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Reply to "Horrible butt burn and gas is killing me!"

Anal fissures tend to hurt more than they bleed. The raw outside skin you describe could just be from having 15-30 BMs/day. I think these are probably two separate problems, but it will be hard to get resolution of either one unless you can get the frequency of your trips to the toilet reduced. Your pouch is fairly new - were you given any instructions about trying to delay bathroom trips, gradually holding in a more reasonable quantity of output? This is often called “stretching the pouch.” It should be done gently and gradually, but if your pouch isn’t irritated you should be able to accomplish this.

For the severe external irritation some folks here swear by Ilex Barrier Cream. I’m guessing the one you have from the compounding pharmacy *might* be for internal fissures, but you didn’t say what’s in it. If it’s not for fissures you could ask your doctor about Rectiv. You might need some topical lidocaine applied gradually (along with some patience) to be able to tolerate applying the Rectiv where it needs to go.

You might get some benefit from psyllium fiber, which could help normalize your stool consistency - you’re aiming for pudding/applesauce consistency. It doesn’t sound like the loperamide is doing you much good - it might be worth trying it just at bedtime, to get more sleep.

I hope there are at least one or two ideas here that give you some relief. Don’t change too many things at once or you’ll confuse the heck out of yourself.

Last edited by Scott F
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