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I have Crohn's and have had 2 setons in place for 6 months while I wait for Remicade to hopefully shrink my fistulas. I can't comment on the constipation issue as I didn't have that problem but I'll share this...

Setons are challenging to your peace of mind, hygiene, and health. You have digestive acids and fecal particles slowly draining onto your skin and that can lead to skin irritation. Additionally, the seton material can cause friction pain in your butt cheeks if you walk vigorously or walk a lot. I find that talking wide strides or stretching my legs in any way causes the setons to pull on the skin that it goes through which also causes pain. Lastly, and perhaps most significantly, the setons make it very difficult to wipe effectively after a bowel movement because they can interfere with wiping motion while using toilet paper.

Given all that here are some recommendations:

1. Buy a bidet. Having fecal matter stuck in your butt because you couldn't wipe well smells terrible, feels gross, and can lead to infection. I've put some links at the bottom of this message for affordable bidets you can install on your toilet or a portable bidet to use on the go. The stream of water will clean you very well after a bowel movement and then just use TP to pat yourself dry. If you have a removable shower head you can use that to wash yourself after a bowel movement if you don't want to install a bidet. I highly recommend the portable bidet. I take mine with me whenever I'm away from home and can carry it discretely in a small tote bag. If I need to move my bowels I can still clean myself properly.
   
   
2. Take long baths daily. Your doctor probably recommended a sitz bath a few times per day for 15 minutes but I found that minimally helpful. I found true relief in soaking in a hot tub morning and night each day for as long as my schedule would allow. While in the tub palpate and press gently on any remaining abcesses to help them drain. I'd read in the tub, browse Reddit, watch Netflix, etc. often spending 90 minutes in a hot/warm bath because it felt so good.
   
   
3. Carry protective pads. Some people like large gauze pads. I found it easier to use panty liners. Your drainage will smell and stain your clothes off you don't protect them. I through 2-3 pads per day now but was definitely more when my drainage was heavier. I keep a few in the portable bidet tote bag in case I need a fresh pad while I'm away from home.
   
   
4. Be careful about the ibuprofen use - and get a colonoscopy. When I came down with abcesses and they found my fistulas my colorectal surgeon didn't think I had Crohn's because I didn't have a lot of common symptoms. It wasn't until we did a colonoscopy a few months after the seton placement that I learned that I actually do have Crohn's. NSAID's aggravate Crohn's so it might be prudent to switch to Tylenol until Crohn's is ruled out in your case.
   
   
5. Calmoseptine Ointment. It's such a great barrier in protecting your skin from moisture irritation. It's like diaper cream with super powers. But if you find yourself without Calmoseptine diaper cream is better than nothing.
   
   
6. You may need to choose different exercises for now. As I wrote above, the setons limit my range of motion and cause friction between my butt cheeks so running is an absolute no no. I've even had to modify my walking gait whereby I have shortened my student considerably and walk at a slower pace.
   
   I'm sorry to dump all this on you. It's an overwhelming time and throwing all this info at you may just make you feel more overwhelmed. But I hope that you'll come to find this information helpful and that it helps you maintain your dignity and sanity as you wait for the fistulas to heal.
   
   Bidet links: I own #2 and #3
   
   1 - Base $35 model, cold water only https://www.amazon.com/dp/B00A0RHSJO
   
   2 - Deluxe $60 model, hot and cold water. Note that you'll need a hot water line close enough to the bidet to be able to run a line from the hot water source to the bidet. Check your bathroom before buying. https://www.amazon.com/dp/B00A0RX2UI
   
   3 - Travel Bidet:
   Not as effective as the built in models but I'm oh so glad to have it when I have to move my bowels if I'm not at home. https://www.amazon.com/dp/B008CSDKSQ
   

I'm gonna take some downvotes here to make a recommendation here to you that you may not be aware of. There is no cure, but a lot of people find some relief through managing their diet. There are a lot of choices, and every person is different, but in my opinion it's worth exploring. Not just my opinion either, but in the opinion of some very smart Doctors and others who see multiple patients and different cases. If they feel that there is some value in pursuing therapy through diet, I'm game to try. For me, so far, I'm experiencing a profound difference in my condition, and I like to think it's partly due to my diet. I don't know, but, it certainly doesn't hurt to try.

