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Hi all. I have had my J-pouch for 2 years.  Why oh why is the itching so insane! Interestingly, my BM in the morning causes no itching and I usually don't go again for 4 hours; again no itching.  From around 2:00 on, I have about 5 BM's which all cause burning and ridiculous itching.  I have an arsenal (about 20) of different lotions and potions; none of which work.  Vaseline is best and that is not saying much.  I worry about the constant breakdown of the anal lining.  I have fissures which itch and use Diltiazem ointment occasionally.  Sometimes a hemorrhoid.  I just feel raw for the first couple inches.  Appreciate any feedback. Thanks.

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Are you taking antibiotics? Antibiotics makes one prone to yeast infections and the itchiness could signal a yeast infection. Applying lotions and Vaseline on it bathe it in a moisture that yeast love and thrive in. Yeast effects the skin in areas where the sun don't shine and where moisture collects. You can't bathe your anus in sunlight, but you can keep it dry and try an antifungal powder like Zeabsorb. 

You might want to see a dermatologist. When I have had past fungal infections on my skin it's a 30 second diagnosis after a superficial scraping of the skin and peek under the microscope. Best treatment for now is blow dryer to the anus at night and morning, keep it dry and apply Zeabsorb morning and night.

I love your answer!  Something I had not considered.  I am a person with very sensitive skin to start with. If you just look at me the wrong way, I will get a rash!  You are right and, after working for doctors for 35 years, I should have considered fungal infection. I did start Flagyl 4 days ago for presumed pouchitis, but the crazy itch well preceded that.  I also agree that the "guck" turns things into a science experiment!  I have used a hair dryer and I definitely like being dry.  When things flare up, I get slight anal leakage at night and that is very skin unfriendly.  I have been trying to get a scope, to no avail now due to Covid. I will buy Zeabsorb tomorrow.  Thanks for your help.

I was plagued by yeast infections when taking cipro and flagyl. I got them in my leg pits mostly but a few were bad and spread all through my groin and underside of my scrotum. A combination of blow drying the area, Zeabsorb, and rotating onto xifaxin which is not systemically absorbed, knocked it out. I had a really bad one that spread because I was putting Desitin on it. My dermatologist told me it spread because Desitin has a high water content and I was just locking in moisture and feeding the fungi. I would see a dermatologist if it doesn't get better soon. There are antifungal pills and I took them once for the one that got real bad.

Last edited by CTBarrister

That sounds unpleasant. To say the least. I have so many allergies to antibiotics that I am down to just Flagyl and Biaxin.  I know there is a one pill "cure" Diflucan.  I would like the definitive diagnosis before the treatment.  No dermatologists are seeing people in Ontario with the Covid. 😞  Thanks again. Will keep you posted.

Fungal infections are the classic cause of itchiness, but another possibility in this case is that the fissures aren’t healing completely and are chronically torturing you. It sounds like you’re using the diltiazem on and off to manage the symptoms, but you may well be stopping it too soon (perhaps much too soon). As pain gets milder and milder it can commonly be experienced as itchiness. I don’t know how you were instructed to use the diltiazem, but you wouldn’t be the first person to get a simmering condition from less-than-decisive treatment. Good luck!

Thank you Scott.  An excellent thought.  I may, well, be discontinuing the Diltiazem hastily.  I feel that I need a scope badly. I have a hard anal lump about an inch in that feels unusual and worrisome (not a hemorrhoid) x 14 days now. I want it diagnosed prior to starting a longer course of Diltiazem, but agree that that may be the answer.  Trial and error seems par for the course with J-pouch and ostomies.  Will keep you in the loop.

@GEB56 posted:

Why oh why is the itching so insane!

I find ilex paste is the best product to alleviate itching.

  Apply a very small pea size amount to the area; I find it best, to apply slap bang into middle of opening and, then smooth the ilex paste outwards and away in all directions.

In such an application, when applying the ilex paste, less is more.

If your itching is caused by an internal Anal Fissure; then apply a small pea size amount of ilex Paste onto the tip of a finger and apply it internally, just to the inner edge of anal sphincter; normally, when applying the ilex in such a manner, once the ilex hits the spot, you’ll know about it; initially, but very very briefly, it’ll sting but in the same instance, you’ll feel instant relief.

Applying the ilex in such a manner may sound uncomfortable and somewhat unpleasant; I can assure you it isn’t and any uncomfortableness, is preferable to the itching; sometimes, needs must.

However, on the ilex tube and packaging; it actually states: For External Use Only, although I’ve been applying it internally, as I’ve described, on and off, for six years and without issues.

Last edited by strange
@GEB56 posted:

Hi Lauren. Thank you. My skin is so sensitive that even water hitting my inflamed behind is painful.  I am not sure I will try this.  Why do you have 13 to 20 BM's ? I am unhappy with my 8 or 9. I use Metamucil with each meal and 3 Imodium with each meal.  That cut things down from 12 times a day.

Oh dear, I am sorry to hear that, I hope things gets better. Maybe when things clear up it might be better to try. 

I am not sure why I have soo many BMS, its always been like that or more. 9% of the community have 13 or over so I am just rare Stool thickner remedies would just clog me up very badly. I tried high fiber diets and they constipated the hell out of me. I am just meant to go that often perhaps. Too bad stool thickner remedies do not work for everyone. You get use to going that often after a while. I am almost at 6 years. 

I clean with a bidet, and follow up with a washcloth towel to dry. Paper tissues cannot dry as well as washcloth towels, and the moisture causes yeast infections. I started using cheap washcloths ($23 for 60 from amazon) during the TP shortages a while ago, and can’t go back to TP anymore. If I do, the itchiness comes back. Of course, I would not recommend doing this without throughly cleaning a bidet first!!!

That sounds great! Another night with 3 hours awake with itching and spasming.  So tired and have to carry on as usual. I do not have a bidet but use a spray bottle to clean my bottom (same effect).  I like your cheap washcloth idea very much for drying. I had switched my toilet paper to Charmin Soft which is kinder than others (expensive), but you are right in that it takes too many wipes to dry so too much friction.  I will get on this immediately.  Thank you!

I have no large intestine and only 36-42 inches of small bowel, a jpouch w/ short bowel syndrome, and I "go" 8-20x/day.  My itching is really dependent on my diet.  As I've experimented and cleaned up my diet through the years, it makes a huge difference to me.  I also wonder, as a woman, if my hormones play a part.  I'm nearly in full menopause at 48yo now, and don't have as many hormonal fluctuations, but do think it made a difference back when I was cycling more regularly.  Mine was also worse in the early months just after my jpouch. Calmoseptine helps me with the skin breakdown and related pain and itchiness.

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