Prescription Cream for Hemorrhoids and Fissures That Actually Work

Medically Reviewed by Dr. Carmen Fong, MD, FACS

Most “extra-strength” tubes at the pharmacy or standard medications are one-note: a dash of hydrocortisone to blunt swelling or phenylephrine to pinch veins. Helpful, sure—but they don’t relax muscle spasm, numb searing pain, or speed fissure healing.

That’s why Bummed pairs multi-ingredient, prescription creams with an entirely asynchronous care pathway that gets the right formula to your doorstep.

How the Bummed Platform Works (Spoiler: You’ll Never Sit on Hold)

Smart Symptom Checker – Answer a few targeted questions and we’ll route you to hemorrhoids, fissures, or another common anorectal condition in under two minutes.
Secure Medical Intake – Fill out a brief health form—meds, allergies, red-flag symptoms—whenever it’s convenient (mid-meeting, 2 a.m., you name it).
Asynchronous Clinician Review – A board-certified provider evaluates your answers the same day, confirms the diagnosis is safe to treat online, and chooses one of our custom creams—or recommends in-person care if anything looks worrisome.
Same-Day Compounding & Shipping – Our 503-A partner pharmacy mixes your exact formula within hours and ships it that evening. Most patients receive meds in 2–3 business days.

Meet the Bummed Line-Up

Cream →

Why It Beats Standard Tubes

Rapid Relief Hemorrhoid & Fissure Rx Cream →

Nitroglycerin Combo. Relaxes the tight sphincter, numbs fast, calms inflammation. OTC phenylephrine shrinks veins briefly but can make pain worse.

Long-Acting Hemorrhoid & Fissure Rx Cream →

Diltiazem Combo. Keeps the internal sphincter relaxed for 8–10 hours to boost blood flow and healing. Oral tablets can’t target this spot.

Sensitive Care Hemorrhoid & Fissure Rx Cream →

Nifedipine Combo. Same muscle-relaxing magic as diltiazem through a different pathway, perfect if you can’t tolerate nitro or calcium channel-blockers.

Anti-Itch Pruritus Ani Rx Cream →

Anti-Itch Comfort Cream. Calms angry skin and eczema-type itch with prescription strength cream.

Why Compounded Beats Commercial—And Why Our Compounds Are Faster

Multiple actives in one swipe—no juggling three tubes.
Precision strengths—we dial nitro or calcium channel-blocker doses up or down to balance relief and side-effects.
Bases that stay put—our ointments cling to the anal canal instead of melting.
Same-day mixing, potent ingredients —our creams are compounded and packed same day

Real-Life Benefits Our Patients Notice

Relief in minutes. Lidocaine numbs within 60 s; vasodilators unwind spasm in ≤ 10 min.
Fewer systemic side-effects. Topical nitro or calcium channel-blockers treat the canal, not your whole circulatory system.
One payment, one routine. A.m. and p.m. dabs cover vasospasm, inflammation, and itch in a single step.
Zero scheduling friction. Fill out the form on your time, not ours; we handle the rest behind the scenes.

OTC Still Has a Place—Just Know Its Limits

If a basic hydrocortisone or witch-hazel pad tames a once-in-a-blue-moon flare, great. But bright-red bleeding, night-waking pain, or a fissure that hasn’t closed in 4–6 weeks means you’ve outgrown over-the-counter strength—and Bummed’s compounded arsenal is ready.

Ready to Upgrade Your Relief?

Skip the aisle guessing game. In less time than it takes to find parking at urgent care, you can:

Complete our Bummed symptom checker.
Submit your medical form.
Receive a personalized, guideline-backed cream shipped the same day—no ice packs, no in-person visits.

Start your consultation now and let a cream that actually multitasks do the heavy lifting.

Bummed content is for general education and should never replace professional medical advice that considers your individual health. If you think you’re experiencing a medical emergency, call 911 or head to the nearest emergency department.

5 Eye-Opening Facts About Anorectal Health

By Rebecca Monahan, Co‑Founder of Bummed

When my family history forced me to reckon with colon‑cancer risk, I dove deep into the science of gut and butt health. Below are five takeaways that reshaped how I care for myself and how we designed Bummed to care for you.

1. Family History Starts the Clock Earlier Than You Think

If a parent was diagnosed with colorectal cancer, guidelines recommend your first screening no later than ten years before their age at diagnosis. My mother was diagnosed at 46, so my target was 36—well before the “average‑risk” starting age of 45. Mark that date on your calendar; your future self will thank you.

2. Hemorrhoids vs. Colorectal Cancer: Know the Difference

Swelling, itching, and bright‑red blood are classic hemorrhoid signs—but colorectal cancer can masquerade with similar symptoms. At Bummed, we flag anything that doesn’t fit the typical hemorrhoid profile and arm you with the words and data you need to bring to your physician. Early clarity beats late uncertainty every time.

3. Colonoscopies Really Aren’t That Bad

Prepping isn’t anyone’s idea of Friday‑night fun, but with the right hydration plan and low‑fiber diet the day before, the procedure itself is quick and painless. Most people wake up asking when the exam starts—only to learn it’s already done. One afternoon for a decade of peace of mind is a trade worth making.

4. Constipation Is the Root of Most Butt Trouble

Chronic straining drives the majority of hemorrhoids, fissures, and generalized anorectal discomfort. Fiber is your friend—but the type matters.

Soluble sources (think oats and psyllium) create a gel that softens stool; insoluble forms (bran, veggies) add bulk. The sweet spot is a balanced mix, plus two liters of water daily to keep things moving.