Here's my favorite resource. A brand new book by a practicing GI and GI prof. He practices at Seattle Children's and is a Professor at the University of Washington. I have confidence that it's at least worth a try. Here's the book, the diet is the Specific Carbohydrate Diet. Good luck friend.

Ask the doc about the Specific Carbohydrate Diet. My doctor had recommended it as an option to me, but kinda down played it since it's pretty strict. I read the book on it, implemented some of the practices, but eventually stopped and started eating whatever thinking that my medication was enough. Eventually had another flare up, and switched to the diet right away. Was amazed by how rapidly I improved. I really think anyone with UC or Crohn's (like me) or anything similar should check out the book. On amazon here: http://www.amazon.com/Breaking-Vicious-Cycle-Intestinal-Through/dp/0969276818/ref=cm_cr_pr_product_top

Happy to chat more on it.

What are you going for there? :)

If you have open skin and/or an active infection, see if you can ask your primary care physician for silvadene cream (silver sulfadiazene). We use it on bedbound patients who get moisture-related skin breakdown from incontinence and that stuff is like magic. We also used the following, just kind of depending on preference of the patient and/or the care provider:

• Coloplast
  
• Calmoseptine
  
• Calazime
  
  And hydrocortisone is your friend, so much love for the lowly hydrocortisone <3

I feel like I post about this here at LEAST once a month. Get a bidet. They're cheap as hell and they make a WORLD of difference. Some people here think it's "weird" but hey, so is shatting blood out of your rear on a daily basis, so they need to get the fuck over it. After the first week of using it I decided it was THE single best purchase I have ever made on the internet BAR NONE. I turned one of my non-IBD friends onto it and he arrived at the same conclusion. We always feel clean, and we now like to joke regularly about being superior to the rest of society on account of having immaculate assholes. The paper still plays a role, but I just use it to pat my ass dry after washing.

I have one of these:

http://www.amazon.com/Luxe-MB110-Non-Electric-Mechanical-Attachment/dp/B001KKRCFA/ref=sr_1_5?ie=UTF8&qid=1417520121&sr=8-5&keywords=luxe+bidet

There are even cheaper options too -- just search for "bidet," anything with a lot of good reviews will be fine.

Really, wiping alone is a pretty fucking crude way of cleaning anything. It's like wiping melted chocolate and peanut butter off an old weathered picnic table with a dry paper towel.

P.S. I used to think I'd need a heated version that sprays warm water, but I've actually discovered that the cooler winter ground water is quite soothing to my irritated asshole when I'm having one of those "4-5 poops before I can leave the house" mornings. Also, wet wipes are seriously not shit compared to a bidet. They're still nice, but there is no comparing the two.

Are you on any type of medication for it to try to gain remission? My daughter is on remicade and 6mp and doing very well.

Also I had this book suggested to me from here if you are interested in it.

Good luck!

This disease is hilarious, I've been living with Crohn's my whole life too. It's good that you can laugh at it, and not let it take over your life. I laughed when you said "almost seven years I should have known not to trust that fart". Stay away from spicy food, caffeine, drink lots of water at least 2 liters a day, take some acidophilus capsules, and buy the book "Life Without Bread" , and follow it.

Bidet is the way to go! A few years ago this one was recommended somewhere on reddit, I bought it and love it (as a mom to a crohnie).

I have an older Consumer Reports on toilet tissue, I don't like Scott 1000 or Angel Soft (or Costco's version of it). I settled on Target's Premium Ultra Soft (or Ultra Strong, I couldn't really tell a difference) that was listed on my report as in the top 5 for dissolving/fewer clogs.

Finally, we also updated our (25 year old) toilets to American Standard Cadet 3 FloWise Tall Height 2-Piece 1.28 GPF Single Flush and haven't had a single clog yet in three years.

Poo-Pourri Before-You-Go Toilet Spray 2-Ounce Bottle, Original Citrus Scent https://www.amazon.com/dp/B0108XRDJE/

That will over power the stankiest stank.

And if you rock a 2 piece wafer/bag, change bags frequently - like once in the morning and once in the afternoon. And be sure to tie up those bags in plastic bags and dispose of them outside of your room.

