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I"ve had my pouch 30 years - butt burn was bad at times - it's really too early to tell for you if you are 4 weeks post take down.  I'd give it quite awhile - experiment with what you eat, on and on...because I remember it hurting a lot to go for the first year or so - and then it got a lot better....ups and downs along the way.  That's just me...I remember using "A and D ointment" - what we had at the time - for ages - like 5 years.  Now, I use only baby wipes and rarely struggle with it - when I do...I usually cut back on food, eat clear liquids for a bit, etc. and sort of try to just calm the whole thing down.  Sigh - it's always something.  But, many great years with the pouch - so don't give up yet!

Unfortunately I am 8 months post takedown.  I have butt burn/itching almost every day.  I love food and it's been very difficult to give up some of my favorites like chocolate, sugary deserts and spicy foods.  Generally if I eat less and make sure I stick to the soluble foods that work well for me like rice, potatoes, bananas and dry bread then I am ok.  

I hope it gets better but it's really just managing the diet.  At this point I do not believe it will.  For me I maintain a pretty active lifestyle and it is still marginally better than ileostomy.  

First of all, no one will be able to tell you how long you can expect to be dealing with it because everyone has difference experiences and outcomes after this surgery.  With that said, 4 weeks is still way too early and it is very common to still be having BB.  I'm 9 years out so I don't really remember how long my lasted. I still get it every now and then and always will.  Really focus on what you're eating.  Keep a diary about what food/liquid makes it worse.  I think bananas, white rice and toast may help.  After years of experimenting, what works best for me for relief after a trip to the toilet is cleaning the area very well with toilet paper soaked with very hot water (I like to press it on there for a few seconds).  Then dry really well and apply A and D ointment and Nupercainal.  Nupercainal is an absolute must.  Hopefully, like most of us, your body will continue to adjust and it will become less of a problem and you will be able to tolerate more types of food.  It just takes time!

Hi all. Long time since I have been on here.  Butt.... �� I wanted to offer my experience on this. 

Its been almost 20 years since take down. Butt burn was horrible at first but only irregularly now.  Finally found soaking in very warm bath with baking soda helped. Nightly, at first. 

CALMOSEPTINE!!  Its the only cream that works for me - and I have tried very many. Don't know why since ingredients read pretty much the same. 

For night-time leakage or incontinence, I took tincture of opium before bed for many years. 

For daytime, I keep a prescription of generic Lomotil on hand.  Only need to take it occasionally now. 

Hope this helps. 

After 24 years I still experience BB. I've found prescription Triamcinolone Acetonide cream .1% does the trick. After reading the posts here, though, I think I'll try some of the other recommended solutions such as Calmoseptine, Nupercainal, and Balmex. It's worth experimenting to find what works best. I had tried A&D Ointment many years ago and found it did not work as well as the Triamcinolone for me.

Just throwing this out there, but a good washlet/bidet works wonders for me when I get BB. Never in a million years thought I'd use one.

Just bought the TOTO handy washlet for $60ish. My favorite so far as my first one crapped out after a few years. Cuts down on the need for creams. I only use it at home, but it's enough to eliminate the burn after a few uses. I'm sure people have different ways they use it, but I feel it with semi-warm water, use it after a BM, then dry off with toilet paper. Every now and then, I'll use it without the need to have a BM and just when I'm having BB. Works then too.

One day when I get a bit older and have my own place, I'm going for one of their fancy toilets. That's when I'll know I've "made" it.

I had BB on and off for years. Taking Metamucil wafers or capsule and/or inmodium to thicken output may help. I used Dessatin for years and then calmoseptine. Had an Rx for anusol I used if really bad, along with a lidocaine.

When I started using baby wipes that cut down on BB and cream use, but the bidet attachment has been like magic! I am on my second one after 4-5 years, but I use the $200 model of Biobidet and I have WAY MORE than paid for it over time in the savings on creams to treat my sore butt. Not to mention better quality of life with no more BB and no hassle of bringing/using cream with every bathroom trip!

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