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December 6, 2011 10:11 PM

Asking on behalf of my husband. A kindy icky question about abraded bum, and suggestions on how to deal and hopefully heal.

My husband, says...

I apologize in advance for the unpleasant nature of the following question.

I have run into a problem with abrasion of the skin in my rectal/anal area. This is due to two connected contributors. I have several bowel movements per day, each one requiring wiping (obviously). Also, I have been using baby wipes to clean vs. just dry toilet paper. Anyway, between the frequency and wiping, I have abraded the skin, and I am bleeding (not profusely, more like seeping) from the area. The problem is that I cannot refrain from wiping it clean long enough to allow it to heal. Also, it itches (I suppose, due to trying to heal), which becomes intolerable, so I end up scratching and making the problem worse. Although I can clean myself in the shower (sorry) to avoid wiping with cloth-like material, I can't do this all the time, like at work. I have tried a silicone barrier cream, but I think it isn't actually absorbing into my skin, due to the bleeding/seepage acting as a film. Lanacane for the itching actually seems to make the itch worse, and hemmorrhoid ointment doesn't seem to do much. The only solution I can think of is to go on a liquid diet (to minimize stool production) until the problem is sufficiently fixed, due to lack of wiping. Any suggestions? I've thought about a topical anesthetic, to minimize itch and, hence, scratching.

posted by Savannah to health & fitness (24 answers total)

I certainly don't know whether this is an issue that calls for a doctor's supervision, and don't mean to suggest that it doesn't, but in the meantime, there is a thing called a Lavette bottle or peri bottle that you can use instead of wiping with any kind of wipe, even at work.
posted by redfoxtail at 10:21 PM on December 6, 2011 [2 favorites]

Vaseline, while it sounds icky, might prove soothing, especially overnight.
posted by Occula at 10:21 PM on December 6, 2011

I'd stay away from a liquid diet. I find that tends to exacerbate the situation for me since my stools tend to get super runny, almost diarrhea quality, which requires even more wiping. Is there a single user/handicapped bathroom you can use at work? Those normally have the sinks right next to the toilet so you can wet the toilet paper and just dab at your bottom that way.
posted by astapasta24 at 10:22 PM on December 6, 2011 [1 favorite]

I find petroleum jelly to be effective in these matters, with the itching and the wiping. You don't need a lot, just around the anus. If you use too much you will get an uncomfortable squishiness between your cheeks. It will protect your skin, may help with the itching, and actually makes wiping less messy.

In the long run, I would consider that you may be wiping too aggressively, in general. Also, when cleaning in the shower, use a gentle body wash, foam it up somewhere else on your body first, apply body wash and rinse with your hands, there is no need for a cloth towel at all.
posted by grog at 10:22 PM on December 6, 2011

Doctor. This may be an anal fissure or other persistent irritation, and may require a course of antibiotics or other serious treatment. (Barrier creams are a barrier, they don't soak in. Witch hazel wipes are a sort of hell/heaven option and do sometimes help, but frankly, it's your ass. See a doctor.)

A wash bottle, like the Lavette bottle redfoxtail mentions, might hold you better for a day or two. You can often find them among feminine hygiene/post-natal supplies, if you've got that handy.

You do *not* want an infection there. You just really really don't. See a doctor.
posted by Lyn Never at 10:22 PM on December 6, 2011 [1 favorite]

I am not a doctor, I'm just a well educated man with an inconvenient backside :).

Hairy bastard with arse wiping problems? Yes I have that problem from time to time. Never of the severity that your husband reports. My friend who covertly admitted to me that he has the same problem wipes his arse with thick baby wipes (you find out about these things when your child craps themself at your friends house :) ). Personally I'm not prepared to do that due to the waste, and aversion to having to buy yet another product at the shops.

In the absence of a flexible hose connected to the same water outlet as the cistern (yes, life is better with a hand held bidet) to use as an alternative to toilet paper, my preference is to shower as frequently as I can, particularly paying attention to washing my arse thoroughly during the process, occasionally exclusively an arse only shower. Drying fairly well is also desirable - a bit of toilet paper should do for this after you develop hand held bidet usage expertise. In the absence of that, a regular application of nappy rash cream (the opaque white stuff, basically a mix of vaseline and some magnesium carbonate) is also very helpful.

It sounds like you've got it pretty bad, and would probably benefit from antibiotics as Dr Lyn says.

It's probably also worthwhile familiarising youself with the Bristol Stool Scale. The looser it is, the more likely it is to sting after an hour or so.

A lot of my bowel problems were cured after I was treated for H. pylori. You may want to get yourself checked out for that. Having to take a bowel movement several times a day is not especially normal, and you should get that checked out, whether the cause is clinical obesity, or something else ... not enough information and in any case you should get it checked out in person.
posted by singingfish at 11:09 PM on December 6, 2011

Sitz baths, a two or three times a day, as hot as he can while still being comfortable. Heat increases blood flow to the area (notice how the skin turns red), which promotes healing.
posted by hydrophonic at 11:11 PM on December 6, 2011

I had problems like this. Once the skin is sufficiently damaged, infections (both yeast and bacterial) get in and make things worse. If it's persistent I'm afraid there may be an infection already.

If that is your problem, you need to go to the doctor who will probably give you an antibiotic/steroid cream that both cures the infection and reduces inflammation. A week to ten days should sort it out, and I would then advise using a different cream as a preventive measure - Sudocrem worked well for me in spite of its baby nappy associations (I think you have that locally.)

This is just my experience, IANAD, YMMV, etc.
posted by Segundus at 12:33 AM on December 7, 2011

BTW, I hope you're not held back by reluctance to have someone look up your bum. I must have seen about eight different doctors and most of them sort of apologised for doing it - I felt like telling them I was sure it was a worse experience for them than me.