Don't burp the bag in bed - go to the bathroom if you have to do that. Hopefully you use filtered bags and don't have to burp often, plus changing the bag 2x per day should keep the filter unclogged.

Have fun on vacation!!

I recommend Cat's Claw 4000mg (until he improves) and to watch what foods. I've had Crohn's for 8 years, multiple fistulas, and those were the most helpful for me. Humira is also good, but I've been med free for 4 years.

Same here! Took a suggestion from this sub and got the Astor (no pun intended by me- but possibly by the manufacturer) Bidet from Amazon for $30 including shipping. It took less than 5 minutes to hook up using their parts. Now my parts are constantly clean and there is no more wiping- sometimes a pat down to dry the area. I still check with TP after particularly crazy BMs and am still amazed that the area is completely clean.


edit: https://www.amazon.com/Astor-Non-Electric-Mechanical-Attachment-CB-1000/dp/B003TPGPUW

For anyone curious this is the one we got. https://www.amazon.com/Luxe-Bidet-Neo-120-Non-Electric/dp/B00A0RHSJO?ie=UTF8&ref_=cm_cr_arp_d_product_top
Not the cheapest and not the most expensive, but it works like a charm

I've been looking at Soylent for a while. I've heard good things, and it seems like it would be well suited to being a meal replacement for people with IBD. I have to mention that I haven't tried it yet though, so I can't guarantee the quality.

So, my fiancée and I had to cave and get a 1 bath (no kids any time soon). Been pretty good the last 3 years.


But...flair is starting...very much considering one of these.

I recommend this one.
Luxe Bidet Neo 120 - Self Cleaning Nozzle - Fresh Water Non-Electric Mechanical Bidet Toilet Attachment (blue and white) https://www.amazon.com/dp/B00A0RHSJO/ref=cm_sw_r_cp_apa_VATWAb88AS8BD

I probably wouldn't worry too much about gluten then. I highly recommend supplementing with this and a green tea supplement as well.
https://www.amazon.com/dp/B01DBTFO98/

Switch to a Bidet and save on toilet paper and your bumm.

Luxe Bidet Neo 120 least expensive but works well

Follow the doctor's advice.

If he wants to try a dietary approach, there are a bunch of different options, many different books. He will have to try different things to figure out what works best for him. If he's really determined, with some luck something will work for him.

Life Without Bread is a low-carb approach.

Breaking the Vicious Cycle works for some.

Inflammatory Bowel Disease by Hunter may be useful; haven't read it yet myself.

I think Cordain's Paleo diet book addresses autoimmune disease. I liked his approach.

Robb Wolf's Paleo book is only slightly different, and also addresses autoimmune disease.

No one diet works for everyone. Some people never find specific dietary guidelines that work. Many people can identify foods that are particularly problematic, and finding these may start with a particularly monotonous diet, followed by adding in individual food items to determine tolerance. I think Hunter's book goes that route, but I'm uncertain.

Things that work for some: extremes, such as vegan/extreme vegetarian, or total carnivore. Highly recommended: fermented foods. Avoid sugar.

I found one toilet at the office is much less prone to blocking than the other.
There's a brush, and that's my best bet if it blocks. If that doesn't fix it, its c a case of fuck it, the cleaners will get it (sorry!)

I've taken to using a portable bidet anyway, and I've found that reduces the amount of paper I need
This is what I ordered. Sometimes I need to refill, which I can't do at the work bathroom, but, still better than nothing
http://www.amazon.com/gp/product/B004IW5ITO/ref=oh_aui_detailpage_o00_s00?ie=UTF8&psc=1

I used the manufacturer's starter packets. Then I would try and remember to save some of my own yogurt to culture the next batch... http://www.amazon.com/Yogourmet-Freeze-Yogurt-Starter-Packaging/dp/B001GVIS4M/ref=pd_bxgy_79_img_3?ie=UTF8&refRID=1BB18G4B36A1ZM1ZEGTF

I've found this cream to work better than even my prescription lidocaine creams. It's cheap and over the counter so easy to give it a shot. Calmoseptine Ointment Tube 4 Oz (Pack of 2) https://www.amazon.com/dp/B01INL3TKU/ref=cm_sw_r_cp_apa_2a1BzbQE8F3YJ

As others have said I doubt others are noticing it on your clothes. If you are still concerned this stuff works great. You spray it directly on the toilet water surface.

