it’s a never ending problem for us. The dreaded butt burn. I’ve tried everything it seems: bidet, cleaning wipes, soft toilet paper, baneol cleanser, hydrocortisone, prep H cream, ilex, barrier cream, AD ointment, petroleum jelly, and prob a few more but can’t think of all of them now. 

By by the end of the day my butt is on fire. Even using the water from the bidet burns it. I try and wipe really well but it doesn’t seem to make a difference. If it’s not burning then it’s terribly itchy. I know I don’t have a yeast infection bc I’ve tried stuff for that too! Not sure what else to do. I have a newborn so it’s not practical for me to bathe every night- I’m lucky if I get a shower every day! I literally don’t know what else to try

Maybe a dermatologist might help? No sure. But this is ridiculous, sometimes at night it’s so irritated it hurts to walk? Any suggestions are welcomed! 

Original Post

Sorry for the issue, the butt burn is something that happens sometimes if I am not cautious. I use the sudocrem anti-rash twice and apply it directly over the hole. Also don't let the bidet water hit directly or use very low pressure. If I use fast water it scratches the skin and then takes a few days of care to fully heal. I use toilet paper gently to absorb any extra water. Reasons for a butt burn for me are if I have runny output or I exert too much pressure on the seat or if the bidet water hits directly on my bottom.

I've never actually suffered from butt burn, although should I experience the slightest of an itch or a burning sensation, I apply ilex paste.

Prior to my takedown I suffered from the most excruciating and painful skin errosion around my temporary stoma; it was so painful I wished I'd never had the surgery and believed I'd made a huge mistake.

I tried every product available to ease my pain and discomfort and the only product which provided instant relief, protected my skin and allowed my skin to heal, was the ilex Protectant Paste.

The ilex paste made all the difference and the oozing, burning and festering skin around my stoma was completely healed within 2 to 3 days.

ilex Paste can also be applied, to either protect the skin and prevent butt burn from occuring or applied to the damaged and inflamed skin and  protect the area fron further damage, thus allowing the skin to repair under a layer of ilex paste 

Trust me, the ilex paste really works.




Another thing that might be worth trying if all else fails is cholestyramine resin. It absorb the bile acids that might be contributing to the problem. It’s a prescription product. Good luck!

Good to now. I’ve tried ilex before but it built up and got really cakey. Maybe I was using too much? It also got stuck in the hair (gross I know) but was a pain! 

Ive tried colespamine lotion (not sure if i spelled it right), would that be the same thing as the script- same ingredients? I know it’s got menthol which does help a bit to cool the burn. 

I also use the bidet spray prob more forceful than I should. It’s so itchy that it helps! Maybe I’ll try to not put it on as high.

Has anyone tried a dermatologist? 

I’ve had to deal with the same  issues quite like you mentioned. The only thing I have found that has worked for me is Calmoseptine Ointment ‘really works’ and especially for the  itchiness. You can get it from a local pharmacy, they can order it for you or I buy it in bulk from Amazon $5 a tube for 4 ounces last quite a while. Good luck! 

Cholestyramine isn’t a lotion - it gets mixed into a suspension and taken by mouth.

The itching suggests fungus, even though anti-fungals/anti-yeast efforts have failed. 1) I wouldn’t use a bidet to scratch the itch - that’s pretty harsh, 2) make sure to let the area dry and to keep it dry, 3) a dermatologist could easily tell if it’s fungal, and suggest an appropriate treatment.

Some people like antifungal powders, though they aren’t my favorite.

Yeah, the ilex paste can become a goopy, sticky mess, which is only tolerable due to the level of discomfort, pain and desperation, however, there's a knack to its use.

  If butt burn is severe resulting in skin errosion, then the ilex paste must be heavily applied, kinda smeared over the affected area, best applied just before bed, whilst also doubling up on Imodium intake. The ilex must remain until it begins to peel away from the skin by its self, although in the meantime, keep reapplying after every BM; it's well worth the inconvenience for a couple of days.

 If need be, the ilex paste is easily removed by use of wet wipes.

 To apply the ilex as a preventative measure, only a very small pea size amount need be applied to the affected area after every BM.


Thansk for the suggestions everyone. I have tried the colesteymine suspension too- the powder. Had to discontinue bc I was pregnant. I still have a ton of it. I hate to add another medication to my regime but if it makes a difference, i guess I’d be game. It tastes horrible tho! Ick.

Ive also tried the C ointment (again can’t rememer the name but someone mentioned it above) and that doesn’t seem to do the trick either. 

I tried the ilex tonight, so far so good. I’ll let y’all know in the am. 

Cholestyramine comes in both sugar-sweetened and artificially sweetened formulations. Neither is pleasant, but they are different in taste.

Treatment is more likely to work if a cause is nailed down. For example, some of the solutions for chemical-type burns can make a fungal infection worse, by holding moisture close to the skin. Cholestyramine won’t help fungus at all.

