect I had with the nitro (rectiv) was a bit light headed. It's all a fearful, dreadful mess! Thanks again.

One more thing, almost forgot, good luck with your process of healing. The bloated stomach sounds like an added discomfort. Sorry to hear that is adding to everything else.

Davimos - thank you, ~I'm on my way but the journey is long and slow. I'm much better than I was 12 months ago though.
The olive oils sounds like it is doing a good job and good if no cholesterol. I couldn't get on with nitro it made it all worse somehow! My fissure is healed anyhow no it's just ongoing soreness and discomfort which my body has to overcome.
good luck with the exam,i hope it isn't too bad and at least maybe you'll get some idea of how things are down there at the moment.