5. Telehealth Is Built for Issues Like These

An ER visit for hemorrhoids ties up crowded corridors and leaves you with a hefty bill. Managing acute anorectal conditions online is faster for patients and frees in‑person resources for emergencies that truly require them.

Bummed connects you with licensed clinicians, delivers custom‑compounded creams to your door, and escalates you to in‑person care only when it’s genuinely needed—a win for you and the healthcare system.

The Bummed Bottom Line

From family history to fiber choices, small decisions add up to big differences in anorectal health. If any of these facts set off a lightbulb for you, don’t wait—act.

Schedule your screening, tweak your diet, or book a virtual consult. Bummed is here to make each step simpler, clearer, and stigma‑free.

Ready to take action? Join our mailing list, take our symptoms quiz, or start your intake today. Your butt—and your future self—will thank you.

A 7-Day Bowel Habit Tracker for Real Life

Medically Reviewed by Dr. Carmen Fong, MD, FACS

This is your personal gut guide. Track your poop, patterns, and habits over the next 7 days to help you (and your provider) get to the bottom of what’s going on.

Instructions

Use one page per day — designed for 7 days

Optional: Print front/back for portability, upload to your patient dashboard.

DAY ___

Did you poop today?
_ Yes
_ No

What time(s)?

What did it look like?

Refer to the chart Bristol Stool Chart above.

Type 1: Separate hard lumps

Type 2: Lumpy sausage

Type 3: Cracked sausage

Type 4: Smooth, soft snake

Type 5: Soft blobs

Type 6: Mushy with edges

Type 7: Liquid/no solid

How hard was it to go? (Scale 1–5)

1 = No problem

3 = Needed to push

5 = Strained a lot

Did you have any of the following?
_ Pain during poop
_ Blood on the paper or in bowl
_ Feeling of incomplete emptying
_ Anal itch afterward
_ Lump or bulge at the anus
_ Used more than 2 wipes

Did you eat and drink today:
_ Fiber-rich meals?
_ At least 2L of water?

Notes:

Weekly Reflection Page

At the end of 7 days, reflect on patterns:

How many days did you poop?

What Bristol types were most common?

Did you notice any triggers (foods, stress, travel)?

Any symptoms that occurred more than once?

What helped things go better?

Bring This to Your Visit

This tool helps your doctor see the whole picture. Your symptoms aren’t just about frequency—they’re about patterns, effort, and what your gut is trying to tell you.

Dr. Fong’s Golden Rules

✔️ Go when you have to go
✔️ Don’t strain
✔️ Hydrate + fiber daily
✔️ Don’t wipe too much
✔️ Get up if nothing happens

This blog was created using an AI model of Carmen’s book, Constipation Nation.

How to Put Hemorrhoid Cream Exactly Where You Need It

Medically Reviewed by Dr. Carmen Fong, MD, FACS

If your tube of Bummed-prescribed cream looks suspiciously… normal (read: no long plastic nozzle), breathe easy. Most flares sit on the outside rim or just inside the opening, so you can treat them with a clean fingertip and a little know-how—no gadgets or gymnastics necessary.

Before You Start: Gather the Basics

Your cream
Optional: The finger cot included in your Bummed package
Mild soap + warm water (or a quick sitz bath)
A soft towel or tissue
A hand mirror if visibility is tricky

Step-by-Step: The “Clean, Dab, Chill” Method

Empty, rinse, dry
- Have a bowel movement first.
- Rinse the area with warm water or a peri bottle; pat completely dry. Moisture makes cream slide off and traps bacteria.
Prep the tube
- Pump the bottle to remove any excess air.
- Aim for a pea-size dab—more is not better (or faster).
Pick a comfy position
- Lie on your side with knees bent, or stand with one foot on a low stool, or the side of your tub.
- Whatever lets you reach without turning into a yoga pose.
Dab, don’t rub
- With a washed finger (or gloved fingertip – we recommend our finger cots), gently pat the cream onto each swollen bump and the surrounding skin.
- No scrubbing—friction can tear already tender tissue.
Hands off for 30 minutes
- Toss the glove, wash hands, and avoid another bathroom run for half an hour.
- Skip tight leggings or sweaty workouts right away; friction wipes off the medicine.

Bummed Tips for Extra Relief

Quick Win →

Why It Helps

Refrigerate the tube →

Cooler cream adds a soothing “ahh” factor.

Swap dry TP for rinse + pat →

Reduces irritation so the cream can work.

Pair with fiber + fluids →

Softer stools mean less pressure, faster healing.

When to Seek In-Person Care

Pain, swelling, or bleeding gets worse after 3–4 days of good use.
You feel or see a hard, blue lump (possible thrombosis).
Bleeding is heavy, persistent, or black/tarry.

The Bummed Bottom Line

Applying hemorrhoid cream is more “dab and relax” than “operation complicated.” Keep it clean, use a pea-size amount, pat—don’t rub—and give the medication time to sink in.

Why We’re Focused on Treating Pregnant Women

Medically Reviewed by Dr. Carmen Fong, MD, FACS

You’re going to hear us talking to pregnant and postpartum women quite a lot here at Bummed. That’s because pregnant people often deal with anorectal issues because of what their bodies are going through, but it’s not always the easiest for them to get the care they need, for a whole host of reasons. We’re digging into all that here.

The Stats

According to one study out of Canada, “Pregnancy and vaginal delivery predisposes women to develop hemorrhoids because of hormonal changes and increased intra-abdominal pressure. It has been estimated that 25% to 35% of pregnant women are affected by this condition.

In certain populations, up to 85% of pregnancies are affected by hemorrhoids in the third trimester.”

Our Chief Medical Officer, Carmen Fong, MD writes in her book Constipation Nation,

“Constipation in pregnancy affects 11 to 38 percent of women (up to 40 percent in some studies). I would say more people are affected with constipation and don’t even realize it and don’t seek medical attention.

