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Butt Burn! What is it! What can I treat it with and most importantly how can I avoid it!

Butt Burn first hit me about 5-6 weeks after my surgery to have my JPouch created and connected in one surgery in August 2017! I had heard people talking about in in forums and I was sitting there thinking ‘ha won’t happen to me, I’ve managed this far so I’m fine!’, well, OMG, I was so wrong!

My bowel was coping well so far with being used again and passing stool for the first time in 2 years.

After surgery I was living on a low residue diet, it was made up of what I class as ‘white foods’, rice’s, chicken, potatoes, pasta and porridge. I assumed my careful diet was letting me ‘toughen’ up my new bottom and the skin was fine, I started very slowly reintroducing foods such as red meats, salad, mainly lettuce and vegetables including well-cooked carrots, broccoli and cauliflower. I think may of rushed it and my stomach started producing a more acidic output fast, it became watery, explosive and VERY frequent! So, this is where I first met butt burn!

I was being very careful at the other end whilst this was all going on, using wet wipes to clean after each bowel movement (bm), making sure I was using tissue to dry properly after etc, but no matter what I did the burn grew!

I was having between 20-25 bm’s a day, possibly due to a reaction to something I had eaten or maybe the early signs of my later troublesome, cuffitis. Each time I went the skin got rawer and sorer, it started to burn with intensity and I was in pain, I dreaded going to the loo, I hurt to sit down and anything that touched my behind hurt! I am sad to say I cried on the loo that day more often than I care to repeat! This escalated over just 12 hours to the point I didn’t know what to do with myself! I sent my boyfriend, Stuart to the shops for a solution!

I remembered back to my childminding days when I had to help babies with nappy rash especially when they were teething, and I recalled a magical cream I used called Metanium, it is a Titanium Oxide based ointment that is bright yellow and thick in consistency, it has a very medicated odour and is long lasting once applied! So, he returned with this armed with soft cotton wool pads and some Epsom salts, the later had been recommended to me in a support group.

I started applying the ointment, using a rubber glove as it stained my hands and was very hard to wash off, I felt instant relief, not gone but the burning eased and overnight, after several generous applications of the ointment, I felt 50% better already! Unfortunately, my bowels continued to have very high acid output, but I found it was often the burning that caused the frequency, this was because as soon as stool was near the now enflamed area in my cuff, I had to clear it out and go! As the burn on the exit eased, so did the urgency. I should add I also went back to a very bland, basic diet until the attack passed.

The next few days I didn’t use wipes or loo roll… each time I had to go I filled a portable potty seat (I had bought before surgery to nurse my stitches after) with warm water and dissolved a scoop of Epsom salts, I used a few large cotton wool pads and with a rubber glove, I gently washed the area every time! Then patted dry and reapplied ointment as needed. It may sound like a lengthy process, but the relief was immense, the area healed completely within a day or two and I was able to return to normal cleaning. However, I still wash when I can instead of wiping.

I ditched the moist fragranced toilet wipes! I will use specialist ones occasionally, mainly if away from home if needed, these are aimed at people with hemorrhoids and are infused with witch hazel and nothing that will irritate or cause a reaction.

I had a bidet installed in one of my toilets and use it whenever I can, it ensures I can wash clean without irritating the butt, it has been one of the best investments I have made since surgery, the main one is the Metanium ointment, closely followed by the portable potty seat I mentioned earlier, the other is a portable bidet bottle I purchased to use when away. All are cheap, accessible and essential products in my opinion.

I have had a few less severe attacks since this in the 14 months I have had my JPouch, considering I have chronic cuffitis, pouchitis and more recently diagnosed with Bile Salt Malabsorption (BAM), I think I’m doing well! If I feel I am starting to get the early tingling sensation when I go, I start the ointment.

I should add that BAM causes acidic, explosive output, often the cause of butt burn, it can be treated, and I am due to start medication to control it today.

Below are pictures of the products I have mentioned, all of which I found online at very little cost, the Bidet was installed by Stuart with no plumbing training, although tricky, its not a job you have to pay someone to do so I hope makes my ideas accessible to all.

Just remember ‘WASH DON’T WIPE’.

I hope this helps, obviously this is my experience, everyone is different, I can’t advertise but can recommend, some use a barrier cream, but I find they sting.

Seek medical help if it is too raw or bleeding or if you are worried. Take care and thank you for reading!

Please share any ideas you have on this to help other readers by logging in and commenting below!

Thank you


Portable potty seat!

Bidet! Connected to the mains water supply!

Portable bidet!


The ONLY wipes I use!

Epsom Salts

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1 Comment

Tracey Piper
Tracey Piper
Jul 25, 2020

Hi fellow J-pouchers. I have had a j-pouch since I was 33, 20 years ago. During the day I was fine, unless I ate something with spice or lactose, which meant many more trips to the bathroom. Up till about 3 weeks ago, I was awaken 1 to 2 times nightly, severe butt burn and tried just about every cream on the market. I wore pads to sleep, as I had frequent accidents. Costco wipes too, but with upwards of 12 + trips to the loo daily i had chronic cuffitis. I started taking immodium 3 times daily and still had trouble and painful bloating. I finally discovered that timing of when I take immodium is the key.

3 weeks…

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