Bum problems (gratuitous detail, NSFW).
December 7, 2009 9:01 PM Subscribe
Bum problems, possibly not (just) haemorrhoids (lots of detail, NSFW or in fact, lunch).
Sometimes my arse leaks. Not olestra-style diarrhea squirts, but heinous-skidmark causing "paste"-consistency crap oozing out over the course of the day. This is often coupled with unbearable itching and in hot, sweaty weather chafing and stinging pain.
It may be somewhat diet-related as it happens more often when I'm traveling and my schedule is disrupted. What will happen is that I'll have a crap of a somewhat "pasty" consistency which never quite feels complete (unlike what I take to be normal, in that each turd is well-formed and has a definite start and end). I will wipe and wipe and wipe and keep wiping but the cleanest I get is a small brown smudge on the tp (despite there being no clingons—it's like as I wipe, poo-paste is continually emerging). Often, it also feels like more of my arsehole is "inside out" (and I can feel this when I wash in the shower too, there's a kind of smoother skin all around my bumhole rather than a neat pucker).
I went to my primary care provider who had a look and a poke and said, "Yep, there was obviously some external tissue tearing and chafing. Eat more fibre". It only kind-of helps (this is a problem which comes and goes). But I'm interested to know about the mechanism of having a crap—should some of the poo-chute emerge and then retract when a proper crap happens? What might be stopping this from happening? Is this merely a symptom of haemorrhoids? Is there anything else I can do to stop it or fix it when it happens (prep-H gives some relief but mostly leads to more grotesque skidmarks)? I'm an early-30s male.
Sometimes my arse leaks. Not olestra-style diarrhea squirts, but heinous-skidmark causing "paste"-consistency crap oozing out over the course of the day. This is often coupled with unbearable itching and in hot, sweaty weather chafing and stinging pain.
It may be somewhat diet-related as it happens more often when I'm traveling and my schedule is disrupted. What will happen is that I'll have a crap of a somewhat "pasty" consistency which never quite feels complete (unlike what I take to be normal, in that each turd is well-formed and has a definite start and end). I will wipe and wipe and wipe and keep wiping but the cleanest I get is a small brown smudge on the tp (despite there being no clingons—it's like as I wipe, poo-paste is continually emerging). Often, it also feels like more of my arsehole is "inside out" (and I can feel this when I wash in the shower too, there's a kind of smoother skin all around my bumhole rather than a neat pucker).
I went to my primary care provider who had a look and a poke and said, "Yep, there was obviously some external tissue tearing and chafing. Eat more fibre". It only kind-of helps (this is a problem which comes and goes). But I'm interested to know about the mechanism of having a crap—should some of the poo-chute emerge and then retract when a proper crap happens? What might be stopping this from happening? Is this merely a symptom of haemorrhoids? Is there anything else I can do to stop it or fix it when it happens (prep-H gives some relief but mostly leads to more grotesque skidmarks)? I'm an early-30s male.
This sucks. Sorry you're going through it.
Have you had a history of constipation or other GI issues? You may want to read about rectal prolapse.
And go see a doc, for sure. Your bum needs help.
posted by Ouisch at 9:33 PM on December 7, 2009
Have you had a history of constipation or other GI issues? You may want to read about rectal prolapse.
And go see a doc, for sure. Your bum needs help.
posted by Ouisch at 9:33 PM on December 7, 2009
Sorry, you said you've already seen a doc -- might be worthwhile to see a specialist.
Also, re: fibre -- there are two kinds, both of which have different affects on the consistency of your poo.
Soluble fibre (found mostly on the insides of plants) will cause a gel-like, viscous consistency, and promotes holding the stools together.
Insoluble fibre (found in the bran and out peels of plants) will add bulk and will soften the stool (provided you drink enough water.)
Also, for topical relief, you might want to try witch hazel on a cotton pad. Or Tucks pads, which I think are essentially the same thing.
posted by Ouisch at 9:38 PM on December 7, 2009
Also, re: fibre -- there are two kinds, both of which have different affects on the consistency of your poo.
Soluble fibre (found mostly on the insides of plants) will cause a gel-like, viscous consistency, and promotes holding the stools together.
