Alright, so, too much fiber = problems. All of the recommended fissure-friendly foods generally contain fiber (of course). I’ve been eating oatmeal, soft whole grain wheat tortillas with flax seeds, whole grain wheat bread, a tiny bit of smooth peanut butter here and there, plain hummus, peaches, Greek yogurt, blueberries, raspberries, strawberries, watermelon, an occasional banana, baby spinach, and on one occasion a bit of brown rice + a few tiny pieces of white chicken breast. I’m drinking around 100 ounces of water per day, and taking a capful of Miralax daily (to the top line in the cap, the recommended dose for adults).

The result? Gas and fairly loose stools – not liquid, but what I would consider borderline diarrhea. A 6 on the Bristol scale, I think. I’m a little confused on the scale because some people are saying you want stools the consistency of toothpaste or soft-serve ice cream, which I would think is what I’m experiencing. But other people say you want soft yet formed/bulky stool. Soft-serve ice-cream texture isn’t going to be formed... If anyone can shed some light on this issue, I’d be grateful.

Anyway, it’s also day 3 of my period, a time when I usually get a nervous tummy and really bad cramps, and I’ve been having this loose stool a bit too much. Last night I put less than half my usual Miralax dose in my water, but this morning I had nausea and loose stools twice. I took one Imodium pill and then cut another pill and took half - I was desperately worried this would wreak havoc on my fissure. Most of the discomfort I’m feeling, however, is the usual uncomfortable sensation I get after diarrhea rather than fissure pain, so that’s a plus. I’m using some preparation H suppositories, and might start using the prescription hydrocortisone suppositories a CRS gave me until I see her next week to try to undo any irritation this may be causing. Given that I have to use more than one wet wipe afterward, I do imagine it could be causing some issues, maybe a bit of inflammation? It can’t be good to coat a fissure with stool. Hence the suppositories to clean it out a bit. Not sure if I want to attempt an enema.

I skipped breakfast this morning due to the nausea, and all I ate for lunch was 5 saltine crackers, Greek yogurt, and a banana. For dinner I tried to choke down some black beans, and they almost came right up again. I can barely get past the taste, unfortunately. I'm going to have some oatmeal shortly instead. It’s possible I’m getting too much insoluble fiber, and need to try to stick with soluble fiber. I’ll probably still take some Miralax tonight to combat the Imodium, although I doubt that small of a dose will do much harm. At least, I hope...

I should note that I’m taking a probiotic pill right now (I skipped last night’s dose because I was nervous it was contributing to the stomach upset), and eat 2 soluble fiber gummies every day. I tried taking a Metamucil pill last night in an attempt to add at least a little bulk to my stool – no luck (yet).

It seems to me that I may be overdoing the fiber, especially when I take Miralax on top of it. Does it matter so much what you eat when you’re on something like Miralax, which should soften your stool (and help you be regular) regardless of the food it consists of? I mean, I’m not planning on scarfing down a giant mixed bag of almonds, popcorn, and crunchy potato chips, but I almost feel like I’m doing myself a disservice by eating so much fiber combined with a stool softener. Someone else on the forum mentioned that Miralax pretty much “pulverized” the food in her stomach, so I’m just wondering if I should stop being paranoid about ONLY eating foods with fiber and incorporate other stuff for balance? I mean, we talk about how you shouldn’t eat any foods that may not be fully digested and therefore have sharp pieces, like tortilla chips, but doesn’t the Miralax “pulverize” everything, chips included?

I do plan on trying to incorporate more/different foods into my diet. According to my research, rye and pumpernickel bread have more soluble fiber than whole wheat/grain bread. Go figure… I’ve put both on my grocery list.

What do you think – what should I do? How much do you agonize about the food you eat when you take an effective daily stool softener?

