Thursday, September 4, 2014

Diary of a Crohn's Flare: Dealing with a sore butt

I suffer from severe diarrhea.  Several issues contribute to the problem:

  • Crohn's Disease
  • 14" of small intestine removed in 1998
  • 12" of small + large intestine removed on 8/2014
  • Ileocecal valve removed on 8/2014
  • Recent surgery
  • Extremely low fiber diet
  • Troubles digesting the soy proteins found in Ensure

All of these factors contributed to having 8 or more (sometimes many more) per day.  All of this action and the associated clean-up after each of these made my rectal area very sore and sometimes caused it to become so raw that bled.

In addition to these issues, I also contracted a yeast infection in the area a couple of weeks after the surgery.

Needless to say, I've been uncomfortable.

I deal with these issues using the following:

Cleansing Wipes:

Each time you clean after a bowel movement, the material you use can leave micro-lacerations (cuts) in the rectal tissue.

I only clean with (generic) Preparation Wipes.  Although the wipes contain alcohol and can cause some pain when used, I am able to complete clean after a bowel movement with only 2 wipes of the area.  Fewer wipes of the area causes less abrasion of the tissue.  The witch hazel in the wipes works as an astringent which helps close up any microscopic lacerations left after cleaning.  The aloe in the wipes both soothed the tissue and helped it heal.

Preparation H/Diaper Cream:

When the soreness and itching get really bad, consider using either diaper cream or preparation H ointment/cream.  Both of these help protect the rectal tissues from exposure to your stool.  They also provide a little protection from damage caused by cleaning up after a bowel movement.  Lastly they aid in tissue healing.

Diaper cream works better as protection while Preparation H does better at aiding healing.  Both of these seem to work fine for me.

Sitz Baths:

Several spots on your body have poor circulation compared to other spots on your body.  Both your feet and your butt have about the worst circulation on the human body.  To aid in healing, you can apply heat to these spots to help stimulate blood flow.  Luckily, the heat also feels soothing to sore tissue.

One way to apply heat to rectal tissues is to sit in a bath of hot water.  One method of providing hot water to sit in is a "Sitz Bath".  This is a plastic bowel that sits in toilet and contains hot water.  Furthermore, a vinyl bag can be filled with even hotter water and hung above the bowel to supply fresh hot water to the Sitz bath bowel allowing the hot water bath to last longer.  Epsom salts can be added to this water for certain conditions (like treating fistulas or abscesses?), however, for the purpose of aiding healing to sore rectal tissue, I recommend not using Epsom salts.  Ask you doctor about this before using them.

Also as I mentioned before, the Sitz bath provides relief to both soreness and itching in the area.

Yeast Infection

When you take Sitz baths regularly, you will be making this area much more moist.  This significantly increases the chances that you get a yeast infection.  To deal with the yeast infection, use over the counter (OTC) yeast infection remedies by following their directions.  However, you should also notify your doctor of this development and inform him of how you plan to treat it.

I've found that generic remedies for yeast infections work just as well for me as the name brand remedies but they're much less expensive (sometimes half as expensive).

Involve your doctor:

Discuss the problem with your doctor (the diarrhea, frequency of stools, consistency of bowel movements, and the soreness of your rectal tissues).  Ask your doctor what else you should be doing and/or other things that you can do to treat it.


Good luck!

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