Maybe they had underlying constipation and felt that their pregnancy constipation was no worse than baseline. Maybe it was just another thing people felt they had to deal with during pregnancy, ‘par for the course,’ so to speak.

I have seen many, many women who saw me because their hemorrhoids got worse during pregnancy and after childbirth. This is because all of the reasons hemorrhoids worsen are magnified during pregnancy and childbirth—the trifecta of constipation, inactivity/sitting, and increased intra-abdominal pressure or straining.”

Why Pregnant Women are More at Risk for Anorectal Issues

Considering pregnancy-related constipation affects most women, which, in effect, is half the population, people are often surprised by it.

The top reasons constipation and hemorrhoids can occur during pregnancy:

1. The most obvious factor is pregnancy-related weight changes and girth. This doesn’t usually happen until the third trimester, when the weight of the fetus-filled uterus actually sits on the colon, impeding some passage of stool contents

2. Most pregnant women require more water intake at baseline to accommodate the 50 percent increase in circulating blood volume (up to three liters a day). Pregnant women increase water absorption from the intestines to help with that. If you’re already not drinking enough water pre-pregnancy, and you have a higher water requirement during pregnancy, and you’re vomiting a lot of it up, you’re already behind on water!

3. Most women have food intolerances during pregnancy—certain smells or tastes that make them vomit. Some women tend to stick with bland, simple-carbohydrate foods, such as rice, toast, and potatoes. There is little fiber in these foods but a lot of starch, leading to further constipation.

4. Some women become anemic during pregnancy because of the increase in circulating blood volume. Doctors prescribe iron supplements for this. Iron is notorious for being constipating (and turning stools black). Lastly, when you don’t feel good, you tend to sit or lay around. Inactivity leads to more constipation.”

The Current Experience

So for all the reasons above, pregnant women experience constipation at very high rates, which leads to them getting hemorrhoids at high rates. However, pregnant women are not traditionally able to access the same solutions that non-pregnant women have.

According to the same Canadian study, “[For pregnant people] The treatment is mainly symptomatic for most patients. Most forms of the condition can be treated by increasing fibre content in the diet, administering stool softeners, increasing liquid intake, and training in toilet habits.

Although none of the topical antihemorrhoidal agents commonly used have been assessed for safety in pregnancy, it is unlikely that the constituent parts (anesthetic, corticosteroids, and anti-inflammatory agents) will harm the third-trimester infant. In most women, most symptoms of the condition will resolve spontaneously soon after giving birth.”

You heard it there, “none of the topical antihemorrhoidal agents commonly used have been assessed for safety in pregnancy.”

Lack of Research

Because of a lack of research, doctors are reluctant to prescribe these effective prescription medications to pregnant people. We’ve heard this same experience echoed from OBGYNS. While women tend to have frequent access to their OBGYN while pregnant, their OBGYN will often refer them out to a specialist, like a gastroenterologist or a colorectal surgeon, to treat their hemorrhoids.

These specialists are often reluctant to prescribe to pregnant women because of the lack of research. It has been well documented that there are many challenges when including pregnant women in clinical research. The lack of research, however, does not always deter women from using a medication they need, as “Up to 90% of women are estimated to be exposed to at least one medication during pregnancy, and at least 60% of women who ultimately give birth take one or more medications to treat a chronic medical condition or a condition that arises during the pregnancy.”

How Telehealth Can Help

So how are we helping the problem of getting pregnant people safe, effective care?

We’re doing the work of gathering all of the specialists in one room:

OBGYNs
Colorectal Surgeons
Gastroenterologists, and more

Each of these specialists have carefully reviewed the ingredients in our special custom compounded formulas, and, reviewing what literature is available, have deemed them appropriate for use while pregnant. We’re also careful to provide all of our patients with paths for escalation, in case we do think you are best served by seeing a doctor IRL.

We also make it a whole lot easier for you to get your speciality prescriptions, by shipping you your meds in discreet, secure packaging. No more running around town to the nearest compounding pharmacy (which are pretty hard to find).

Telehealth provides a crucial solution for pregnant women experiencing anorectal issues, offering access to specialists who have carefully reviewed and approved treatments for pregnancy. This approach bridges the gap in care and addresses the lack of research on traditional treatments during pregnancy.

Our pregnancy-safe medications include:

Long-Acting Hemorrhoid & Fissure Rx Cream
Sensitive Care Hemorrhoid & Fissure Rx Cream
Anti-Itch Pruritus Ani Rx Cream

The Bummed Guide to Hemorrhoids, Anal Fissures & Anal Itching

Medically Reviewed by Dr. Carmen Fong, MD, FACS

This blog was created using an AI model of Carmen’s book, Constipation Nation.

Hemorrhoids

What Are Hemorrhoids, Really?

If you’ve ever Googled “Why does it feel like I’m sitting on a grape?”—you’re probably familiar with hemorrhoids.
But here’s the truth: everyone has hemorrhoids.
Hemorrhoids are not a disease. They’re part of your normal anatomy—vascular cushions located in your anal canal. Their job is to help keep your poop in. They provide bulk and seal. They’re like little air pillows that expand and contract with pressure.
So what’s the problem?
They become symptomatic when they swell, bleed, or prolapse. This usually happens when you strain to poop, sit on the toilet too long, or ignore the urge to go. Once irritated, they can:

Bleed with wiping or stool passage
Protrude outside the anus
Cause discomfort, itching, or a “full” sensation

There are two main types:

Internal hemorrhoids: painless bleeding or protrusion
External hemorrhoids: painful, swollen lumps at the anal opening

Understanding this anatomy helps you understand that hemorrhoids aren’t an infection, cancer, or a punishment for eating poorly. They’re your body’s own structures, just angry.
Why You Keep Getting Hemorrhoids (and How to Make Them Stop)
Let’s talk about patterns. If your hemorrhoids flare up after every vacation, every stressful deadline, or every week you eat less fiber—there’s a reason.
Here are the usual suspects:

Straining: Whether it’s constipation or habit, pushing increases rectal pressure.
Sitting too long: Especially on the toilet. Those 10-minute scrolls? They press on the vessels.
Dehydration: Hard stools are harder to pass. The harder you push, the more irritated your hemorrhoids become.
Low-fiber diet: Without enough fiber, your poop stays small, dry, and reluctant to exit.