I understand completely - I am at year 3 post J-Pouch surgery; the But Burn is the single worst thing about my Jpouch. I have gathered some takeaways from the kind folks posting what helps them,some of these have brought me a little relief.

Here are a few of my thoughts:

0. Step Zero and perhaps most important, "Everyone is Different"; however you are aiming for output that is not runny and not to solid. This is can be as challenging as throwing a dart and hitting a bullseye from 200 yards. Remember what you enjoy eating in the am can and will Burn in the late am\early pm ; I like this guide:

1. Be sure to use a Barrier Cream such as Calmoseptine, Ilex and or ZincoFax. I am still trying to determine which one works best for me... Everyone is different.

2. Do not use to much pressure with Bidet sprayer; will cause tissue damage and spread the burn everywhere..

2. Be sure to use medical gloves when using Bidet, applying barrier and or pat drys. I have had the output literally remove the skin off my hand (make sure you are not allergic to Latex - if not get Latex free; . I like  - Gorilla brand Vinyl Gloves - Amazon has them)

3. Some folks seem to suffer with But Burn more than others. I often have wondered if this has to do with the length of time someone has suffered with Ulcerative Colitis. In my case I endured 16 years before I had to have Colon removal or die.. aka hard headed Could part of the BB issue be do to damaged floor muscles? I suffer a bit of rectal leakage no matter how good a day I am having.

4. Sitz baths can be fabulous. On a real bad day I also apply 5% Lidocaine Ointment to numb the tale section. Your Doctor can prescribe Lidocaine and it is covered by insurance somewhat; over the counter offerings as well.

Hang in there...

Never heard of Zincofax. I’ll look it up. We just use petroleum jelly on her bum unless she’s got a rash. 

I usually have light stuff for breakfast - cereal mostly, maybe toast. It’s the stuff I eat for dinner I think that causes me issues - but again, nothing too spicy. Just chicken and rice, lasagna, pasta, meat, etc. we’re  pretty plain. 

I have tried the Ilex after every bowel movement for the past two days and it does seem to help. I don’t like how it gets so darn goopey, and then peels off later but I guess hats what it’s supposed to do. I know the baths are good but I can’t find the time with the baby, unfortunately. Sometimes I even have to hold her while I’m on the toilet! Not ideal but we do what we have to, right? 

Yeah, the ilex does get messy but it worth tolerating for a couple of days.

If the affected area is not red raw, oozing n weeping , the ilex paste can be thinly applied; it's not so messy when applied sparingly.

It may be possible to pin point a specific area that's more prone to the butt burn rather than just apply the ilex everywhere.

Once the ilex has been applied and dried, it's best to use wet wipes rather than toilet paper to cleanse as the toilet paper tends to drag and tear.

There's nothing wrong in completely removing the ilex by the use of wet wipes and reapplying after each BMs, you can pinch off clumps of dried ilex between wet wipes to remove it. 

Rather than diet being the cause, it could just be the wiping with toilet paper and the number of BMs.

 If find, after a BM, it's best to blot the area with toilet paper a few times, to absorb any residue before wiping; doing so will prevent chaffing.



Last edited by strange

Mentioned this in the past but for me it is all about Metamucil or any type of psyllium husk.  I believe with me it is about the acidity in my stool and the Metamucil thickens everything up.  If I don't take it 2x per day I get butt burn.  It's a life saver!

If you do manage time to sit in a bath or just to use a wet wash cloth, stick with cold or warm water. My doctor told me that hot water will make you feel the itch/burn more. So far, my experience has been best when I use a cool wash cloth to try to calm the burning feeling. Then I dry with the softest towel I have - lightly - or I use a little hand-held fan. Last, I apply some diaper rash cream. 

At least, when you buy the diaper rash cream you don't have to pretend to have a baby at home, which what I do.

But the best treatment is to thicken things up so that you don't get the burn so much. Hard to do! 

Amazon has an ointment called Uber Numb.  It's 5% lidocaine and I mix it with calmoseptine.  Best thing is to limit your diet to see what it is that's hurting you.  Stick to non gassy, non spicy foods for awhile and see if that helps.  


I tend to get sensitive/burn using toilet paper too much.  I have found that the pre-moistened wipes help me tremendously.  (Charmin Fresh Wipes or Cottonelle wipes).  It helps to clean off the acid and residue -- think about how you use wipes for your baby - same idea.  I can then lightly blot with toilet paper (super soft kind) to dry the area. 

I've also found that certain foods tend to increase butt burn.  For me it's tomato based products, or anything too spicy (chili, etc.).  You might want to do a trial with removing spicy foods for a week or so, then gradually add them back in to see if that is the culprit.

And, I totally agree with using Calmoseptine and Metamucil.  They've been my "friends" for 20+ years.

There might be an easy fix...old fashioned but easy...light and  the good old days they would put sunlamps on episiotomy scars and other moist zones down could try using a blow dryer or a sun lamp (for no more than 3-4 minutes at a time)...yeast hates light, air and heat generally works quite well.

If not, you need to walk around butt naked when at home and sit/sleep on a terry towel.


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