Skin care for people with bowel problems

Advice on skin care for people with bowel problems

Why is good skin care important?

Anyone who has frequent bowel motions, diarrhoea or accidental leakage (faecal incontinence) may get sore skin around the back passage from time to time. This can be very uncomfortable and distressing. Taking good care of the skin around our back passage can help to prevent these problems from developing.

Why may I get sore skin?

There are several different reasons why skin may become sore:

• Chemicals contained in the bacteria of the bowel motions can cause itching.
• Your bowel contains digestive juices and acid 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 contain juices and acid which start to eat away any skin which they contact.
• If you have faecal incontinence, the small quantity of juices and acid left in even normal stool can damage skin.
• If you open your bowels very frequently, repeated wiping can damage the sensitive skin of the anus.
• With sore anal conditions, it is difficult to wipe your bottom effectively – a little always seems to get left. This stool starts 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. P
• People who are not eating a healthy balanced diet, not drinking enough or not taking enough exercise are more prone to soreness, as are people who are generally unwell and not very active or mobile.

Tips to prevent soreness

With careful personal hygiene it is possible to prevent soreness even if you have a bowel problem.

• After a bowel movement, wipe gently with soft or moist toilet paper, discard each piece after one wipe so that you are not re-contaminating the area
• When possible, wash with warm water around the anus after a bowel action with a shower attachment or soft disposable cloth.
• Do not be tempted to use disinfectants or antiseptics in the water as this can sting. Plain water is best.
• Avoid using products with a strong perfume such as scented soap or talcum powder on your bottom, choose non-scented. Baby wipes contain alcohol and are best avoided.
• When drying the area be gentle and pat dry with soft toilet paper/ towel. If you are sore, you can use (carefully) a hairdryer on a cool setting.
• Wear cotton underwear to allow skin to breathe and avoid tight clothing or tights. Use non-biological washing powder.
• Avoid using creams or lotions on the area unless advised to do so. If you do use a barrier cream, choose a simple one such as Sudocrem or zinc and castor oil.
• If you wear a pad, try to make sure that no plastic comes into contact with your skin, and that you use a pad with a soft surface.
• Wherever possible, try to eat a healthy balanced diet, drink plenty of water and take as much exercise as you can. Some people find that certain foods or drinks make them more prone to soreness, especially citrus fruits. It may be worth cutting these out on a trial basis.
• Women should wipe front to back as the bacteria from the bowel can infect the bladder and vagina if you wipe from back to front.

If you are already sore

• Follow all the advice in this leaflet. In addition:
• You may find that damp cotton wool is comfortable to use for wiping.
• Use a barrier cream or ointment recommended by your nurse eg Sudocrem or metanium.
• If drying the skin after washing is difficult, try using a hair dryer on a cool setting.
• Try not to scratch the anal area, this will make things worse.
• Try to allow the air to get to the anal area for at least part of the day.
• Don’t struggle alone! Talk to your nurse or doctor, especially if your skin is broken. If this persists you may have an infection which needs treatment.

Contacts/Further information

Biofeedback team - 01223 348106