Then again the last one said "so, you want me to have a look up there", and I wanted to say "No, as a matter of fact that's showing up quite strongly on the list of things I'd rather you didn't do, but we both know it has to happen, don't we?"

And it does.
posted by Segundus at 12:41 AM on December 7, 2011

When my son was circumcise by a well respected doc, we were directed to get those sterile gauze bandage pads you use for big cuts, smear them with petroleum jelly, and then place them over the wound until it healed.

I suggest a similar application for this problem. Forgive my wording, but just wedge the smeared pad "up in there" and wait for healing. We changed the pad every diaper change. So, frequently.

Good luck.
posted by jbenben at 12:49 AM on December 7, 2011

It may sounds obvious but - eat less for a little while. If your stools are too loose, try reducing your fiber intake a bit. And take a couple of days off work if you can (call in sick as this is a type of illness) - say a Thursday and Friday. This means you don't have to wipe for 4 days - just get in the shower and wash with Betadine (from Wikipedia: Betadine may be used topically for surface infections of the human rectum). If you can't take time off work, put some Betadine on your wipes and use discretely at work.
posted by hazyjane at 1:25 AM on December 7, 2011

A guy I know has a very similar problem. He uses Cottonelle Wipes exclusively, he even takes travel sized packages to work.

He also uses Boudreaux's Butt Paste after wiping. Boudreax's is great for lots of things. Not only diaper rash, I use it for razor burn on my legs too. Nothing soothes like Boudreaux's.
posted by TooFewShoes at 2:26 AM on December 7, 2011 [1 favorite]

Try Aquaphor or some Neosporin on the affected area. I have had success with both, with Aquaphor offering a little more protection (its thickness hepls with this I would guess, while the ingredients in Neo or Polysporin can help heal a problematic area. Good Luck.
posted by chosemerveilleux at 3:32 AM on December 7, 2011

This may be overkill, but here is a review of a number of ways to protect the perineal area in incontinent patients (I realize your problem is not incontinence but frequency, but the same principles apply). That may give you some ideas.

Your husband may also want to look into why he is have such frequent bowel movements. What is normal varies quite widely, but if they are coming so frequently that he is having problems with skin breakdown, that is not normal.
posted by TedW at 4:59 AM on December 7, 2011

While the other posters are correct that this CAN be a serious problem, I will offer this method to try before seeing a doc. He's probably scratching it, when just makes it much worse. He's probably got "seepage", when the anus basically produces some clear liquid in response to the scratching. Tell him to get some cortisone salve. After each bowel movement, wipe with a baby wipe, PAT day with paper (not wipe), and then liberally apply the cortisone. DO NOT SCRATCH! After a few days of this, he should see a marked improvement in the itchiness of the area. Keep doing the cortisone for a week, and he should be all healed up.
posted by cosmicbandito at 5:38 AM on December 7, 2011

Don't use baby wipes, use a wet washcloth - a flannel rag would be best. My older son had terrible, terrible rashes and we ended up getting some of what my mother referred to as a "lollipop" from her nursing supplies at her work at a major hospital. It looks like a lollipop on a stick, but the top is made up of a foam soaked with polyurethane-smelling liquid which is almost like a mild superglue to rub on the wound to really coat it well. It takes a few seconds to dry, but then lasts 24 hours and really helped fix the worst of the problem. Know anyone who works in a hospital or nursing home?
posted by kpht at 6:02 AM on December 7, 2011

Thanks everyone! I agree, it's time for a doctor visit as well. He is very grateful for all the responses.
posted by Savannah at 6:05 AM on December 7, 2011

Sitz baths, definitely. Also, somewhat inspired by a tangent in a toilet-related fpp, I ended up getting an add-on bidet for my bathroom at home and haven't regretted it.
posted by rmd1023 at 6:17 AM on December 7, 2011

Witch hazel.
posted by gjc at 6:33 AM on December 7, 2011

Eat psyllium husk. A dessertspoon of husk + a cup of water --> soft, cohesive and mostly non-adhesive turds. That plus rinsing instead of wiping, then patting dry and slathering with a mild and soothing antiseptic cream like Savlon, should clear things up.
posted by flabdablet at 6:52 AM on December 7, 2011

I found that Benedryl helped with itching. Particularly helpful at night, since it also makes me sleepy.
posted by Billiken at 7:11 AM on December 7, 2011

A&D ointment works on this. It's like petroleum jelly/Vaseline, but with Lanolin, zinc and vitamins A & D, all of which promote healing.
posted by beagle at 11:48 AM on December 7, 2011

Diaper rash ointment aka zinc oxide ointment is the absolute best! My oldest used to get red weepy diaper rash everywhere, and Desiden was the only thing that would heal it. It sticks to raw wounds and immediately soothes, unlike vaseline and even better than A&D (although A&D isn't too bad.) There are some diaper rash ointments that smell better than others, so you might ask your druggist. When I had some gut problems that left me raw, this was what the doc recommended. I told him I was already on to it. Seriously, good stuff.
posted by BlueHorse at 8:34 PM on December 7, 2011

Stop using soap down there. You can develop dermatitis in sensitive areas (heck, even your face) from soap you've been using for years. A friend of mine with a similar problem had a doctor who said only to use water, and if needed there's a medical cleanser, the name of which he can't recall. The baby wipes also have soap (and possibly SLS or whatever other chemicals soap has that can irritate), so that might inadvertently be making the problem worse. Hopefully the doc can give him some cortisone cream or something to help clear it up, but for long-term maintenance, remember: no soap!
posted by Addlepated at 12:06 PM on December 8, 2011