Any information would be greatly appreciated... Ironically i don't believe my fissure to be to bad at least so far. Most of the pain is coming from a hard stool i cannot seem to soften enough to pass...
Little Background Information:
I've recently developed an anal fissure, after attempting to pass a hard stool, even having to stop in the middle of the movement. This bout of constipation came a few weeks after an earlier bout in which i actually had a GI X-ray which showed a moderate amount of stool throughout and what appeared to them to be a "Bone Island" a small 8x8mm object.
Anyway, the last time stool softeners and oral laxatives eventually turned my waste into paste after about 3 days and i was able to pass the remainder with no issue. This time however, it hasn't been so easy. This time i've improved my diet, more water, more fiber, stool softeners, I just started taking miralax 2 days ago but going isn't really my issue.
Now i have a fissure which doesn't bother me until stool hit's the descending colon and makes it route to the rectum. There it sits and attempts to come out but its to large and hard, i already passed one large and hard stool with this fissure and it was the most unbearable pain i had ever suffered in my life, not to mention probably the largest stool. It felt like i had given birth, i was in tears lol.
Like i said my diet is consisting mostly of salads, soups, yogurt, maybe some fish if i really need meat, and lots and lots of water. I'm taking Stool Softeners 100mg Decusate Sodium 2 a day, Benefiber one of those pre-portioned packets a day. And like i said just began taking Miralax but going isn't really my issue, does Miralax help break down the stool as well? as far as i understand it's simply a laxative that makes you need to go.
Is there anything i can do to even just reduce the pain, or further steps to soften the stool? it only hurts when i attempt to pass a bowel movement...

Miralax is a laxative in the sense that it causes water to be retained in the stool, making it softer and easier to pass. Unlike other types of laxatives it is not a stimulant that works on the nerves and muscles of the bowel. Getting the right combination of diet and fiber and stool softeners when you have a fissure takes a lot of experimenting and even more patience. Since everyone is so different in the way their digestive system responds, it is really something that has to be tailored to each individual. It sounds like you are heading in the absolute right direction. Miralax can be slow to act in some people, fast in others. You may need to start experimenting with increasing the dose until you achieve a softer consistency that allows for easy passage with no straining.
Have you seen a colorectal surgeon about your fissure? A surgeon can help give you guidance on dosages to take as well as discuss treatment options with you such as topicals that can help relieve the sphincter pain and spasms and promote healing.
In the meantime, soaking in a warm bath or sitting on a warm heating pad can help with the pain, and lubricating with Vaseline before a bowel movement can also help some with the pain of passing stool.

Keeping everything soft (like many have stated) is the key to healing a fissure. Hard stools won't allow your fissure to heal. Fiber supplements helped me stabilize my bowels. Good luck!

I have used Vaseline even to the point of caking it on, it has little effect on my issue. I have not seen a surgeon, my doctor is sending me for a routine blood panel, and following that i believe he is going to refer me to a G.I. Doc.
This fissure first appeared at least in severity maybe Tuesday or Wednesday of last week, so i haven't had to deal with it nearly as long as many of you have i can guarantee that, However I know holding in stool can cause larger problems but i just can't pass whats there. I have been dealing with harder stools and constipation for quite awhile though so that's where my understanding of what path to take has come from. However, softening it has never been this difficult.
I've even attempted rubber gloves and plenty of Vaseline to break it apart before coming out, but my muscles are doing their job pretty well and just seem to want to innately force it all out quickly. I will attempt to up the dosage of Miralax, now that i know it's full potential. Now i understand why everyone praises it.

Keep in mind that with a fissure, constipation issues can be more stubborn than usual because in the presence of a fissure there is increased muscular tension in the sphincter and probably to some extent the pelvic floor muscles. So you may need higher doses than you would normally to see an effect. Fiber is also important, but as you know, with increased fiber there also needs to be a huge increase in water consumption or else the increased fiber will just exacerbate the constipation. Deep abdominal breathing can help relax the pelvic floor, especially during bowel movements, and for some it can also be very helpful to elevate the feet during a bowel movement (a stack of books or footstool will work). The higher you can get your knees and then leaning forward on the toilet slightly helps bring the rectum and anus into a more relaxed, straightened position. As your stools become softer they more or less just fall out without any effort.
A good GI doctor should recommend some sort of topical such as nitroglycerin or nifedipine or diltiazem...but some of them still recommend steroid creams. Watch out for steroids, which can be counter productive for fissures. You are early in the fissure cycle, and so it is important to get good treatment early on for a better chance at healing. The longer you have the fissure the more difficult it becomes to heal with conservative measures.
I hope you find relief quickly. This is such a painful and frustrating affliction that affects every aspect of our lives.

First off i would like to thank all of you for being so helpful and right off the bat none-the-less this has been a great help... I did do some research and found information on nitroglycerin, nifedipine, and diltiazem and their aid in pain relief... I will have to bring this up when i have my appointment with my G.I. Doctor.
I do believe that the Miralax and water are beginning to take their affect, as the bloating and pain are less frequent. Just hope I'll beable to pass a stool sometime soon i suppose, and patiently wait for the G.I. appointment.
Question though, my mother recently bought me some hemorrhoid cream could that possibly offer me relief?

Hi Neon,
I have read some posts here about squirting warm water or olive oil into your rectum to help soften a stool that feels too hard. They use a bulb or medicine syringe.
If you do a search here for 'olive oil' some of these discussions will come up.
Good luck with the miralax and more water!
Hope you heal quickly.
-Tanya

I will check those out thank you...

some hemorrhoid creams can be helpful, but some of them are actually worse for the fissure... Do you have the active ingredients handy?
So glad to hear the Miralax seems to be kicking in. Oh, and some people experience a lot of excess gas when they first start Miralax. This is caused by the flora in the intestine getting adjusted to it. If there is increased gas most people report it gets better over the first couple of weeks. Just FYI.

Basically I am very backed-up i actually just attempted to pass a stool, with relatively little pain comparatively but i could feel it getting stuck, i need the watery consistency i used to get...
Granted the last time i passed a stool was 3 days ago and it was a large one... but within a day i seemed to fill back up... Plus the passing was incredibly painful... i now have a new appreciation for expected mothers painful... and i think I've only been on the miralax for about the same amount of time so I'm giving it some more time. I'm not going and it doesn't seem softer however it seems more compact if you know what i mean... like still there just smaller in density, which I'm assuming is Miralax work.
and the Hemorrhoid Ointment Ingredients:
Mineral oil 14%
Classified Purpose Protectant
Petrolatum 71.9%
Classified Purpose Protectant
Phenylephrine HCI 0.25%
Classified Purpose Vasoconstrictor
Shark Liver Oil
Classified Purpose Protectant