It's a very difficult one to answer, as we are all so individual, and react to foods so differently too.
Since I started on movicol I find it is very reliable, and most foodstuffs come out nice and soft. It's very important to drink plenty of water though so the movicol can do it's job in drawing water into your bowels and keeping your bm nice and soft.
Just try to remember... A dry tortilla chip will not come out as a dry tortilla chip... It will get mixed with other foods and drink and get broken down by digestive juices in the stomach. Unless you have a condition like ibs, you should trust in your body that it will digest the food properly, and with adequate water along with a stool softener, you should be ok.
I must also add though, that I'm not saying go out and eat a pizza and steak etc.... But try not to get scared to eat!

I use to wonder the same thing about Miralax so I got a little brave one night and had tacos, rice and beans... I paid for it the next morning. My BM was huge and bulky and I took a cap full of Miralax before dinner with a lot of liquids that day. BUT, I do feel like I'm some what free with my diet. I eat pasta and breads (only whole wheat/grain) chicken, seafood, muffins, brown rice, oat bran muffins, honey high fiber English muffins, eggs, dairy free ice cream (yum) and I've just started drinking "Boost" drinks to help me gain weight. I take the recommend amount of Miralax every night and my BM's are still different all the time. I can't get myself to be on the same exact diet every single day. I love food WAY TOO much. So to answer your question, eat what you want including chips and nuts (I eat both pretty much everyday along with fruits and veggies) but don't get crazy. I wouldn't go and eat a burger or a pizza or fried taco shells and count on the Miralax to discard it. Eat eat eat! :)

owmybum wrote:It's a very difficult one to answer, as we are all so individual, and react to foods so differently too.
Since I started on movicol I find it is very reliable, and most foodstuffs come out nice and soft. It's very important to drink plenty of water though so the movicol can do it's job in drawing water into your bowels and keeping your bm nice and soft.
Just try to remember... A dry tortilla chip will not come out as a dry tortilla chip... It will get mixed with other foods and drink and get broken down by digestive juices in the stomach. Unless you have a condition like ibs, you should trust in your body that it will digest the food properly, and with adequate water along with a stool softener, you should be ok.
I must also add though, that I'm not saying go out and eat a pizza and steak etc.... But try not to get scared to eat!

Well, I see so many people here (and elsewhere) warning against food that may not be fully digested (chips, nuts, basically hard/crunchy foods), so I'm trying to eat mainly softer stuff. But I'm hungry for something other than fruit, oatmeal, applesauce, and yogurt. It gets old fast. Today I actually chewed two pretzels and then just spit them out, I was so desperate for something I actually found tasty. :roll: After reading that it's really soluble fiber we want, I've stopped eating my wheat bread, which I believe is mainly insoluble. Unfortunately the majority of the fiber I normally eat is insoluble, I think.
And of course, everyone talks about eating a very specific diet and avoiding cheese, certain meats, etc, which got me to wondering...shouldn't Miralax take care of that? Why are we still so limited if we're taking a softener? I'm not advocating switching to a 100% awful diet. Eat your veggies, whole grains/wheat, fruit, etc, but can't we have some of the rest too?

Like owmybum said, every body is different, but I can take Miralax and eat ANYTHING except high fiber foods and my stool still comes out nice and soft, like melted ice cream. As long as it isn't high fiber, there are no limits to my diet. Of course, I still try and drink lots of water.

Thisfissurecankissmyass- (like your user name btw) what happens when you eat high fiber food with mirilax? And by anything do you really mean anything?? Cheese? White bread? Alcohol? I'm so jealous! Lol what dosage do you take.

