by NeuropathicGuy » 01 Aug 2010, 18:26
Hey there, Metamucil is a bulk fiber adder. It makes stools bigger (as you've already discovered) but not necessarily softer. That's where the Colace, Miralax, etc. comes in. I tried Colace for a while too but it was never nearly as effective as Miralax for me personally. If you find the Colace sufficient then stick with that; if you want to try something else, Miralax would be a good candidate IMO.
I had my fissure for about half a year before I went for Botox. Before Botox, I tried nifedipine and nitroglycerin. Nifedipine never did much for me, but nitroglycerin at least brought the pain down to manageable levels. After Botox, I was blissfully pain free for several months. Maybe a bit too pain free because then I stopped taking Miralax and started eating "bad fissure foods" again, which led to a re-tear.
After I re-tore the fissure, I tried diltiazem, but it wasn't too effective for me. I know some others have gotten good results from it though.
I also made radical changes to my diet. Before my fissure, I ate fast food, junk food, plus coffee and beer all the time. After the fissure, I eat mostly veggie soup and no red meats at all. Even now, after surgery, I still eat mostly veggie soup and any meats consist of only fish and chicken (preferably boiled). I can eat chocolate and other junk foods, no problem there, so long as I take Miralax and drink lots of water.
There's definitely hope, but most people who have had a fissure do have to be careful diet-wise forever.
Also, not to play doctor or override your CRS' advice, but most of us played around with different diets and stool softeners until we found what worked for us individually. A lot of times doctors will just give general advice that doesn't account for individual variances. Soft stool really is key no matter what ointment or other treatment method you decide on, so I can't stress how important it is to find something that keeps your bowel movements soft and effortless.