What makes it worse?

Ignoring the urge to go
Frequent diarrhea (yes, too much wiping causes irritation too)
Pregnancy, where increased pressure and hormones collide

Breaking the cycle starts with behavior: Go when you need to. Drink water. Eat fiber. Here are some fiber supplements you can also add to your routine. And most of all—get off the toilet if nothing’s happening.

The 6 Types of Hemorrhoid Treatments—From Creams to Surgery

If you’ve tried every cream in the pharmacy aisle and your hemorrhoids still won’t quit, it may be time to explore other options. The right treatment depends on what kind of hemorrhoid you have and how severe it is.
Here are your options:

Lifestyle changes: Hydration, fiber, bathroom habits, and movement. Still the first line of defense.
Topical creams & suppositories: These may help with symptoms, especially if there’s inflammation or itching, but they won’t fix the hemorrhoid itself.
Custom compounded prescription creams: Bummed’s prescription treatments are uniquely formulated to target the inflammation, swelling and irritation, providing immediate relief as well as longer-term results. Our prescriptions use more than just active ingredient, and so they are often more effective than out-of-the-box prescriptions that may only include lidocaine or hydrocortisone.
Rubber band ligation (RBL): Office-based. A tiny band cuts off blood flow to an internal hemorrhoid so it shrivels and falls off.
Sclerotherapy or infrared coagulation: Injection or light-based options to shrink internal hemorrhoids. Less common, but effective.
Surgical excision: Used for large external hemorrhoids, persistent bleeding, or protruding skin tags that interfere with hygiene.

No one wants surgery, but when hemorrhoids interfere with your life, you deserve relief. The good news? Most people never need it if they intervene early.
Do I Really Need Hemorrhoid Surgery?
Short answer: Probably not.
Most hemorrhoids improve with basic changes—diet, water, not sitting too long. But here’s when it might be time to talk about surgery:

You have persistent bleeding despite trying everything.
You’ve developed skin flaps that trap stool or make wiping difficult.
Your hemorrhoids protrude constantly and cause hygiene issues.
You’re in pain that’s not improving.

Surgical options include:

Hemorrhoidectomy: removal of the hemorrhoid tissue
Stapled hemorrhoidopexy: pulling the tissue back up, often for prolapsing internal hemorrhoids
Excision of thrombosed external hemorrhoids (done early for sudden painful lumps)
Surgery isn’t for everyone. But if your quality of life is suffering—talk to a colorectal surgeon.

Sitting Is the New Pooping Problem: How Your Toilet Habits Cause Hemorrhoids
Let’s talk about your relationship with your toilet.
If your bathroom break includes 15 minutes of scrolling TikTok, you’re not just wasting time—you’re stressing out your anus.
Here’s the physiology:
Sitting with your hips flexed increases pressure in the rectal veins. Over time, that pressure distends the hemorrhoidal cushions, weakening their support and leading to swelling or prolapse.
Mammals poop in about 12 seconds. That includes elephants. If you’re there longer, something’s wrong—or nothing’s ready to come out.
The 12-second rule:

Feel the urge → go
Sit for a few minutes
If nothing happens, get up

The longer you sit, the more likely your hemorrhoids are to get squeezed. Don’t bring your phone. Bring your awareness.
Hemorrhoids After Pregnancy: What to Expect and What You Can Do
You just birthed a human being. Your body is healing. But now there’s a painful bump at your anus that bleeds, itches, or makes sitting unbearable.
Welcome to postpartum hemorrhoids.
During pregnancy:

Hormonal changes soften vessels
The growing uterus adds pressure on pelvic veins
Constipation is common (thanks, progesterone and iron)

During labor:

Pushing increases pelvic floor strain
Blood vessels stretch or rupture
External hemorrhoids may appear suddenly

After delivery:

Internal hemorrhoids often resolve on their own
External skin flaps may persist
Pain and swelling typically improve in 1–2 weeks with:
- Sitz baths
- Ice packs
- Stool softeners
- Witch hazel pads (sparingly)

If a skin flap remains and causes hygiene issues, a surgical excision may be needed later—but there’s no rush. You’ve done enough.
Bummed also provides pregnancy-safe treatment options for pregnant and post partum women, including our Long-Acting Hemorrhoid & Fissure Rx Cream.

Anal Fissures

What’s That Sharp Pain When I Poop?
If it feels like you’re pooping shards of glass—or like something ripped on the way out—you may have an anal fissure.
A fissure is a tiny tear in the skin of your anus, usually caused by a hard or large stool. It sounds minor, but the pain can be excruciating. You may see bright red blood on the toilet paper, feel a stinging spasm after wiping, or start dreading your next bowel movement.
The injury itself isn’t dangerous—but it can become a cycle of pain and fear. The more you tense up to avoid hurting, the harder it becomes to relax and go. And that tension? It slows blood flow to the tear, delaying healing.
Fissures are common, treatable, and more about muscle tone than hygiene. The key is to break the cycle before it becomes chronic.

