Hi all. I'm preparing for my j pouch op next week. I'm currently looking for advice on toilet paper and wipes. I have read about the butt burn and have no idea what wipes or toilet paper is the best. Do the wipes need to be fragrance free? Any recommendations? Also has anyone tried a sitz bath with Epsom salts. Feel free to suggest any tips on avoiding butt burn. Thanks xxx
I have fragrance free wipes, and charmen t paper. They work the best for me. You can just wet t paper for that matter. Dab dont wipe. A member on this site swears by ilex cream or paste. In my humble opinion, he's right. You can purchase it on amazon. Caliseptin and even desitin are okay. Make sure you have gas remedies ready also. It's pretty bad for a week or so. I've found drinking peppermint tea helps me the most so far. Good luck with you takedown. It's pretty great.
I use Charmin toilet paper for the most part and have used alcohol free and fragrance free wipes, no particular brand.
Applying any barrier cream (even plain zinc oxide) after every BM should help a lot, assuming the skin has been well cleaned. The barrier cream prevents irritation rather than treating it. I am a bit suspicious of wipes, unless they are just water-moistened. I think they might dry out the skin and make it *more* sensitive, but they are clearly more comfortable to use than TP. A bidet is a great choice, if you can manage it - it took me ten years to figure that out.
Short of installing a bidet, there are inexpensive top-of-the-toilet-seat sitz baths - basically a plastic bowl that fits over the toilet seat - you just put plain water in it. I got one on Amazon and found it very helpful in the early period. What I use now ongoing is a simple plastic squeeze bottle with a movable nozzle ("portable bidet," also on Amazon) filled with water to rinse the anal area. Then dab gently with soft toilet paper. Highly recommend. As Scott says, zinc ointment is the best to relieve skin soreness or itch. Simple is best.
Bidet all the way! I don’t use wipes at home- just the bidet every time, Charmin toilet paper (bc it’s the softest) and ointment or past after every BM. When I’m at work or out, I take a travel size baggie with wipes in it- I ordered a 10 pack of generic wipes from Amazon and it’s lasted me a few months since I only use them at work.
Mid also avoid acidic food at first. I found tomato sauce was killer!!
Congrats on the takedown. Good luck!
Thanks. I will older some fragrance free wipes. I have bought a few creams and pastes that people have recommended. I've read a lot about the ilex cream but it so so expensive to get it here. Wish the sold it in the UK. I've bought a sitz bowl for my toilet and a portable bidet. I guess I will start with a rinse, pat dry and then cream. I never thought I would have to go to so much effort to wipe my own arse. Can anybody also recommend gas tablets or any other tablets they take to slow down transit and bulk things up? Also anybody tried the VSL probiotic capsules. I hear they are good. 6hanks everyone for the suggestions. I think I am as prepared as I can be. Thank God for this website. What did we do before the internet. I was worried about the butt burn but now I'm worried about gas. Before my ileostomy bag I had terrible gas pain so I'm dreading that. I'm sure it will all be worth it. X x x
It will be, personally I've had great success with peppermint tea. I'm sure some of the veterans of the j pouch on here can give you some good ideas. Good luck. Sounds like you're pretty well prepared.
To actually slow the gut Imodium or Lomotil are the go-to choices. I’ve used Lomotil since my surgery 16 years ago. I find it most effective to use it just at bedtime or before going to a bathroom-free zone (like a boat or bike ride). To bulk things up I use psyllium powder, also every day since my surgery.
I use VSL, too, but that’s awfully expensive (at least to get a useful dose) unless you turn out to need it. Some people (perhaps most) just don’t get pouchitis enough to warrant it. The VSL capsules are a fairly low dose, like most probiotic brands.
A bidet is the best to keep the area clean, and pat dry. I used a portable squeeze bottle with special nozzle (Amazon) for a few weeks after takedown, and it worked so well I invested $100 on an attachment bidet for the toilet that hooks up to my bathroom water pipes. Plus $40 for a handyman to install it because I don't know plumbing, but I think there are YouTube lessons. It's the best small investment I've ever made. When I'm away from home I miss it! I carry moistened paper towels in my bag away from home. Whatever baby wipes you use, never flush wipes down any toilet -- even if it says flushable -- the wipes are never flushable because they do not dissolve like toilet paper is designed to do. You will end up with a blocked toilet and raw sewage backing up just when you need the toilet.
I would not recommend adding Epsom salts in your sitz basin. The sitz bath is meant to soothe the inflammation, bring blood to the area to help heal from the inside, and any additive might cause stinging or burning. Try plain water, as warm (or as hot) as you can tolerate. The hot water will bring a rush of blood circulation and will help heal fissures, sores, etc. I used mine (from Amazon, or health specialty store) only a few times and it work so quickly I didn't need it again.
Be prepared that after takedown, when your intestines start to wake up, it will hurt. I'm not trying to scare you, but this is a fact and if you are prepared and expect it, it might be easier. I didn't expect it, didn't know what was happening and I suffered. My gas pain lasted 15 hours straight and the nurses could only give me hot black tea but no medication is available that eases the gas pain. Just know that it will pass, as soon as you can pass gas. I hope it goes easily for you.
My doc recommended gas-ex and at first I would take it daily. Now that more time had passed, I need it less and less.
Also, I still take a probiotic - Floristor- since my insurance won’t pay for VASL. Still good to take one.
Although everyone seems to be a little different, I echo what everyone has said - toilet top ( or portable) Bidet, wet toilet paper (I settled on Northern quilted), pat, don’t wipe, zinc oxide barrier cream (Calmoseptine works well for me) and stay away from acidic foods like tomato sauces for a while, I even tried my best to stay away from anything with citric acid ( although conversely it seemed to help if I added lemon juice to my water) lomotil to slow down output ( peanut butter or bananas worked will also for me). If you do want to use wet wipes I would suggest getting those that do not contain alcohol.
In addition to wildly different doses, probiotics can be completely different products. Florastor is a fine product, but it contains no beneficial bacteria at all. Instead it contains a beneficial yeast species that may be helpful in preventing C. diff infections. If you’re trying to reduce the likelihood of developing pouchitis then a bacterial probiotic would be a better choice.
COLONCUTIE..... ilex Paste is available in the UK and it's also available on NHS prescription; so I would assume it's totally free in Scotland.
Your Stoma Nurse should have sample sachet available or you can acquire samples direct from ilex:
When I first started using ilex during 2014, it wasn't available on NHS prescription, so after receiving a few sample sachets, I also managed to acquire a sample tube as well; I claimed, there wasn't enough in the sample sachet to evaluate completely
During my 3 yrs with a J pouch, I've never actually experienced the dreaded butt burn, although I did suffer from extensive skin errosion around my temp ileostomy and the ilex totally cured my pain and discomfort within a matter of days.
During my first year with the J pouch, I initially used Huggies Pure wet wipes to cleanse and I applied the ilex paste, maybe two or three times per week; whenever I experienced the slightest of irritation, itching or burning sensation, during or after a BM; overtime, this has become less and less and I very rarely use the ilex now, maybe only once or twice every couple of months.
I use just regular toilet paper now; never used a bidet and no cleaning routine or procedure either, although I still keep the wet wipes on stand by.