The Colon Club

BrownBagger wrote:... The whole soluble fiber thing was a revelation to me. In addition to their other benefits, soluble fiber sources like white rice are digestive system lubricants. They keep it all moving. I noticed when I had the ileostomy that after eating rice, I'd always get a nice clean slide when draining the bag. I didn't figure out until later that it was the soluble fiber slicking things up.

Kenny -

On a different thread, Eric made reference to the soluble/insoluble fiber distinction, which I think is one of the main keys to avoiding butt pain in the first place. To deal with butt pain, I think the preference would be to prevent it from happening at the outset if at all possible so that you don't ever have to focus on what kind of treatment to apply.

From my point of view, prevention involves four primary dimensions, all of which have to be dealt with at the same time. These dimensions are:

• Acidity of stool: The acidity of the stool must be minimized to the greatest extent possible. A lot of this is under the control of the patient by avoiding foods and condiments that are acidic or spicy in nature. This means focusing on a very bland diet. There are various leaflets available to help the patient identify foods, beverages, and medications for minimizing acidity of the stool output. I think that pain is likely to occur in the rectal, anal, or anastomosis region whenever acidic stool content passes through.
• Bulk/hardness of stool: The stool needs to be small and soft, not hard, because large, hard stools will expand the anastomosis junction and/or the anal canal and cause severe pain. Large stools can also cause anal fissures, which will cause even more excruciating pain. This is where the soluble/insoluble fiber issue comes into play. The softness of the stool is largely under the control of the patient if the patient pays attention to what is put into his/her mouth. This includes medications, since some medications can cause constipation as a primary or secondary effect. This means that the patient needs to focus on diets that have the right kind of fiber and the proper proportions of other ingredients. There are various leaflets available in this area to help patients identify which combinations of food/beverage/medication/supplements will reliably yield a soft stool. You will want to avoid a hard stool at all cost because this can cause an anal fissure, which will then take a long, long time to heal. A large, hard stool might even cause a rupture or leak at the anastomosis junction, which is an even more serious problem. You will also want to avoid large stools due to eating large meals. This is why the standard recommendation is to eat 5 or 6 small snacks per day and to never eat a very large meal.
• Method of wiping/cleaning: I would say that the preferred method of cleaning oneself after a bowel movement is to use water spray (e.g., bidet or small hose with nozzle). The worst practice is to use rough toilet paper with a scraping motion or wet wipes containing noxious chemical moisteners. Some problems with surface butt pain are exacerbated by patients using an inappropriate method for self cleaning.
• Exercise/physical movement: The normal functioning of the intestine is facilitated by normal body movement, such as walking. For good intestinal motility, it is bad to be horizontal in bed all day or in 'couch-potato' mode. The body should be in a vertical position a majority of the time to prevent extremes in digestive function (i.e., diarrhea, constipation). To facilitate regularity of bowel movement and to facilitate the reliable production of soft, semi-solid stools, physical exercise is an important component.

So, I would recommend focusing on preventing butt pain first, rather than waiting until the only option left is to treat butt pain or seek its relief in various creams or preparations.
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Keywords: butt pain, butt burn, proctitis, rectal pain, radiation pain, sore bum hole, sore bottom, painful anus, anal pain, sore butt, anal fissure ooooo

I am so feeling your pain. my current Irinotecan Tx is blocking me up something chronic and until the "dam breaks" two or three days after infusion I go through hell. Im also a martyr to acidic stool, rectal tears and fissures and just general overuse.

Ow.

Luckily my wife has some good narcotics for back pain, so if the Ibu or paracetamol isn't bringing it, I pop one of those.

Im a fan of psyllium husks too, but keep forgetting to take them.

That's a good post o stoma Mia, thanks for that.

It seems this is just another pain in the butt we all have to go through.

Sophy, I'm sorry you're having to deal with this on a permanent basis.

Pog I hope the dam breaks soon so you can get some relief.

pog451 wrote:I am so feeling your pain. my current Irinotecan Tx is blocking me up something chronic and until the "dam breaks" two or three days after infusion I go through hell. Im also a martyr to acidic stool, rectal tears and fissures and just general overuse.

Ow.

Luckily my wife has some good narcotics for back pain, so if the Ibu or paracetamol isn't bringing it, I pop one of those.

Im a fan of psyllium husks too, but keep forgetting to take them.