The Difference Between Hemorrhoids and Anal Fissures

Both fissures and hemorrhoids can cause blood and discomfort—but the experience is very different.

Fissure = sharp, cutting pain during or right after a bowel movement. May include bleeding.
Hemorrhoid = pressure or swelling, sometimes with blood, but usually not painful unless thrombosed.

Dr. Fong’s tip:
“If it feels like a paper cut on your butthole, it’s probably a fissure.”
Fissures are more likely to hurt with each poop. Hemorrhoids tend to come and go in waves, often related to straining or sitting too long. Getting the diagnosis right helps you get the right treatment—and relief.
Why You Got a Fissure (and How to Prevent the Next One)
Let’s be blunt: hard poop tears your anus.
That’s how most fissures start. A bulky, dry stool stretches the anal canal too fast, and something gives—right at the midline, where the skin is thinnest. But that’s not the only cause:

Constipation → hard stool + straining = injury
Diarrhea → frequent wiping + acidic stool = irritation
Tight pelvic floor → tension increases risk
Delaying the urge to poop → stool dries and hardens

Preventing future fissures means changing the behavior that caused the first one:

Hydrate
Eat fiber, and add in a fiber supplement
Go when you feel the urge
Take your time, but not too much time (12-second rule!)

The Silent Saboteur: How Holding in Poop Causes Anal Fissures
We’re taught not to poop in public. To hold it until we’re home. But every time you ignore that natural urge, your colon continues to absorb water from the stool—making it harder.
By the time you’re ready to go, that stool has turned into a rock. And the anus? It tightens in response to stress or shame. Then you strain. Then it tears. Hello, fissure.
Dr. Fong’s one rule:
“Go when you have to go. Don’t go when you don’t.”
Bathroom shame is deeply ingrained, especially for women. But the consequences are real—and avoidable.
Treating a Fissure Without Surgery
Good news: most anal fissures heal without surgery.
Treatment is all about reducing pressure and soothing the tissue:

Warm sitz baths: 10–15 minutes, 2–3 times daily
Stool softeners: to keep bowel movements gentle
Topical creams: prescription ointments that relax the anal sphincter (e.g., nifedipine, nitroglycerin). Check out Bummed’s custom compounded prescription creams here.
Fiber and hydration: to prevent recurrence

Only chronic fissures—those lasting more than 6 weeks or resistant to treatment—require surgical evaluation. And even then, it’s a minor procedure with high success.

Pruritus Ani (Anal Itching)

Why Your Butt Itches (And Why Wipes Might Be to Blame)
Anal itching (also called pruritus ani) isn’t just annoying—it’s often misunderstood. Most people think it’s caused by being “dirty.” So they wipe more. Use scented wipes. Add creams. And the itch? Gets worse.
Here’s why:

Wipes and soaps strip away your natural skin barrier
Steroid creams used long-term thin the skin
Overwashing leaves your butt dry, raw, and vulnerable

You don’t have to clean your anus with industrial strength. Your butt isn’t broken—it’s over-loved.
Don’t Do Anything to Your Butt You Wouldn’t Do to Your Mouth
Dr. Fong puts it simply:
“Would you rub a scented wipe on your gums three times a day? Would you scrub your tongue with a washcloth?”
Of course not. The skin around your anus is just as delicate. It’s not meant for frequent abrasion or chemicals. So when in doubt, treat your anus like your lips: gently, respectfully, and with minimal friction.
The Perpetual Itch: Understanding Pruritus Ani
The most frustrating part of anal itching? The itch-scratch cycle. It goes like this:

You feel itchy → you wipe/scratch
Skin barrier weakens → more irritation
You feel even itchier → more scratching

This feedback loop leads to chronic inflammation, especially if you’re also dealing with:

Hidden hemorrhoids
Fungal or bacterial imbalance
Allergies to laundry detergent, soap, or diet

Breaking the cycle starts with stopping the over-cleaning. The skin needs time and space to heal.
Stop the Scratch: How to Actually Treat Anal Itching
Let’s talk treatment:

Step 1: Stop using wipes or soaps. Water only. Pat dry, don’t rub.
Step 2: Wear cotton underwear. Avoid synthetic fabrics.
Step 3: If needed, try a bland barrier cream—like zinc oxide or petroleum jelly.
Step 4: If you suspect infection (especially if moist, weeping, or foul-smelling), see a provider. We recommend Bummed’s Anti-Itch Pruritus Ani Rx Cream, which includes clotrimazole for its antifungal properties and hydrocortisone to calm inflammation.

Not Sure What You’re Experiencing?

Take our Bummed symptoms quiz to determine the best prescription medication based on your symptoms.

The Best Fiber Supplements for Constipation (and a Happier Gut)

Medically Reviewed by Dr. Carmen Fong, MD, FACS

If your bathroom routine has been… let’s say, less than smooth, lately, you’re not alone. Constipation happens to the best of us—whether it’s from stress, travel, pregnancy, or just plain bad luck. The good news? The right fiber supplements can make a world of difference.

Bummed Chief Medical Officer and Colorectal surgeon Dr. Carmen Fong recommends several fiber, enzyme, and probiotic options to help you stay regular and keep your gut feeling good. Below, we’ll break down her favorites, why they work, and where to snag them online. All supplements listed are pregnancy-safe!

(P.S. This isn’t medical advice—always check with your healthcare provider before starting a new supplement. But if you’re just trying to figure out which fiber supplement to keep in your cupboard, you’re in the right place.)

Why Fiber Supplements Matter

Fiber is basically the broom of your digestive tract. It sweeps things along, bulks up stool, and makes trips to the bathroom easier. Unfortunately, most of us don’t get enough fiber from food alone. That’s where supplements come in.