Go for the diet! I highly recommend. My partner has ulcerative colitis and this was the only thing that worked. You're very lucky you have a doctor open to this; most refuse to investigate non-medical options, strangely. Ignore any weird references toxins or cleanses - this must be some new, lame spin on it - SCD is actually very straight forward and science-based. Yes, strict at first , but once you get your guts stabilized, you can experiment and let some "illegal" foods back in...

Books to get started:

http://www.amazon.com/gp/aw/d/0969276818/ref=pd_aw_sims_2/182-1240542-1141736?pi=SY115&simLd=1

http://www.amazon.com/gp/aw/d/159233282X?pc_redir=1412274841&robot_redir=1

So my fiancee has Crohn's and I installed a Bidet in our bathroom, it was MUCH easier and cheaper than I had expected and it works great, SOO much less irritation for her.

The only downside is that our 3 year old sometimes squirts the wall with the damn thing...oh well, that's what towels are for.

I drink Soylent Bottles

Tastes kinda like the after milk from Cheerios sorta but bland. I mix mine with chocolate syrup sometimes.

I think smoothies in general might be a good option also but my blender sucks so I don’t do that yet.

If you're interested in reading the book (Breaking the Vicious Cycle by Elaine Gottschall), you can find the PDF online if you're really starving for money (seek seekhapiness' comment below). I read through the ebook and eventually decided that it'd be worth my time to buy the book off Amazon and commit to the diet.

EDIT: Removed link.

Curcumin. My daughter's GI suggested it for it's benefits in the inflammation of the Intestines, but we find it brings her joint pain from a 6/7 to a 0/1. She even recently has started working out again. She takes two of these https://www.amazon.com/gp/product/B01DBTFO98/ref=ox_sc_act_title_4?ie=UTF8&psc=1&smid=A32DGYOAL6LMZV a day, which is the amount that the tests the NIH show to be beneficial.

https://www.amazon.ca/Toilet-Paper-Flowers-Children-Disease/dp/0929173473

Toilet paper flowers: http://www.amazon.ca/Toilet-Paper-Flowers-Children-Disease/dp/0929173473

https://www.amazon.com/Breaking-Vicious-Cycle-Intestinal-Through/dp/0969276818/ref=sr_1_1?s=books&ie=UTF8&qid=1473729134&sr=1-1&keywords=breaking+the+viscous+cycle

Read the reviews.

Why not try a travel bidet?

Here's the one I got: http://www.amazon.com/gp/product/B008CSDKSQ/ref=oh_aui_detailpage_o01_s00?ie=UTF8&psc=1

I've been using it for less than a week, so I haven't made a final decision on how I'd rate it. So far it gets the job done, though.

if not: https://www.amazon.com/gp/product/B00A0RX2UI/ref=oh_aui_search_detailpage?ie=UTF8&psc=1

Best $70 I ever spent

Calmoseptine Ointment Tube 4 Oz (Pack of 2) https://www.amazon.com/dp/B01INL3TKU/ref=cm_sw_r_cp_apa_i_D4.ADbFPTW6KX

Check it out. Even the reviews!

>Vegan cookbook maybe?

Is she vegan? If she is, probably a good idea. If not, she may be confused (and perhaps too polite to say so) :p

-----
First, an anecdote.

I recently flew on ANA airlines a 10 hour flight. I got bumped to business class (this was awesome!). As not to be too stereotypical of Japanese toilets - ANA's sky toilet had a heated bidet (washlet?) with adjustable spray and pressure. At least business class did (I need to ask my coworker about economy). It was amazing and hilariously enough, ANA is Japan's #2 airline.

So in all seriousness... If she lives in a warm region this kit. If she is in a very cold region this kit. To note: All water from a faucet will be cool but in northern regions water may be painful cold.

Some things I always travel with are purell wipes, toilet seat covers, and these butterfly pads for leakage if you're dealing with that.
I also bring immodium, tylenol, and a heating pad if I'm currently flaring. For some reason, traveling always makes my symptoms worse for a few days.

I keep one of these in both my bathrooms. Just fill it with water and give it a squeeze. I hate using anything else after using one of these.