Insoluble fibre (found in the bran and out peels of plants) will add bulk and will soften the stool (provided you drink enough water.)
Also, for topical relief, you might want to try witch hazel on a cotton pad. Or Tucks pads, which I think are essentially the same thing.
posted by Ouisch at 9:38 PM on December 7, 2009
affects = effects. Sorry, I'm neurotic about these things.
posted by Ouisch at 9:39 PM on December 7, 2009
posted by Ouisch at 9:39 PM on December 7, 2009
Jeez, I posted (anonymously like you) almost exactly the same question a couple of years ago. Well perhaps not as colourfully as you, but the mods were evidently so disgusted that they wouldn't put it up. You must have more juice if you'll pardon the pun.
Anyway, in my experience, the cause is totally dietary, and I avoid it by not eating the usual suspects. Occasionally I will backslide (sorry) and the symptoms reappear on schedule.
Good luck.
posted by Neiltupper at 9:58 PM on December 7, 2009
Anyway, in my experience, the cause is totally dietary, and I avoid it by not eating the usual suspects. Occasionally I will backslide (sorry) and the symptoms reappear on schedule.
Good luck.
posted by Neiltupper at 9:58 PM on December 7, 2009
Good lord! You need sitz baths, pronto. Three or four times a day. Sit in a bathtub with a few inches of hot water, as hot as you can stand, for ten to twenty minutes. Heat stimulates blood flow which supposedly speeds up healing--you'll notice your skin gets red in the hot water. Go take one now.
posted by hydrophonic at 10:05 PM on December 7, 2009
posted by hydrophonic at 10:05 PM on December 7, 2009
The sitz bath is a good idea for whatever ails you. Having had rectal prolapse, it doesn't sound quite like it - but like mucosal discharge. Normal up to a point, or when excessive, often an indication that your lower gut is unhappy. Be kind to it. Up the fibre.
posted by Flashduck at 10:17 PM on December 7, 2009
posted by Flashduck at 10:17 PM on December 7, 2009
Thanks to this site, I now know that many people call a moderate version of your condition "mudbutt". 2005 thread. 2008 thread.
You may actually have or be on your way to fecal incontinence, which usually results from constipation and straining. If you can get your digestion sorted out so that you avoid the extremes of loose stools and constipation, you stand a pretty good chance of letting your sphincter recover from the strain of constipation, and you can reduce or eliminate leakage when your stool is more loose. Many people get a little mudbutt sometimes. You just want this to be very rare.
How clear have you been with your doctor? Does he know that it's not just mudbutt, but leakage between BMs? Can you see someone else if the words "I think I might have fecal incontinence" don't alert your doctor to try harder?
posted by wexford_arts at 10:22 PM on December 7, 2009
You may actually have or be on your way to fecal incontinence, which usually results from constipation and straining. If you can get your digestion sorted out so that you avoid the extremes of loose stools and constipation, you stand a pretty good chance of letting your sphincter recover from the strain of constipation, and you can reduce or eliminate leakage when your stool is more loose. Many people get a little mudbutt sometimes. You just want this to be very rare.
How clear have you been with your doctor? Does he know that it's not just mudbutt, but leakage between BMs? Can you see someone else if the words "I think I might have fecal incontinence" don't alert your doctor to try harder?
posted by wexford_arts at 10:22 PM on December 7, 2009
Aside from the leakage (ew...), that's relatively normal wear and tear, really. Keep it clean but be gentle (pro tip: check it with a mirror!), don't strain, get some ointment, take some sitz baths (not too hot—don't scald your delicates), drink plenty of water, eat more fibre.