There are two main types of fiber:

Soluble fiber: dissolves in water, creates a gel-like texture, and helps soften stool.
Insoluble fiber: adds bulk to stool and helps it move through your system faster.

For constipation, a balance of both is key—which is why Dr. Fong’s list of supplements covers the whole spectrum.

Fiber Supplements for Constipation: Dr. Fong’s Top Picks

Here are some of the best fiber supplements that can help keep things moving:

1. Coloflax

A physician-recommended fiber blend designed specifically for bowel regularity. Coloflax includes both soluble and insoluble fiber, making it a solid choice if you need an all-in-one solution. As a bonus, Coloflax also has pre- and probiotics in it!

2. Plain Ground Psyllium Husk

Psyllium is the superstar of fiber. It absorbs water, bulks up stool, and is one of the most effective fiber supplements for constipation. Go for the plain ground version if you want to avoid added sugar and flavors.

3. Plain Ground Flax Seed

Flax is high in both soluble and insoluble fiber. Bonus: it also contains omega-3 fatty acids, which support heart health. Add it to smoothies, oatmeal, or yogurt for an easy daily boost.

4. Metamucil

Probably the most famous fiber brand out there. Metamucil is psyllium-based and comes in powders, capsules, and gummies. It’s a reliable, widely available option for daily use.

5. Konsyl

Another psyllium-based option, Konsyl is known for its extra-fine texture that dissolves more easily than some other powders. Great if you’re picky about mouthfeel.

6. Benefiber

Made from wheat dextrin, Benefiber is flavorless and dissolves completely in water or food. If you don’t like the gritty texture of psyllium, this may be your best bet.

7. Citrucel

Citrucel uses methylcellulose, a non-fermentable fiber that’s gentler on sensitive stomachs. If fiber supplements tend to make you gassy, Citrucel is worth a try.

Digestive Enzymes for Extra Support

Sometimes, constipation and bloating aren’t just about fiber—they’re about digestion in general. That’s where enzymes come in.

RMDY Digestive Enzymes

Formulated with enzymes that help break down proteins, carbs, and fats, these supplements can reduce gas, bloating, and stomach discomfort. Think of them as little helpers making your food easier to digest. RMDY also has pre-and probiotics, as well as magnesium, which helps get your colon moving (and can help with sleep and relaxation, too!).

The Best Probiotics for Gut Health

Probiotics are the “good bacteria” that help keep your gut balanced. When paired with fiber, they can improve digestion, reduce constipation, and support overall gut health.

1. Physician’s Choice Probiotic

A broad-spectrum probiotic that supports digestive health and regularity. Popular for its effectiveness and affordability.

2. TruNature Probiotic (Costco Exclusive)

Available through Costco, this budget-friendly probiotic is another solid choice for everyday gut support.

3. SEED Daily Synbiotic

A premium probiotic + prebiotic blend designed with cutting-edge science. It’s more expensive, but highly recommended for those who want the most research-backed formula.

Extra Resources for the Gut Health Nerds

Want to dive deeper? These resources can help you learn more about how probiotics and fiber affect your gut:

IBS Probiotics – Research summaries on probiotics for IBS.

The Microsetta Project – A citizen science project exploring the human microbiome.

Poopedia – Yes, it’s exactly what it sounds like: a community resource all about poop.

Final Thoughts: Choosing the Best Fiber Supplement for You

When it comes to finding the best fiber supplements, there’s no one-size-fits-all. Psyllium (like Metamucil, Konsyl, or plain husk) works for most people, but if you’re sensitive to bloating, try Benefiber or Citrucel instead. Flaxseed is a great natural option, and Coloflax provides a balanced blend.

Pair your fiber with plenty of water, add in probiotics for long-term gut health, and consider digestive enzymes if you struggle with bloating. With the right mix, constipation doesn’t stand a chance.

Because let’s face it: sitting shouldn’t be a struggle, and pooping shouldn’t feel like a part-time job.

Meet Dr. Carmen Fong: Surgeon, Storyteller, and Chief Medical Officer

At Bummed, we’re redefining what gut and butt health looks like—and we’re proud to have Dr. Carmen Fong at the helm of that mission. As our Chief Medical Officer, Dr. Fong brings more than a decade of clinical and surgical experience, along with a deeply human, no-nonsense approach to one of the most misunderstood issues in healthcare: constipation.

She’s not just a colorectal surgeon. She’s Your Friendly Neighborhood Colorectal Surgeon™—and the author of Constipation Nation: What to Know When You Can’t Go, a book that has become essential reading for anyone who’s ever suffered in silence, sat too long on the toilet, or been told “it’s just in your head.”

Leading a New Kind of Care

As Chief Medical Officer, Dr. Fong leads all research efforts at Bummed and is responsible for ensuring that everything we offer—especially our medications—is grounded in clinical evidence, safety, and patient-first thinking. She’s built a multidisciplinary panel of advisors including OB/GYNs, gastroenterologists and pelvic floor specialists. Together, this team reviews, formulates, and approves every product we bring to market.

This means nothing gets the green light without Dr. Fong’s sign-off—and without rigorous input from the full range of specialties that intersect with gut health. It’s part of our commitment to treating the whole person, not just one symptom at a time.

Science, With a Side of Real Talk

Dr. Fong doesn’t believe in sugar-coating, shame, or vague instructions. She believes in science, clarity, and telling you what’s actually going on in your body—whether that’s pelvic anatomy, poop physics, or the reason why your hemorrhoids flared after that keto diet.

