Hi GEB56,
I’m 3 years out and experience similar symptoms. Through trial and error, here’s what I’ve found helps:
- When symptoms get this bad, I give my bowel/pouch a rest. For two days, I go off solid food and drink 3-4 elemental shakes per day. I’ve been using AbsorbPlus since my UC days. Since the formula is essentially pre-digested, there is little if any stool. Because of that, your fissures and/or other inflammation from frequency will have a chance to heal.
- Continue with the very warm sitz baths.
- Use a toilet seat bidet or bottle bidet with every BM if possible. Pat dry carefully. Use a hair dryer on cool setting to completely dry the skin. Spread your cheeks and make sure it’s dry. Apply Ilex paste (available on Amazon—it’s the best for damaged skin!).
- After 2 days, begin solid food with a small amount of slow cooked oatmeal (never steel cut) and continue using the shakes as needed to maintain nutrition and protein. Eat foods you know are gentle. And of course eat your dinners as early as possible.
- Most important, never strain on the toilet. If you eat soluble fiber foods like oatmeal and bananas, you will pass stool with the right consistency and that helps you to not strain. If you feel trapped gas after the initial flow and you start to push and strain, STOP. Just get up, clean up and be done. You’ll have to go soon enough again and when you do, it will hopefully be easier. For me, even slight straining can cause pain and discomfort for days.
I’m also using Canasa generic right now as well as Visbiome. I also use 1-2 Lomotil tabs at bedtime and that definitely gives you better sleep.
Hope your situation improves!