Question: Hi: I am 43, 5' 9", and about 185 pounds.
I have been suffering with anal itch and burning in the anal area and anal canal for about three months now.
Background: I do have a hemorrhoid, which has been present for several years without much nuisance, but I thought this was the root of the problem. I have been applying every ointment I could find..prep h, tucks, etc, without much more than very temporary relief. I think they made the matters worse.
More history: Shorty before this started, after experiencing some abdominal pain, I was diagnosed with Diverticulitis. After taking Antibiotics for about 8 days that infection apparently cleared. I have had no pain since. After telling the gastro Dr that I was seeing for this about the itch/discomfort i felt and my hemorrhoid, he took a look down there and told me to put some Balneol cream on it after I shower, that it looked more like the area around the hemorrhoid was probably just sensitive/aggravated, but that he didn't think the hem was the main issue.
More history: Last year I had jock itch around my groin. After applying Lotrimin for two weeks I thought it fully cleared.
Some details on the current anal itch/burn: it comes and goes throughout the day. