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Discussion Starter · #1 ·
I was diagnosed with an anal fissure a few weeks ago and am using a prescription cream of lidocaine and nifedipine. I've had IBS-C for years and never had a fissure before, and I don't think it's a coincidence that it developed after I started taking Linzess a few months ago. I'm on the highest dose (290 mcg) but unlike when I was on the lowest dose several years ago and had what I called "borderline diarrhea" almost every day, the drug now is unpredictable. I have days with no activity and days with a lot, sometimes very hard, large stools that probably caused the fissure and now are interfering with healing. I'd like to try something to make the stools a little softer and easier to pass. My doctor suggested lactulose, which I tried a few years ago and recall that it did little or nothing despite assurances that it would have a very strong effect. I told the doctor I"d like to try magnesium. My magnesium level was tested recently and is normal, so I guess I wouldn't need a high dose. He suggested a product, which I didn't see the first time I browsed in a store, but will continue to look for. In general, what type of magnesium should I try, and what's an entry level dose? I'd like to try something that I can adjust, like a liquid, rather than a tablet with a fixed dose that might be too much.
 

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so sorry you have a fissure--must be painful. i'm only familar with magnesium citrate in the capsule and magnesium citrate in tablet form--not liquid magnesium citrate. the tablet form you can cut in halves or in thirds. good luck. hope you can find liquid magnesium citrate.
 

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Discussion Starter · #3 ·
so sorry you have a fissure--must be painful. i'm only familar with magnesium citrate in the capsule and magnesium citrate in tablet form--not liquid magnesium citrate. the tablet form you can cut in halves or in thirds. good luck. hope you can find liquid magnesium citrate.
Thanks. I'll look around. I didn't spend a lot of time on the health products aisle last time I was in the store, so I need to try some other places and evaluate the options. A tablet I can halve would be fine. I'm just wary of taking too much and thought it best to start slow. I've begun taking fiber as a powder I mix with iiquid, but although the maximum daily dose for adults is two tablespoons, I started at 1/4 tsp. and have only upped it to 1/2 tsp., soon to be 1 teaspoon. I bought a bottle of liquid magnesium citrate a few months ago when a doctor recommended drinking the whole thing, which I think was 8 ounces, as somewhat of a "cleanse" like colonoscopy prep solution following a particularly bad backup. I could get that and take a small spoonful. But at any rate, I need to do more research and shopping. Some days I have a lot of activity now, although it's unpredictable, and don't want to make that even worse while trying to get some benefit the rest of the time.
 

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I usually suggest magnesium citrate for this purpose, and the titratable product I recommend to my clients is the Calm product. It's a powder you mix with water. The full dose recommended on the bottle is 325 mg for 2 tsp, but you can adjust this infinitely to suit your body's needs. That full amount may be enough to encourage a BM the next morning, but some people require more. And for some, no matter the amount, it doesn't do anything.

Ultimately, anything you try is testing whether that solution is part of your symptom mechanism, so even if it doesn't work, in this case, you would know that liquid content of your stool isn't part of the mechanism of your constipation. (This is how magnesium citrate loosens stool).

I hope that helps :)
 

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Discussion Starter · #6 ·
I usually suggest magnesium citrate for this purpose, and the titratable product I recommend to my clients is the Calm product. It's a powder you mix with water. The full dose recommended on the bottle is 325 mg for 2 tsp, but you can adjust this infinitely to suit your body's needs. That full amount may be enough to encourage a BM the next morning, but some people require more. And for some, no matter the amount, it doesn't do anything.

Ultimately, anything you try is testing whether that solution is part of your symptom mechanism, so even if it doesn't work, in this case, you would know that liquid content of your stool isn't part of the mechanism of your constipation. (This is how magnesium citrate loosens stool).

I hope that helps :)
I bought both magnesium oxide tablets (500 mg) and magnesium citrate, which I believe are 200 or 250 mg. I decided to try the oxide; although the label recommends 2 to 4 tablets, I've only taken one, and at this point only two days in a row (I skipped yesterday). Two days is probably not nearly enough time to reach any conclusions, especially since I'm taking such a low dose. My doctor suggested I take more Miralax to supplement the Linzess 290, rather than magnesium or lactulose (which at my last office visit a month ago he very strongly advocated; I filled the prescription but haven't used it). If I use both Miralax and calcium, I won't know what's helping, although I've used Miralax for years and know that it will ultimately make something happen, although when and what is uncertain. Would you recommend switching to the magnesium citrate formula, one tablet or two? The way my system is so difficult, maybe I should use both magnesium and Miralax.
 

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I strongly encourage you to try them separately so you can tell which effect is coming from what. Sometimes, up to 400 mg or even more of mag citrate is needed for the effect. Start low and work your way up to whatever amount does the trick for you. The worst that can happen is it doesn't do anything, and you go back to the miralax.
 
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