Advice after your nerve block for surgery
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Anyone who has frequent bowel motions, diarrhoea or accidental leakage (faecal incontinence) may get sore skin around their back passage from time to time. This can be very uncomfortable and distressing. Occasionally, the skin may become so inflamed that it breaks into open sores. These sores can be difficult to heal.
Taking good care of the skin around your back passage can help to prevent these problems from developing.
Why may I get sore skin?
There are several different reasons why your skin may become sore:
- Your bowel contains digestive juices which break down your food to enable your body to use the nutrients in it. If you have very fluid bowel motions, the diarrhoea will still contain these juices, which start to damage your skin if in contact with it.
- If you have faecal incontinence, the small quantity of juices left in even normal stools can damage the skin.
- If you open your bowels very frequently, repeated wiping can damage the sensitive skin of your anus.
- With some anal conditions, it is very difficult to wipe your bottom effectively as a small amount of faeces is often left, which can start to make you sore.
- Sometimes, the area around the anus becomes infected.
- If you have incontinence of the bladder and bowel, you will be more likely to get sore, as the urine and faeces react together.
- People who are not eating a healthy balanced diet, not drinking enough or not taking much exercise are more prone to soreness, as are people who are generally unwell and not very active or mobile.
Toilet hygiene
With careful personal hygiene it is often possible to prevent soreness, even if you have a bowel problem.
- After a bowel action, wipe gently with soft toilet paper. Some people find damp cotton wool is more comfortable
- Discard after one wipe, so that you are not re-contaminating the area you have just wiped.
- Whenever possible, wash around the anus after a bowel action. You may be able to use a shower attachment with your bottom over the edge of the bath, or use a soft disposable cloth with warm water. Avoid flannels and sponges, as they can be rough and are difficult to keep clean. Sometimes a little ingenuity is needed, especially if you are away from home. Some people find that a small plant spray, watering can, or jug filled with warm water makes washing easy on the toilet or over the edge of the bath.
- Do not be tempted to use disinfectants or antiseptics in the washing water as these can sting. Plain warm water is best.
- Avoid using products with a strong perfume such as scented soap, talcum powder or deodorants on your bottom. Choose a non-scented soap (e.g. a plain soap or baby soap). Many baby wipes contain alcohol and are best avoided.
- When drying the area be very gentle. Pat gently with soft toilet paper or a soft towel and do not rub. Treat the whole area as you would a new-born baby's skin. If you are very sore, a hairdryer on a low heat setting may be most comfortable, but please use it carefully and away from water.
- Women are advised always to wipe front to back. This keeps the stool bacteria away from the bladder and vaginal openings, as contamination can cause repeated infections.
Topical treatments
- Avoid using any creams or lotions on the area, unless advised to do so.
- If needed, a barrier cream can be helpful to form a protective layer over the skin. Make sure you have washed off the old layer of barrier cream each time. Choose a simple one (such as zinc and castor oil, Derma-S, Sudocrem or Metanium), use a small amount and gently rub it in. Large amounts of cream can make the area sweaty and uncomfortable.
- Some people are allergic to lanolin, and creams containing this additive should be avoided.
Clothing choice
- Wear cotton underwear to allow the skin to breathe.
- Avoid tight jeans and other clothes that might rub the area.
- Women are usually best to avoid tights and to use stockings instead.
- Try to allow the air to get to the anal area for at least part of every day.
- Use non-biological washing powder for underwear and towels.
- If you need to wear a pad because of incontinence, try to make sure that no plastic comes into contact with your skin and that you use a pad with a soft surface.
Lifestyle changes
- Try not to scratch the anal area, however much you are tempted, as this will make things worse. If you find that you are scratching the area in your sleep, you may consider wearing cotton gloves in bed (available from your chemist).
- Whenever possible eat a healthy, balanced diet.
- Drink plenty of water
- Take regular exercise (such as a 20 to 30 minute walk most days).
- Some people find that certain food or drink makes them more prone to soreness, such as citrus fruit. It may be worth cutting these out on a trial basis, to see if this helps.
Do not struggle on alone. Talk to your nurse or doctor, especially if your skin is broken. If you have persistently sore skin you may have an infection which needs treatment, and there are other products which can be prescribed to help heal the soreness.
How can I find more help and information?
Websites with more information:
Contact us
If you have any queries relating to this information, please contact the General surgery service.
About this information
Service:
General surgery
Reference:
Y/058
Approval date:
1 May 2023
Review date:
1 May 2026
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Important note
This page provides general information only. It is developed by clinical staff and is reviewed regularly every 3 years for accuracy. For personal advice about your health, or if you have any concerns, please speak to your doctor.