I'm not sure if you have Crohn's as it's not clear from your post so this may not apply.

Fissures became the ultimate reason I got an ostomy, I remember the pain of bowel movements so vividly. I actually became afraid of eating and started losing lots of weight.

I was taking sitz baths several times/day and using witch hazel pads for wiping. Each offered only moderate relief. A portable bidet actually helped a little, but sometimes it was also painful to have the direct contact. Something like this one, https://www.amazon.com/gp/aw/d/B001KKRCFA/ref=mh_s9_acsd_top_bkUNrH_c_x_4_w?pf_rd_m=ATVPDKIKX0DER&pf_rd_s=mobile-hybrid-11&pf_rd_r=382Z096K0MFFZ8744RFY&pf_rd_t=30901&pf_rd_p=c21ec71f-52a5-57f0-a441-f6e3c87ea1d7&pf_rd_i=686953011

Sorry I don't have more to offer.

I currently have that but it's because I had an abscess drained and it's constantly leaking. If your leakage is white it might mean you have an infection, and pus is coming out. Idk any stool related problem that would cause white secretion.

Edit because I forgot to give some sort of solution:

I bought THESE they work very well but are relatively expensive. You can use toilet paper but make sure you wear briefs and not boxers. Trust me. Nothing is more embarrassing than a gross piece of TP sliding down your leg and out your pants...

If I tried the same thing as you, I would still be sick.

How about this:

+4500mg Cat's Claw (NOW Brand is really nice)

\<0.15 V/m RF Acoustimeter reading in your bedroom

\<1 milligauss Magnetic Field Meter reading in your bedroom

+Almond Milk or Organic Peanut Butter (for Vit E)

+Kimchi (for diverse Veg Probiotics)

+Raw Milk (for diverse Milk Probiotics)

-Fruit (except for organic thick skin fruits such as pineapple and mango, to reduce exposure to pesticides)

+Carbs (it's ok to eat gluten unless you have gluten intolerance, we need the glucose)

+Carrots (for Vitamin K)

+Eggs (for phosphorus)

+Stetzer Filters for home

+Red Meat (for Iron which is used to create tissue and red blood cells)

-Move bedhead away from any outlets

This probably looks very convoluted and probably doesn't make much sense which is actually a good thing, because it makes you aware of variables you hadn't considered. According to the American Association of Environmental Medicine, the greatest risk to human health in the 21st century is over-exposure to non-ionizing radiation which is emitted from anything that uses electricity such as wires, computers, powerlines, cellphones, cell towers, smart meters, electrical outlets, microwaves, etc. Non-ionizing radiation stimulates the nervous system and yes it doesn't cause thermal damage, but it can cause damage to the body in other ways. By over-stimulating the nervous system, cells become stressed causing free radicals to be produced. Free radicals damage DNA and if you've taken biology, you would know that one type of DNA damage is deletion of a stop codon which causes cancer. Well if you are getting rid of stop codons in the nervous system, it makes sense you could potentially develop a problem where the nervous system doesn't stop, and if your cells are constantly stressed, it makes sense that your cells would become more sensitive. Non-thermal non-ionizing radiation has been linked to cancer, neurological diseases, allergies (allergies to electricity), DNA damage, chromosomal damage, and more.

Cat's Claw is a potent anti-inflammatory herb with genetic repairing capabilities. Start 500mg and increase at own pace. Expect diarrhea the first 1-2 weeks, which is common and will go away with use. At full dose (4500mg), it would be capable of stopping a flare up in less than 2 minutes.

Nutrition is extremely important but I expect you to figure out what nutrients you are missing. Red meat is probably the most important so you don't become anemic, and a source of phosphorus (Sugar+Phosphate+Base = DNA)

Read this: https://www.aaemonline.org/emf_rf_position.php

Watch this: https://www.youtube.com/watch?v=kf2CLsr-uMs

Buy this: https://www.amazon.com/NOW-Cats-Claw-500-Capsules/dp/B001B4LN9Q/ref=sr_1_8_a_it?ie=UTF8&qid=1527810479&sr=8-8&keywords=cat%27s+claw

"You cannot solve a problem with the same level of awareness that caused it." - Albert Einstein

I included all this more to increase your awareness, really you just need the Cat's Claw, but everything else is important.