If it is in fact beyond the typical fissure, there are a couple of surgical options, as well as—no, I'm not kidding at all—botox. There's also a couple of not-so-fun butt cancers that you might want to get screened for, but they're really rare.
posted by Sys Rq at 10:29 PM on December 7, 2009
If it is in fact beyond the typical fissure, there are a couple of surgical options, as well as—no, I'm not kidding at all—botox. There's also a couple of not-so-fun butt cancers that you might want to get screened for, but they're really rare.
posted by Sys Rq at 10:29 PM on December 7, 2009
What you've got does not really sound like hemorrhoids. External hemorrhoids are distinct protuberances, painful lumps on the rim of the anus. Usually there is some (minor and not medically significant but visible) bleeding with hemorrhoids. Take fiber more seriously, take a supplement like metamucil, the kind you mix with water, twice a day, every day, at roughly the same times every day. A better diet/lifestyle is probably the larger answer, but supplemental fiber taken with strict regularity (no pun...) can seriously revolutionize the way you poop. Having gone through a horrible abscess condition which was no fault of my own (it was an unusual I guess and lingering after-effect of some hard-core out-both-ends food poisoning) and having to be very, very, very conscientious and caring towards the nether regions I can sympathize that butt problems are no joke and they can really plague your life. For me the fiber does more good than anything else (though when I eat particularly well - lots of vegetables and whole grain, not so much fat, starch and sugar - is when the whole digestive system runs most smoothly throughout).
To run down the usual list of troublemakers: don't sit on the toilet for a long time - reading or particularly bad, sitting and straining to try to "finish." Be as gentle as possible cleaning up. Try moistened wipes but look for adult wipes like the medicated ones sold for hemorrhoid sufferers. If you do dry yourself well after to avoid chapping. The problem of not being able to evacuate your bowel full has mainly to do with diet I think, though other stresses might come into play - the large intestine is very mood-sensitive. Hard boozing generally exacerbates butt problems in my experience. You may be causing some of the discomfort and things not feeling quite right downstairs yourself by simply messing with it too much, poking around trying to figure out what's going on. Give it a rest, literally. Give fiber and diet a chance to work and just keep as clean as possible
posted by nanojath at 10:56 PM on December 7, 2009 [1 favorite]
To run down the usual list of troublemakers: don't sit on the toilet for a long time - reading or particularly bad, sitting and straining to try to "finish." Be as gentle as possible cleaning up. Try moistened wipes but look for adult wipes like the medicated ones sold for hemorrhoid sufferers. If you do dry yourself well after to avoid chapping. The problem of not being able to evacuate your bowel full has mainly to do with diet I think, though other stresses might come into play - the large intestine is very mood-sensitive. Hard boozing generally exacerbates butt problems in my experience. You may be causing some of the discomfort and things not feeling quite right downstairs yourself by simply messing with it too much, poking around trying to figure out what's going on. Give it a rest, literally. Give fiber and diet a chance to work and just keep as clean as possible
posted by nanojath at 10:56 PM on December 7, 2009 [1 favorite]
All of this advice is good - also try eating some apples or applesauce - the pectin in apples can help firm things up.
posted by The Light Fantastic at 11:19 PM on December 7, 2009
posted by The Light Fantastic at 11:19 PM on December 7, 2009
I can't speak to the leakiness, but my baby daughter has had problems with overly squishy poo and a couple of doctors have recommended Culturelle, which is concentrated lactobacillus in a capsule. Probiotics or acidophilus tablets are also supposed to help with general digestive happiness, too, and better digestive happiness might give the pooping end a chance to heal up from whatever's making it unhappy.
But the next time you go to your doctor I would discuss this again---it doesn't sound like the advice you got was particularly helpful.
posted by leahwrenn at 11:23 PM on December 7, 2009
But the next time you go to your doctor I would discuss this again---it doesn't sound like the advice you got was particularly helpful.
posted by leahwrenn at 11:23 PM on December 7, 2009
It sounds like your digestive tract could really use a cleanse. Have you considered doing a Master Cleanse, or another form of bowel detox? This would require you to spend a couple of days on the toilet but the results are amazing. Do a google image search to see what you can expect to expel (it's incredible). If your bowels haven't been functioning properly, it's likely that you have built up a 'plaque' of insoluble gunk on the inside of your intestines. Post cleanse, follow up with acidophilus and fibre to restore a healthy environment.
posted by heytch at 2:33 AM on December 8, 2009
posted by heytch at 2:33 AM on December 8, 2009
Colon cleansing and "detox" are in the realm of quackery; there is no such thing as a plaque of insoluble gunk on the inside of your intestines. There is a layer of mucus which is supposed to be there; it protects the colon from the caustic effects of shit. The solutions used for the "cleansing" enemas have a type of clay in them which bulks up and fools you into thinking that was inside you and cleaned out of you.
