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Irritable Bowel Syndrome (IBS) Message Board
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Old 09-24-2009, 06:32 AM   #1
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Afraid to go after impacted stool caused fissure

I had been put on antibiotics a month ago which always kicks in my IBS (constipation). Usually it goes away with increased water/fiber, but that has not worked as well this time. There is bulk to my stool, but its becoming severely dry and impacted.

Two days ago, I had a huge BM urge, but when I went, it was so impacted that it would not come out. I strained and ended up passing it, but created an extremely painful fissure that nearly made me pass out... there was a decent amount of blood.

I went to my PCP and she told me to start taking Miralax, but I'm afraid to because I'm sure there's still impacted stool in there and if I try to go again immediately, the fissure hasn't had enough time to heal. I can't go through that pain again. Will the Miralax soften the already impacted stool in the end of my colon? Or does it only work on "new" stool. I know I should not prevent myself from going, and I haven't had an urge yet, but I haven't taken the Miralax or anything else either... Should I try an enema? What else can I do to soften the stool at the base of my colon???

 
Old 09-24-2009, 01:52 PM   #2
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Re: Afraid to go after impacted stool caused fissure

From my understanding, Miralax works in the colon and draws more water in so I can't see that making anything worse down there excect for the urge to go and you have to go otherwise it will get worse. I understand your hesitance because it is painful to pass a large lump of stool especially when you suffered a tear. It likely will soften some of the stool and around the stool to help for an easier passage. If it is already quite a hard dry lump then I don't know if it will break it down too much but lubricating helps make things easier and less painful. But I would think that it would be better than trying to pass on your own, the longer it sits in your colon the worse.

I am a nurse in geriatrics and for hard impacted stools in the rectum I usually give a glycerin suppository. the suppository works on the hard stool in the rectum softening around it and softening it (it isn't going to make this perfect soft stool though) it still isn't fun to pass but the suppository lubricates around the stool and helps to protect the rectum by making it easier to pass. I sometimes have them take a nice warm bath first to relax and then do the suppository and get good results.

enemas work fast so they don't really have the time to soften everything right up, they usually create a strong urge to go and then you go. That doesn't sound like something you are wanting. suppository sits in there for about 45 minutes and works on the stool and creates a better situation for passing it. I would do a suppository (glycerin) as a first step. Make sure you read instructions and insert correctly.

It is up to you and what your doctor has recommended. With the tear you have, you have to keep things soft so that it heals. I am not very familiar with miralax, but what we use in our practice is lactulose daily. It is a syrup like stuff that stays in tact in the tract and softens stool and around it. But I hear miralax is pretty good for constipation.

the number 1 prevention comes from your diet and water intake though

If you are really afraid and don't think you will be able to pass the stool without severe pain you can go to your hospital for assistance, they can help you to go !!

good luck.

 
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Old 09-24-2009, 01:57 PM   #3
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Re: Afraid to go after impacted stool caused fissure

Oh and just so you know you should be sure there is stool in the rectum before you do a suppository. The suppository won't work if there isn't any stool there and can cause cramping instead. So I always do a rectal check first to make sure there is stool there and then go with the suppository. If there isn't stool there then it has to be treated orally !! Just wanted to clarify that foryou

 
Old 09-24-2009, 10:55 PM   #4
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Re: Afraid to go after impacted stool caused fissure

hi!! yes i definitely would try a soapsuds enema. if you need advice on how to do it i will tell you.

 
Old 09-25-2009, 06:52 PM   #5
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Re: Afraid to go after impacted stool caused fissure

30 ml mineral oil at around 6 PM, again a 6 AM. Stool softener with it like coliase. Do not overdo the fiber and water, reduce sugar, red meat, and processed foods. When you have the urge, sit and relax for 30 seconds, push some, if nothing, get up. No oil based suppositories or ointments. Do not wipe too often - dab instead ith moist cloth - easy on the soap too... It helps to squat when cleaning or do a sitz bath - but open cheeks up in the bath by sitting on one leg or lieing down, get warm (not hot) water on it as often as possible - especially after BM - sometimes before can relax you. Do not read on the pot. An enima is the best way to prevent a new fissure if you feel a hard stool - and you can manipulate it too - gross, but effective. Lube things up with a non-petroleum based cream. Glycerine suppositories melt and make it easier for a hard stool to pass - leave it in for a while if you can (20 -30 minutes) . Calmoseptine works at preventing itch in the passage and is a good protector for the opening.

Get to an anal surgeon who has fixed fissures and done many LIS.

 
Old 09-28-2009, 06:24 AM   #6
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Re: Afraid to go after impacted stool caused fissure

Just to mention this, buy a jar of Fleets suppositorys and keep them in the fridge. They are so gentle and no cramping like some of the other stuff out there.
Getting it in is a bit hard but you can do it and then lay down to let it work on the impacted feces. A little at a time it works and you can walk not run to bathroom.
They stay fine forever in the fridge and you have them if you need them.

 
Old 10-05-2009, 04:33 AM   #7
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Re: Afraid to go after impacted stool caused fissure

To soften stool you can try something like Movicol. It draws water into your stool and softens it, it however works for some people and not others. I do not have any experience with Miralax, but I've read some good reviews on it. Movicol worked for me for painful and hard stools, obviously accompanied by drinking lots of water.

What I suggest (this works for me, I suffer/ed from pretty serious constipation sometimes which was accompanied by bleeding and painful stools) is to read when you're on the loo. I know it sounds silly, but it distracts you from the discomfort and that causes your muscles in your anus and surrounding area to relax which REALLY helps. I always take a book with me these days, else it just doesn't get things going.

Last edited by ifeelcrazy123; 10-05-2009 at 04:35 AM.

 
Old 08-27-2011, 02:16 PM   #8
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Angry Re: Afraid to go after impacted stool caused fissure

Quote:
Originally Posted by tammykinz View Post
Oh and just so you know you should be sure there is stool in the rectum before you do a suppository. The suppository won't work if there isn't any stool there and can cause cramping instead. So I always do a rectal check first to make sure there is stool there and then go with the suppository. If there isn't stool there then it has to be treated orally !! Just wanted to clarify that foryou
my impaction is high up in the colon and im taking miralax what isgoing to heppen i wnt to know if the impaction is going to come out, im passing some stool but the impaction is bulging in my stomach high up near my belly button and around teh pelvic areas its so gross, three monts

 
Old 09-03-2011, 09:27 AM   #9
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Re: Afraid to go after impacted stool caused fissure

i went to er in june with bloating and nausea,had xray they said my bowels wre full, i drank magnesuim citrate,didntwork went back they gave me other meds, ct scan finally someone gave me rectal xam said it was too high up to take out manually gave me miralx sent me home,its ten days of stomach crmps and nausea,will it ocme out

 
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