Hell's Ditch continued the group's slow departure from Irish music, giving more emphasis to rock and straight folk rock, and forsaking their earlier staples of traditional compositions almost entirely. MacGowan parted with the band after the release of the album, owing to the decline of his reliability as a performer, which was caused by his abuse of alcohol and drugs. Several of the songs on the album have Asian themes, in sound or in content, notably "Summer in Siam", "The House of Gods" and "Sayonara"—although only the latter has a noticeably far-eastern tune. The song "Lorca's Novena" draws on MacGowan's affinity for Spain, and the famous Spanish poet Federico García Lorca. It tells of the poet's murder by Francisco Franco'sNationalist supporters in the Spanish Civil War, and how his body, never having been recovered, was said to have walked away. "The Wake of the Medusa" is a first-person narrative inspired by Théodore Géricault's painting "The Raft of the Medusa", which had appeared on the cover of the band's second album, Rum, Sodomy, and the Lash. The title track is based largely on the life and writings of French author and playwright Jean Genet, in particular The Miracle of the Rose and Our Lady of the Flowers, with its vulgar description of squalid prison life. The album was produced by The Clash's Joe Strummer, who later served as a temporary replacement for MacGowan when the band went on tour. The cover-art for the album was designed by Josh Shoes.
The Hell's Ditch demos were recorded prior to this album. "Murder Ska" and "Redemption Song" are both unreleased tracks featuring Spider Stacy on lead vocals. "Victoria" and "Lust for Vomit" are both instrumental versions of songs that later appeared on Shane MacGowan and the Popes' 1994 debut album The Snake, the latter retitled "A Mexican Funeral in Paris". "NW3" and "Murder Ska" were played live as early as 1988 but never properly recorded. A studio version of "NW3" was recorded for inclusion on Hell's Ditch, but MacGowan was unable to deliver a satisfactory vocal performance, leaving the track as an unfinished instrumental. Thus, "NW3" is an early version of "Mother Mo Chroi", which was released on MacGowan's second solo effort, 1997's The Crock of Gold. "NW3" or "Mother Mo Chroi" appears to be very similar in sound and structure to The Pogues' original song "Rake At The Gates of Hell". The Falconer demos are widely available on the Internet, and unlicensed copies occasionally surface on the online auction siteeBay. They also appear on the Pogues box set of rare and unreleased material released by Rhino Entertainment on 17 March 2008.