You need fiber (of both kinds). You need to incorporate fiber into your diet consistently, not occasionally to see if it will help.
Stop using toilet paper whenever you're able (like at home). It's made of cellulose which is very abrasive with repeated wiping. Use a squirt bottle of water to clean your anus and pat it dry (no rubbing) with tp.
posted by reflecked at 3:16 AM on December 8, 2009 [4 favorites]
You need fiber (of both kinds). You need to incorporate fiber into your diet consistently, not occasionally to see if it will help.
Stop using toilet paper whenever you're able (like at home). It's made of cellulose which is very abrasive with repeated wiping. Use a squirt bottle of water to clean your anus and pat it dry (no rubbing) with tp.
posted by reflecked at 3:16 AM on December 8, 2009 [4 favorites]
Plaque or not, people with impaired bowel function often benefit from cleansing or fasting. There are many fads out there, but the master cleanse is not one of them. It consists of lemon juice, salt and olive oil (read: nothing quackers can make profit from selling). I can testify that it works!
posted by heytch at 3:33 AM on December 8, 2009
posted by heytch at 3:33 AM on December 8, 2009
Someone I know was having bad butt problems and had to do a major cleanse before a colonoscopy. After the procedure, their problems all but(t) vanished. I'm going to assume it was the cleanse, rather than the camera jarring something loose, that cured this person's butt problem. All they did was the butt doctor's standard pre-procedure cleanse, which is a one-day fluid diet followed by a big bottle of Gatorade and a Miralax preparation. You can look up various recipes online ("Miralax cleanse" or similar). An evening in the toilet may cure some of your problems.
posted by theraflu at 3:57 AM on December 8, 2009
posted by theraflu at 3:57 AM on December 8, 2009
Increase your fiber like others have suggested and prevent further skin breakdown so the skin around your anus can repair. Sage Comfort Wipes have a barrier cream that protects your skin from the acidic nature of stool. Don't use any wipes that have alcohol in it.
Calmoseptime lotion is a barrier lotion that you might try. Both are available at most drug stores over the counter.
This is a common problem. You're not alone. Both of these products are used in hospitals and have a proven track record of solving your problem and preventing it from getting worse.
I second what reflecked says regarding clensing. That can make the problem much worse especially if it consist of lemon juice and salt which are abrasive to skin and suck moisture away from skin, drying it and causing more breakdown, preventing healing, adding more painful burning cracks and bleeding.
posted by dog food sugar at 5:44 AM on December 8, 2009
Calmoseptime lotion is a barrier lotion that you might try. Both are available at most drug stores over the counter.
This is a common problem. You're not alone. Both of these products are used in hospitals and have a proven track record of solving your problem and preventing it from getting worse.
I second what reflecked says regarding clensing. That can make the problem much worse especially if it consist of lemon juice and salt which are abrasive to skin and suck moisture away from skin, drying it and causing more breakdown, preventing healing, adding more painful burning cracks and bleeding.
posted by dog food sugar at 5:44 AM on December 8, 2009
People confuse evacuation with "cleansing" all the time. An enema is an enema; it does the job. Warm water (a little salt can't hurt, but makes no difference) is as good as anything. The evacuation needed in order to be able to visualize your lower intestine has to be exceptionally thorough, so a product is generally used.
If you're constipated, you're going to feel better after a successful enema. The trouble with enemas is that they work by distending the bowel and causing a rebound strong peristalsis. If you use enemas too much, your bowel becomes less effective in initiating an effective peristalsis on its own.
I am speaking as a medical professional, and have a lot of experience working with people who have GI problems.
Exercise and enough water and fibre are the key to healthy bowel function for most people. Please, OP, consult your MD before using "cleansing".
I still advise more fibre, enough water, regular exercise. :) And stop using toilet paper on that sore anus.
posted by reflecked at 5:46 AM on December 8, 2009
If you're constipated, you're going to feel better after a successful enema. The trouble with enemas is that they work by distending the bowel and causing a rebound strong peristalsis. If you use enemas too much, your bowel becomes less effective in initiating an effective peristalsis on its own.
