Hi all
I'm a 25 year old guy who has had an anal fissure for coming up on 4 years now. It's (as you guys no doubt understand) taken over my life and driving my crazy.
For the first 1.5 years it was terrible, and I had spasms of pain for hours every day. It improved somewhat after that and I almost got it to heal about 2 years ago, but it did not.
1 year ago I finally began drinking 12 cups+ of water a day and that made a noticeable difference. But from around that time, I have been unable to empty my bowels completely in one go. I used to be able to go have a BM and it would take about 35 minutes, and wouldn't go again during the day.
Now,
I started Miralax 1.5 months ago, and the bowel movements are very smooth. My problem is, I can't seem to empty. It takes 2 or 3 times in the morning over a period of 1.5 hours or so and it involves straining so there is no healing progressing!!! It feels that if I don't get everything out from the previous day, then I had a sense of fullness in my anus all day and discomfort. So much so that I will willingly strain in order to avoid the sensation.
Today I tried to not strain (like I've tried before) and left whatever is in there sit there, but I was basically in discomfort all morning and finall at 2pm I gave in to the urge and went again. There was not that much either, which drives me nuts because I am sure before I had the fissure or even 3 years ago I could hold in that much stool for another day. I don't know if it's cause my stool is so much softer, or my anxiety, or what.
I've tried 1/2 dose miralax, 1.5 doses miralax, (spread half over AM and PM), to no avail. I'm back on 1/2 dose each in the AM and PM.
Does any one have any advice? I really think I could heal my fissure if only I could empty in a reasonable time period/ without straining, or get through the day withoiut that sensation. But I mean I am thinking surgery too but I can see how I'd still have this problem after surgery anyways which could make it useless...

Hello Mangofort,
I'm sorry that you are feeling this way, it can be frustrating to feel incomplete emptying... I know how this one goes!
First of all, I think you should go see a doctor if you haven't. You could have another condition along with the fissure (which might actually contributing to the fissure not healing) and this should be taken care of as you try to heal the fissure.
So one day I had a very severe "clog" - dry stool and similar symptoms with things getting "stuck". My miraculous remedy was basically a glycerin suppository. Now, I'm not recommending you to use one without talking to a doctor, but I must say that when I had this problem, the suppository was magical. It worked in about 30 seconds.

Thanks for the post Dan. I don't really have dry stool at the end, it's generally progressively wetter at the end, so I don't think anything crazy is going on.
I have seen a CRS and have been under his care for 2 years now. I've tried GTN cream, diltiazem (currently) and have had 3 botox injections (sadly these don't seem to be working as well)
Sadly I was putting off surgery cause I was afraid of incontinence but now I am scared I left it too long and now I have bowel habit changes that might not resolve.

Oh, I see. Mangofort, I don't think that having maintained these habits for too long is that much of a big deal. In my personal experience, the body has a great ability to adapt.
For instance, before my fissure, I'd go to the bathroom once a day - for YEARS! A few days I'd go twice, but 90-95% of the days I'd go ONCE in the morning.
After the fissure, I changed my diet to have way more fibers and water. Now I go 3 times/day - it took some 4-5 weeks to get "regular" again but now I'm veyr regular going once early morning, another time after breakfast (yes, twice in a 2-3 hour period) and one last time after dinner. That's it.
So what I'm saying is that you shouldn't lose hope about getting your BMs right again. I'm not yet healed, but I'm feeling much better and noticed that my better state of mind is giving me way less weird urges. This condition can be hard on the nerves and this can totally affect your BMs.
Also, Diltiazem affected my stools - my CRS says it's a rare side effect, but it happened with me in a very obvious way. Like I said, I'd get crazy dry stools if I used too much diltiazem, and it was really hard to dose it since I'm so sensitive to it. I've been using Nifedipine in the last 2 days and haven't seen dry stools yet, so maybe the diltiazem could be affecting you too.

I have had incomplete emptying for quite a long time. I have IBS and have all sorts of troubles using the toilet. I have noticed that now that my sphincter is relaxing a bit more because of the hot baths, I don't have that feeling of stool sitting there waiting to come out quite as bad. I wonder if it is because the sphincter is relaxing enough to let more out? I know that it is an uncomfortable feeling, but maybe if you just ride it out, so to speak, and get some healing, it will resolve itself?

Tablespoon of coconut oil before bed always works for me!