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New and need advice: best pain relief for seton

Hello all! I'm very new to this forum community, so I'm not sure if this is a good sub forum to post in about this but everyone seems supportive here so here goes nothin.

I just had a surgical draining and seton placement last week, the first few days I was really surprised that the pain wasn't as bad as I predicted. Definitely was hard to figure out the whole.. wiping situation after bowel movements but I got the hang of it. The past few days though its been way more uncomfortable. I had to sit on a hard chair yesterday and it was really awful and painful.

Basically I, wondering if anyone has discovered some temporary on the site pain relief tricks? I've tried ice packs, I do the sitz baths, but nothing lasts more than an hour of relief. Would ointments be a bad idea because they might clog the fistula?

Any advice is greatly appreciated!

Thanks so much!
 
Hi Emily. Hope you don't mind me moving your post here to your own thread, as it might not get noticed at the end of the sticky thread. I;ve never had a seton myself, but there are some lovely folks here who will be able to advise you on the best way to relieve he pain you're having. Hang in there :)
 
Hi Emily,
Heat is most effective for my seton pain. Have you tried sitting on a heating pad? It is true that the pain relife mostly only lasts for as long as you are using it, but it is so much more convienant than a sitz bath.

I use calmoseptine cream all the time without any problems. You may want to try it, it is good for skin irratation from drainage and is cooling. My local drugstore carries it but you have to ask for it, they do not keep it on the shelves.

Is it pain from drainage irratating it or the knot rubbing the opening?
 

sawdust

Moderator
Location
Pennsylvania
Hi Emily, and welcome to the forum.

At first, I found warm baths to be the best for comfort for me. I think Sailorluna's heating pad idea is a good one too, as it's not very easy to be taking a bath every time you need some relief.

It took a little while for my soreness to settle down, but I eventually got more and more comfortable over time. I'm sure it depends where your seton is, but the more active I was at first, the more discomfort I had, but after a short while, things seemed to "settle in" where the seton wasn't so sore. I don't know if I explained that well, but what I'm trying to say is I hope that you experience an easing of the soreness as some time wears on.

I really looked forward to baths in the first few weeks. I made arrangements to go home at lunch time from work to take a bath. It meant I had to sit in the car two ways, but it was worth it! I had it down to a science.

To keep clean outside of home, I had a little bathroom bag and kept a package of those round facial cleansing pads and balneol. I believe it's for post-pregnancy applications, but by CR surgeon suggested it to me and it worked great when I wasn't home. I wouldn't say that it was very soothing, but it certainly helped when I couldn't bathe.
 
After my seton placement my CR introduced me to calmoseptine and let's just say I have nicknamed it "butt nirvana creame". It is the best stuff ever! I still use it often when the seton irritates my skin.

Also he gave me a prescription for lidocaine cream which I used often for pain before the surgery. After I mostly did sitz baths and was on a healthy stream of pain meds.
 
Thanks so much everyone! I appreciate all the suggestions.

My swelling has gone down from what it was post surgery which is definitely making it easier to sit normally on seats (which was super impossible for a while). The abscess that my CR drained in surgery which is connected to the fistula (I think?) has been feeling SO much better.

My only concern now is after I go to the bathroom, which is unfortunately a lot since now the stomach crohns related pain is kind of uneasy the past week, the part that the seton is in has been bleeding. At first it scared me because it was a good amount of bright red blood. I realized I just need to be more careful wiping that area after I have a bowel movement. It's also still a little painful where the seton is when I am going to the bathroom.

The initial problems are getting better though! Thanks again for the feedback!
 
Hey, so right after my seton surgery I used a squeezy bottle to spray warm water on my bum after a BM and then very lightly dabbed with TP to dry it. That helped a ton. My mom found the spray bottle at Sally's beauty store. It's actually a hair dye applicator, but the nozzle is at a angle so it makes it quite easy to spray that area. Yeah...we got a little creative!
 
Don't be afraid to gently move the seton round into a more comfortable position, very often the knot tends to get caught up in the fistula causing a lot of pain. Hope this helps.
 
Agreed with bigtruck! That can be so uncomfortable. I like to move my seton whenim showering because the soap and water makes it easier to move.
 
Hi! Glad I found this thread I am having the same problem. I just had a seton put in and I was pleased the pain was getting better and now its getting worse!

The advice about "cleaning" is very helpful. I can't bear to touch it all at the moment but I need to get over it!

Apparently I have "quite a big cavity" I'm so worried its not going to heal. I can't see the logic of leaving an open wound where there is quite a lot germs hovering around. Please tell me there is a logic?

I'm hoping it going to get better and be easier to touch/clean/sit on.
 