I can eat ANYTHING (although I don't drink any alcohol) and still have regular, soft stools! I eat pizza several times a week. However, when I eat high fiber foods or take fiber supplements (even synthetic fiber), it bulks up my stool. This might be good for some people, but large, soft stools don't work for me. I tried the whole "increase your fiber intake" advice for over a year and reducing my fiber intake was one of the best decisions I made. Right now, I take a half dose of Miralax a day (I used to take a full dose, but it made my stool a little too soft). My CRS said he is fine with me reducing my fiber intake for a while (6 months or so) and then to slowly introduce fiber back into my diet and see how things go. But for now, I avoid all forms of fiber as much as I can, and it works for me (thanks, IMO, to the miracle of Miralax).

thisfissurecankissmybutt wrote:I can eat ANYTHING (although I don't drink any alcohol) and still have regular, soft stools! I eat pizza several times a week. However, when I eat high fiber foods or take fiber supplements (even synthetic fiber), it bulks up my stool. This might be good for some people, but large, soft stools don't work for me. I tried the whole "increase your fiber intake" advice for over a year and reducing my fiber intake was one of the best decisions I made. Right now, I take a half dose of Miralax a day (I used to take a full dose, but it made my stool a little too soft). My CRS said he is fine with me reducing my fiber intake for a while (6 months or so) and then to slowly introduce fiber back into my diet and see how things go. But for now, I avoid all forms of fiber as much as I can, and it works for me (thanks, IMO, to the miracle of Miralax).

You are making me want to call up Pizza Hut RIGHT NOW and order 20 pizzas.
Man oh man, I wish. I get to see a CRS on Tuesday, so I'll be curious what she sees/tells me. For now, I'll continue being careful, especially since I had to take an anti-diarrhea pill yesterday.

Hmm I wonder if more of us could get away with eating more of what we want but were just too scared to try..

Hi,
Just to add, I think key here, is not so much the focus on the diet in the later fissure stages, but the focus on your diet at the stage when you have a very acute and painful fissure and what you need to do then to ensure that everything comes out in the softest form possible so as to reduce the pain factor and promote the healing process asap. Your stools have to be softer than soft at this stage because you simply can not cause further stress to the area for the sake of both the fissure and your sanity!
I think that when anyone develops a fissure and because of all that pain that comes with it, most people automatically switch to fissure-friendly foods/ start taking stool softeners / up their fibre levels etc. in the hope that this will suddenly "cure" things and because it is the recommended thing to do. I am in no way arguing that, because my belief is that these very things are majorly important and long-term too, especially since Constipation & straining are undoubtedly major factors in the creation of fissures for a lot of people.
I do believe however, that once a fissure is healing/ healed, it IS possible to return to eating pretty much what you want but absolutely in moderation and with a high level of fluids every day. I believe there's a lot of stress involved in just figuring out what to eat, which stool softener to take!
For me personally, although healed, I have pretty much returned to the diet I was eating pre-fissure and with no issues but I have learned from the experience that:
1) Primarily, I was definitely NOT drinking enough fluids and perhaps became dehydrated without realising it. = NOT good, hard, difficult to expel stools = Fissure alert!
2) Some of the foods I was eating were rubbish! - Pizza, Chips, White bread, Biscuits, Cakes DO produce harder stools without a doubt. If I eat these, it's not so much issues with straining now I get ( I just don't do it!) but poorly formed and lumpy stools which are more difficult to expel and I know that these should be eaten rarely now. I do eat a slice of pizza or a portion of chips but these are rare occasions these days......
3) My fibre levels were already sufficient. I didn't actually need to change that at all and consumed adequate fibre in bran cereals/ wholegrain breads/ fruits/ veggies/ beans etc already.
4) Because of the above, my stools were soft enough. I introduced a stool softener in the painful days to get through the experience and admittedly, was scared to stop taking that but having substituted with Magnesium, I have the softest stools ever these days.
Part of the recovery is to gain trust again in your body that you can digest any foods with generally no issues but to be aware always that you should be drinking a lot and doing it all in moderation. In some respects, I think we are the lucky ones! We may have all experienced a lot of pain and stress with a fissure but at least our "wake-up" call to healthy eating/ healthy living is nothing life-threatening. Consider all the others out there suffering far more serious medical conditions due to poor dietary habits, alcohol abuse etc... over the years....... :)