At a glance
It is a confusing place to be. You have done the work. Stools are soft now. But they still feel wide, you can feel the stretch, and the fissure tears again.
- Soft and small are not the same thing. A stool can be soft but still large enough to stretch the anal canal.
- With a fissure, the inner sphincter is often tighter than usual. That means the opening has less give, so even soft stools can pull on the tear.
- Fibre type matters. Some fibres mainly add bulk. Others mainly hold water. People commonly report that swapping the type, not just the amount, made the difference.
- Stool changes can only do so much. If tears keep happening with soft stools, it is worth asking a clinician about treatments that relax the sphincter.
Why soft stools can still be too big
Stool size comes from how much is in the stool and how long it sits in the bowel before you go.
Bulking fibre adds mass. Wheat bran, wholegrains, and supplements such as psyllium (Metamucil, Fybogel) and methylcellulose (Citrucel) add bulk. That is their job. For many people it helps. For some with a fissure, it means soft stools that are still wide.
Holding on makes stools bigger. When going hurts, people often put it off. The longer a stool waits in the rectum, the more it builds up and the more water it loses. Fear and delay are a very common thread in these accounts.
A tight sphincter has less stretch. A fissure often comes with a sphincter muscle that is in spasm or has a higher resting tone. A stool that would pass easily through a relaxed opening can still tear a tight one. This is why some people heal with stool changes alone and others need treatment from a clinician.
What people describe trying
Across many anonymised accounts, these are the changes people mention most. None of them work for everyone.
Changing the type of fibre. This is the most common turning point. People describe:
- Cutting back on wheat bran, bran cereals and high-fibre bars
- Getting more fibre from cooked vegetables, fruit, oats and lentils
- Swapping a bulking supplement for one that adds less bulk, or stopping it for a while
- Steaming or cooking vegetables rather than eating lots of raw ones
Lowering a very high fibre total. Some people had pushed fibre far beyond what they used to eat, thinking more was safer. Several describe stools shrinking after easing back towards a more moderate amount.
Softening without adding bulk. Some people moved from a bulking fibre to an osmotic option such as macrogol (Miralax, Movicol, Laxido), which softens stools without adding much mass. Many describe stools getting narrower after this change. A pharmacist can help you decide whether this suits you.
Smaller, more regular meals. Some people found that eating smaller amounts more often led to smaller, more frequent stools rather than one large one.
Going when the urge comes. People describe trying to go when they first feel the urge rather than waiting. Smaller, more frequent stools are often easier than one large one that built up.
Posture and patience. A footstool to raise the knees, leaning forward slightly, breathing out and not straining. People describe this as helping the muscle relax so the stool can pass with less stretch.
The “why bulk up at all?” question
This one confuses a lot of people. They are told to bulk up, then find bulk is the problem.
The idea behind bulking is that a formed, soft stool passes in one go and keeps the bowel regular. Some people find it really helps. They describe fewer trips, less wiping and less burning than with very loose stools. For them, bulking was the answer.
Others with a tighter sphincter find bulking makes stools too wide for a healing tear. For them, softening with less bulk works better.
Both groups are right about their own bodies. The aim is soft and formed, and comfortable for you to pass. That might mean more bulk, less bulk or a mix.
Where this fits with other treatment
If stools are soft and the fissure keeps tearing, that is useful information to take to a clinician. It suggests the sphincter itself may be part of the problem.
Clinicians may talk about:
- Prescribed ointments that relax the sphincter muscle
- Botox injections into the sphincter
- Surgery, such as a lateral internal sphincterotomy, for fissures that do not heal
These are decisions for you and your clinician. A simple record of what you eat, what you take, how your stools look and when tears happen can make that conversation much clearer.
Questions people take to their appointment
- “My stools are soft but still large. Should I change my fibre?”
- “Would an osmotic softener suit me better than a bulking one?”
- “Is my sphincter tight, and would treatment for that help?”
- “Could a dietitian help me get the balance right?”
- “How long should I try stool changes before we look at other options?”
When to seek care
Get urgent help (call 999 in the UK, or your local emergency number) if you have:
- Heavy bleeding that will not stop, or you feel faint
- Severe pain with fever, or severe tummy pain with vomiting
See your GP or call NHS 111 soon if you have:
- Pain that is getting worse rather than better
- Fever, swelling, a hard painful lump or discharge near the anus
- Bleeding that is heavier than usual or not settling
- Bleeding alongside unexplained weight loss, ongoing tiredness, or a family history of bowel cancer
Book a GP appointment if:
- Your fissure keeps tearing despite soft stools
- It has not healed after six to eight weeks
- You often feel you cannot fully empty, or stools are very large most days
- Your bowel habit has changed and stayed changed. This matters at any age, and more so over 50