by jr2 » 23 Feb 2013, 14:47
If you are literally urinating 20 times a day or anywhere near that you're overloading on the water. Yes, Metamucil and Miralax require a good amount of water, but that's pretty extreme. In fact, at some point when you dilute your body that much with water you can actually do yourself more harm than good. It can cause all kinds of disturbances, electrolyte imbalances, etc.
For the irritation you could try a barrier type of cream like Calmoseptine or even Desitin to protect and soothe the skin. A short course of low dose of over-the-counter hydrocortisone cream might help to soothe the irritation (no more than a couple of weeks).
As far as how much Miralax to take, you should take the smallest amount you need to achieve soft, easy-to-pass stools that don't damage the fissure. The only way to know how much that is for you is to try different amounts out.
If the irritation continues you need to get that looked at to make sure it isn't an infection of some kind. It could be the Miralax or something in your diet, or just the frequency of urination and being exposed to all that moisture, but if it doesn't clear up with simple steps at home or gets worse you really ought to have it looked at.