I get something similar in about the same timeframe, post chemo, Pog. I've noticed that it's gotten better over time. For the first couple of infusions, my rectum swelled up and I got a fissure. Now, I drink a big glass of Metamucil for four days straight, beginning on infusion day. That takes care of most of the constipation, and I think it helps minimize the swelling. My biggest complaint now, after my digestive system wakes back up on day 2 or 3, is the frequent urge to go. I try to control that with Lomotil and Imodium. If I balance the two remedies correctly, I can get by with a minimum of discomfort and disruption. When I get butt burn (not always), I resort to Calmoseptine.

Anyway, my point its that my body tends to adjust to the chemo side effects, lessening them over time. I'm hoping you see similar results. Good luck.

kennyt-wisted wrote:Kelly
I didn't have radiation fun the first go around. Did the five day high dose and surgery I believe 7 days later. I did have some of this same pain while recovering from LAR surg. I'm guessing this could be radiation induced though

Kenny - hope you know I was teasing

When my sister was in the hospital last year for some serious health issues, she developed some wicked serious sores on the butt, UCSF compounded some ointment that has cocaine in it (sounds crazy). They said they usually use it in labor and delivery for pain. I tried searching, but I couldn't find the exact name or compound, but it was an ointment (probably zinc based?). It was hard to get, you had to get it at a specialty pharmacy that compounds, but it sounded like it was some good pain control.

Hope you get some relief soon.

Of course I know you were teasing. I like it. I was going to ask onc for a serious butt creme I'd really be moving up in the world if I start using cocaine laced butt lube.

I'm just going to put this out there in case it might help someone. I too was experiencing butt pain after my surgery (before reversal) and I got pelvic floor physical therapy. Made all the difference in the world. I actually delayed my reversal so I could finish my PT. For a woman they go in through your vagina and help relax the pelvic floor muscles. Not sure what they do with men Best of luck Kenny Kristi

With that being said, I think I'll stick with the pills for a while

First of all, so sorry about your heinous anus. My time is hopefully coming up in late spring. Because of my @$_(# insurance company I am having to do things a bit out of order. Currently am in chemo instead of recovering from my resection. I have to tell you how grateful I am that you haven't lost your sense of humor. You crack me up.

Teddi

Teddi wrote:First of all, so sorry about your heinous anus. My time is hopefully coming up in late spring. Because of my @$_(# insurance company I am having to do things a bit out of order. Currently am in chemo instead of recovering from my resection. I have to tell you how grateful I am that you haven't lost your sense of humor. You crack me up.

Teddi

Sorry Kenny to intrude on your thread, butt cocaine might work without mixing it with calmoseptine Perish that thought
Teddi,
I did some major chemo and radiation before surgery to shrink the cancer before surgery. It is not pleasant, and I feel it was very beneficial to me.
Michael

We're all Butt hurt here Michael. At times anyhow. I'm always happy to hear from a fellow nutcase.

Teddi, it would sure be nice if we could laugh our way back to health. When we lose our sense of humor we've then lost everything.

kennyt-wisted wrote: When we lose our sense of humor we've then lost everything.

OR in my case ... what passes for a sense of humor ...
BUTT ... HEY
I'll take what I can get....

So I took what I could get
Yes, I took what I could get
And then she looked at me with them big brown eyes

And said,
You ain't seen nothin' yet
B-b-b-baby, you just ain't seen n-n-nothin' yet

Sorry folks ... have not had enuff great song lyrics here lately

BUTT following on from my bro' kenny ...

If I can't try to laugh at life's joke on me then I am taking myself too seriously, and that gets me down. -CRguy

'nuff said !

Cheers All
CR

Well here is my simple pain reliever, butt pain reliever I mean. I sit in the bathtub with the hottest water I can stand. The water is so hot it leaves my skin bright red, NO SOAP, just water. When I can't stand the heat any more I get out. I dry off and make sure, did I say "make sure" the "butt burned area" is dry......really dry and then I put plain old vaseline on it and go to bed. It's the only thing that worked for me.

Cathie

Cathie wrote:Well here is my simple pain reliever, butt pain reliever I mean. I sit in the bathtub with the hottest water I can stand. The water is so hot it leaves my skin bright red, .......
Cathie

WELL you see Cathie ..... the guys here may NOT exactly wanna join you in the super HOT bath ....
'cos ... OK maybe that came out wrong BUTT you see ... we GUYS may have a reason for NOT dipping our nether regions in boiling hot water ... butt pain be damned ...

BTDT

NOT recommended ... BUTT JMO

Ya see I use a bidet ... so I can direct whatever water at whatever temp ... WHERE it needs to go and .....
how shall I say this ..... reduce any collateral damage ... ???

Kenny : the "guys" will thank you ..... BTDT !

cheers all
CR

live and learn, CRguy. i knew about the cold water issues, but this is news to me. lol