In her writing and in her work at Bummed, she blends surgical expertise with cross-disciplinary insight. She reads far beyond the scope of her own specialty because, as she puts it, “someone needs to have a comprehensive overview of constipation across all disciplines”. That’s the standard she’s set for Bummed: evidence-based, interdisciplinary, and always explainable.

The Doctor You Wish You’d Seen Sooner

Dr. Fong built her career treating the consequences of constipation—fissures, hemorrhoids, incontinence, and the surgeries that often follow when prevention fails. But prevention is exactly what she’s working toward now.

At Bummed, she’s turning that experience into action. From product development to patient education, Dr. Fong ensures that everything we do is practical, medically sound, and actually relatable. Because yes, everyone poops—and everyone deserves a doctor who knows what they’re talking about and actually listens.

With Dr. Fong leading the way, Bummed is more than a place to get treatment—it’s a place to finally get answers.

Ready to take your gut and butt health seriously? You’re in expert hands.

What Exactly Is a Compounding Pharmacy — and Why Aren’t Its Meds “FDA-Approved”

How Bummed’s Partner Compounding Pharmacy Puts Quality First

Walk down any chain-store aisle and every tube, tablet, or inhaler you see has a big back-end story: years of clinical trials, lengthy FDA review, and strict factory inspections.

A compounding pharmacy lives in a different—but equally important—corner of the medication world. Here’s how it works and why the finished product doesn’t carry an FDA approval stamp.

1. Compounding 101: Made-to-Order Medicine

How it differs from mass manufacturing

Patient-specific recipes
Small batches, quick turnaround
Ingredient flexibility
Regulated by state pharmacy boards

What that looks like in real life

A provider writes a prescription for you— not for a warehouse.
Pharmacists mix, test, label, and ship the same day instead of cranking out 100,000 tubes at once.
Swap allergens (lactose, dyes), tweak strengths, or combine multiple actives in one base.
Same folks who license your neighborhood pharmacy also inspect compounders for clean rooms, documentation, and USP standards.

Two main pharmacies exist:

503A pharmacies – Traditional shops that dispense only against an individual prescription and can ship across state lines in limited amounts.

503B “outsourcing facilities” – Larger operations that may compound in advance and sell to clinics or hospitals; they register with, and are inspected by, the FDA but their products are still not “approved drugs.” (Human Drug Compounding Laws – FDA)

2. So…Why Aren’t Compounded Drugs FDA-Approved?

Short answer: U.S. law (Food, Drug & Cosmetic Act, Sections 503A/503B) deliberately exempts compounded medications from the full FDA approval process as long as the pharmacy follows strict limits—patient-specific prescriptions, “essentially not a copy” of a commercial drug, high-quality ingredients, and clean compounding practices. (Compounding and the FDA: Questions and Answers, Human Drug Compounding Laws – FDA)

Because each batch may be unique, it’s impossible to run the multi-year, multi-million-dollar trials the FDA requires for a mass-produced product. Instead:

Safety & quality oversight shift to state boards of pharmacy, USP chapters <795>/<797>, and, for 503B sites, routine FDA inspections.
Active ingredients are FDA-approved—nitroglycerin, diltiazem, lidocaine, hydrocortisone—but the finished combination isn’t reviewed before it reaches you.

That’s why every compounded label legally must say “This medication has not been evaluated by the U.S. Food & Drug Administration for safety or efficacy.” (Pros and Cons of Pharmacy Compounding – U.S. Pharmacist)

3. The Risk-Benefit Equation

Potential advantages

Custom strengths for pregnancy or ultra-sensitive skin
Combine multiple actives in one swipe (goodbye juggling tubes)
Omit problem fillers—dyes, gluten, alcohol

Possible trade-offs

No pre-market FDA testing of the final mixture
Quality depends on the pharmacy’s training, equipment, and testing rigor
Insurance coverage varies; cash pay is common

4. How Bummed Keeps Compounding Safe & Simple

Patient-specific prescribing. After you complete our asynchronous medical form, a board-certified clinician writes a prescription tailored to your condition (hemorrhoids, fissure, or itch).
503A, USP-compliant partner. Our pharmacy meets USP <795>/<797> sterile and non-sterile standards and is licensed in all the states we serve.
Same-day fill. Active ingredients are weighed, mixed, potency-tested, and on a truck within hours.
Follow-up messaging. We check in to be sure you’re improving and to adjust the formula if needed.

The Takeaway

Compounding pharmacies exist to solve medication puzzles mass manufacturers can’t—delivering personalized, flexible treatments when standard tubes fall short. Their drugs skip the FDA approval line by design, trading large-scale clinical trials for rigorous state oversight and pharmacy-specific quality controls.

Have questions about a compounded cream? Drop us a message at help@bummed.co and our team will explain every ingredient and every safety step, no waiting room required.

Poop Foundations & Education

Medically Reviewed by Dr. Carmen Fong, MD, FACS

What Is Constipation, Really?

This blog was created using an AI model of Carmen’s book, Constipation Nation.

Most people either say, “I’m always constipated,” or “I’ve never been constipated.” And yet, they’re both usually wrong.Constipation isn’t just about not going. Medically, symptoms of constipation are defined using the Rome IV criteria, which include:

Fewer than 3 bowel movements per week
Straining during at least 25% of poops
Hard or lumpy stools (think little rocks)
The feeling that you haven’t fully emptied
Needing to manually assist things (yes, really)

You only need two of these to qualify as constipated.And yet, many people meet this definition and don’t even realize it. You don’t have to be doubled over in pain or skipping an entire week of bowel movements to qualify. Constipation symptoms are subtle, frustrating, and way more common than people think.