I am speaking as a medical professional, and have a lot of experience working with people who have GI problems.
Exercise and enough water and fibre are the key to healthy bowel function for most people. Please, OP, consult your MD before using "cleansing".
I still advise more fibre, enough water, regular exercise. :) And stop using toilet paper on that sore anus.
posted by reflecked at 5:46 AM on December 8, 2009
Get an add-on "bidet" attachment for your toilet. They're inexpensive (I've found them for $20), easy to install and remove, and the best thing for the bathroom since indoor plumbing. You can spend a lot and get one with a built-in water heater and blow-drier, but in my experience those are more trouble than they're worth. The simple ones just hook up in line with the cold water going to the toilet tank, clamp under the screws that hold the seat in place, and have a control that lets you adjust the water flow. They quickly and completely rinse you clean; just pat dry with a couple of sheets of tp and you're good to go. They save lots of wear and tear on the old "nether region", leave you feeling clean and fresh, and cut tp use by about 90%.
posted by Death by Ugabooga at 7:03 AM on December 8, 2009
posted by Death by Ugabooga at 7:03 AM on December 8, 2009
follow-up from the OP
Holy crap (!) I love Ask MeFi. Thanks guys.posted by jessamyn at 7:52 AM on December 8, 2009
To those who suggested sitz baths, it sounds like that could well help
my symptoms but it's a little impractical while on the road. I'll try
the Tucks pads though.
I think wexford_arts has it (by which I mean to say, has named what I
have): mudbutt. To those concerned by the possibility of rectal prolapse
and fecal incontinence I think maybe I was a little too graphic, what's
described in the "2008 thread"
(http://ask.metafilter.com/97396/a-shitty-question) is exactly my
problem. It's not permanent, I have gone through lengthy periods of my
life in the wonderfully nirvanic state of one or two gargantuan, firm,
satisfying craps a day. It's just that right now, in a different country
with a different diet, little privacy and an irregular (ha!) schedule,
it's difficult to get the space to allow things to calm down.
I also wonder about a wheat intolerance. If I have a wheat-based cereal
for breakfast I fart like a brass band all day; "gluten free" avoids
that problem. Also what nanojath mentioned about the booze rings true,
but beer is especially problematic. A big night on red wine or spirits
and I don't get the same problem, necessarily (but could that be
dehydration?). And why is a dissolve-in-water supplement better than the (particularly more convenient) pill form?
And why is a dissolve-in-water supplement better than the (particularly more convenient) pill form?
I don't know the why or if it is a general reality, just personal experience of it working better.
posted by nanojath at 10:11 AM on December 8, 2009
I don't know the why or if it is a general reality, just personal experience of it working better.
posted by nanojath at 10:11 AM on December 8, 2009
Whatever you can do to cleanse the area with as little irritation as possible will probably help with some of the issues. If you are traveling a small squirt bottle from the drug store can function as a mini-bidet. Blotting with wipes is much preferred to wiping with dry tp.
posted by Big_B at 1:31 PM on December 8, 2009
posted by Big_B at 1:31 PM on December 8, 2009
My husband has a variation of this, from a combination of IBS and some badly removed hemorrhoids in the 80s. His GI doc did a bunch of tests (not celiac, not gallbladder). He gave him carafate and told him to quit lactose. It's made a big difference.
posted by media_itoku at 5:40 PM on December 8, 2009
posted by media_itoku at 5:40 PM on December 8, 2009
Coincidentally, I just received spam from a company from which I once bought a bidet attachment. They're having a "holiday sale". (Yeah - I know - "Merry Christmas, Dad - go wash your ass!") But FWIW:
http://store.bidanco.com/
posted by Death by Ugabooga at 6:08 PM on December 9, 2009
http://store.bidanco.com/
posted by Death by Ugabooga at 6:08 PM on December 9, 2009
This thread is closed to new comments.
That said, you might find it worthwhile to buy a travel-size pack of wet-wipes. These may help you get a cleaner wipe faster when you're traveling, without the chafing/abrasion/irritation that surely comes from over-wiping with dry paper.
posted by 2xplor at 9:17 PM on December 7, 2009 [1 favorite]