I was the same way when I first go mine. It gave me MAJOR heebie jeebies! The incision that the surgeon made on mine was very large, so I had almost a two inch hole that had to heal. And it did. My first BM with a seton was so scary. My mom literally was holding my hands the whole time (thanks mommy, nothing like a surgery to make you revert to being a baby!). But it actually wasn't bad.

Mine still gets painful. I take hit site baths and it helps. It's surprising, but that hole heals really well! I was on antibiotics I think. Plus I used a spray bottle to get extra clean after a BM. Stupid setons!
 
Location
Ontario
Hi! Glad I found this thread I am having the same problem. I just had a seton put in and I was pleased the pain was getting better and now its getting worse!

The advice about "cleaning" is very helpful. I can't bear to touch it all at the moment but I need to get over it!

Apparently I have "quite a big cavity" I'm so worried its not going to heal. I can't see the logic of leaving an open wound where there is quite a lot germs hovering around. Please tell me there is a logic?

I'm hoping it going to get better and be easier to touch/clean/sit on.
I had quite a large hole to heal as well, the surgeon "cleaned" out the fistula before placing the seton. It was quite painful for awhile but it did heal eventually. It took about a month before I could sit normally though. Because bringing a donut cushion to work is so cool.
 
Buy a donut pillow!!! It was the best investment i have made! My fiance said to get one for ages and i tried and tried not too, was the best feeling to be able to sit comforatably TRUST ME!!!
 
Donut pillow is a great idea if your wound is near your rectum. If it is too far to the side it may not be helpful. Good luck.
 
Donut pillow is a great idea if your wound is near your rectum. If it is too far to the side it may not be helpful. Good luck.
I agree, be careful on donuts. They can put to much pressure on the area and can cause your cheeks to spread which can pull things weirdly. Just be aware... If you feel uncomfortable on one stop using it.

A super squishy pillow worked better for me. Still sucked though either way.
 
Hello New and Need Advice
I have beet using a topical lidocaine viscous 2% when I wipe. It is a prescription and was originally prescribed for my "GLOSSITIS -soreness on my tongue. Since it numbed the pain in my mouth I thought I'd try a wipe with it in the area of my anal seton and in that particular situation it has supplied numbness required until my next bathroom trip. It soothes otherwise burning sensation and because it is a topical like Some gels for soreness in the mouth.it provides a pleasant reprieve from the pain that comes from making so many bathroom trips and also dealing with a sore seton. All the best to you, "New and Need Advice" - hope these words can help. Thank you for asking. QUOTE=emilyrose230;556353]Hello all! I'm very new to this community, so I'm not sure if this is a good sub forum to post in about this but everyone seems supportive here so here goes nothin.

I just had a surgical draining and seton placement last week, the first few days I was really surprised that the pain wasn't as bad as I predicted. Definitely was hard to figure out the whole.. wiping situation after bowel movements but I got the hang of it. The past few days though its been way more uncomfortable. I had to sit on a hard chair yesterday and it was really awful and painful.

Basically I, wondering if anyone has discovered some temporary on the site pain relief tricks? I've tried ice packs, I do the sitz baths, but nothing lasts more than an hour of relief. Would ointments be a bad idea because they might clog the fistula?

Any advice is greatly appreciated!

Thanks so much![/QUOTE]
 
I found the same thing as BigTruck. Sometimes I just needed to move the knot to a different area and that would do the trick. Also, I found the longer it was in the softer the material became and it generally became less noticeable.
 
Hello everyone,

I'm glad I found this forum and know I'm not alone with my illness. I'm a single, depressed man that lost his colon (about 5 years ago) to Ulcerative Colitis and have a J pouch. I had two fistulas and just had a complex seton put in. It really hurts and I've been taking pain medication for it, but that makes me dizzy. I find that taking hot showers is the best relief so far, but sitting is extremely hard. Is there anyone out there that has a J pouch and seton together? If so, how do you cope with it?

Thanks and I hope everyone is feeling okay!
 
Does anyone have an experience in self (patient) removal of a draining seton? I've heard of seton's falling out but never someone cutting it with scissors and removing themselves, mine is very very loose and moves about a lot.
 

cmack

Moderator
Staff member
Hi Normanski,

I have had setons before, and I would let the doctor look at it. They can usually see if it's ready to come out. If you take it out too soon it could possibly abscess, I wouldn't want that to happen to you.


Regards,

Chris
 

cmack

Moderator
Staff member
Don't be afraid to gently move the seton round into a more comfortable position, very often the knot tends to get caught up in the fistula causing a lot of pain. Hope this helps.
This is true, be sure to use a sterile finger/s or glove though. I also wouldn't move it if it is freshly placed as it will really hurt.
 
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