Poop Anxiety Is Real: Let’s Talk About Parcopresis

Ever held in a poop because you didn’t want to go in a public bathroom? Or waited until your partner left the apartment to sneak into the bathroom?

You’re not alone.

Parcopresis, or the fear of pooping in public, affects tons of people—especially women. We’re taught early on that poop is gross, smells bad, and should be hidden. It starts in potty training, and it snowballs from there.

The result?

You “hold it in” when nature calls
Your colon reabsorbs more water from the stool
Poop gets hard, painful to pass, and leads to hemorrhoids or fissures

The fix?

Normalize talking about poop
Don’t delay the urge to go
Remind yourself: everyone poops—even your boss

The bathroom isn’t a shame cave. It’s where you take care of yourself. You wouldn’t hold in a sneeze for 3 days, right?

Do You Know the One Poop Commandment?

Let’s keep it simple. The One Poop Commandment is this:

Go when you have to go, and don’t go when you don’t have to.

That’s it.

Ignore the urge too often? You’ll start to lose the urge entirely. Sit on the toilet hoping something will happen? You may push out hemorrhoids instead of poop.

Bowel health is mostly about listening to your body. Poop should happen when your rectum is full and your body is ready. The rest is strategy, not struggle.

Nutrition, Lifestyle & Behavior

You Can’t Poop Out a Bad Diet

No supplement, smoothie, or stool softener can fix what your plate keeps breaking.If your diet is all cheeseburgers and zero greens, constipation symptoms are almost inevitable. Fatty, processed foods slow your gut down and dry your stool out. Laxatives may give you temporary relief, but they won’t fix the root cause.
Here’s what works:

25–30 grams of fiber daily
2+ liters of water daily (more if pregnant, active, or breastfeeding)
Regular movement, even just walking

Start your day with warm liquid, keep your plate colorful, and poop will follow.

How Much Water Is Enough (and Too Much)?

You’ve heard “8 glasses a day.” But is that right?

Kind of. The average adult needs about 2–2.5 liters of water daily. That’s 8–10 cups, depending on your size and activity level. But here’s the catch: fiber without water becomes concrete in your colon.

Drink enough to keep your urine pale yellow. On hot days, or if you’re sweating more, drink more.

Can you drink too much?

Yes—though it’s rare. Water intoxication happens when you drink faster than your kidneys can process it. Unless you’re chugging multiple liters in an hour, you’re probably safe.

In short: don’t sip all day, hydrate with intention.

Fiber Supplements vs. Food: What Works Best?

There’s no perfect answer—but there’s a clear starting point.
Food first.

Leafy greens, beans, oats, berries, apples (with the skin)
Aim for 25–30 grams of fiber daily

If that’s not cutting it, or if your diet is restricted, then fiber supplements like psyllium or wheat bran can help.
But fiber needs water. Without it, you’ll just add bulk to a dry system. That’s a recipe for hard, painful poops.
Rule of thumb: If you’re adding fiber, add water. If you’re not thirsty, you’re not ready for fiber supplements.

Gut Health & Microbiome

A Bug Up Your Gut: Do Probiotics Really Work?Probiotics are everywhere—capsules, yogurts, powders—but do they help with constipation symptoms? Answer: Sometimes. The evidence is mixed, and results vary based on:

The strain of bacteria
The dose
Your existing microbiome

Some people get more regular, others feel no difference. What matters more? Feeding the bacteria you already have. That’s where prebiotics (like fiber) come in. Dr. Fong’s take? Probiotics might help. But fiber, hydration, and healthy habits will do more.

Do You Have a Healthy Anal Immune System?

Your butt is smarter than you think.
Despite being a high-traffic exit ramp, the anus rarely gets infected—even after surgery. Why? Because the skin and mucosa down there are lined with immune cells and supported by “good” bacteria that clean up after you.
What disrupts this balance?

Over-wiping
Alcohol-based wipes
Creams with steroids
Witch hazel or harsh soaps

Think of your anus like your mouth. Would you scrub your gums with a washcloth 6 times a day? No. So don’t do it to your butt.

Poop Myths, Culture & History

Why You Shouldn’t Sit on the Toilet for 20 Minutes
If you’ve been scrolling Instagram on the toilet for 15 minutes, here’s your reminder: poop shouldn’t take that long. All mammals—including humans—poop in about 12 seconds. It’s not about squeezing. It’s about rectal readiness.
Sitting too long increases pressure on your anal veins, which can cause:

Hemorrhoids
Anal fissures
Numb legs (seriously)

If it’s not coming out, it’s not ready. Get up. Try again later.

The History of Poop Obsession in America

In the early 1900s, Americans were obsessed with poop. Laxatives were used for everything, from headaches to weight loss. People took mercury, drank poison (literally), and inserted all sorts of bizarre devices.

Why? Because constipation was seen as the “root of all evil.” Sir William Arbuthnot Lane even removed people’s colons to “cure” it. Modern medicine no longer recommends such extreme measures, but the fear persists. The takeaway? Pooping is important, but daily BMs (bowel movements) aren’t mandatory. Focus on comfort, not perfection.

What Freud Got Right About Constipation

Freud believed that potty training could shape your personality. And while some of his theories didn’t age well, this one… has merit. Poop shaming during childhood can lead to “anal-retentive” behaviors—perfectionism, control, and yes, constipation. If you grew up being told poop was gross or embarrassing, you may now:

Avoid public bathrooms
Hold it in too long
Ignore your body’s natural cues

Undoing that conditioning is part of restoring your gut health. Let go of the shame. Go when you need to go. Your butt will thank you.
Bummed content is for general education and should never replace professional medical advice that considers your individual health. If you think you’re experiencing a medical emergency, call 911 or head to the nearest emergency department.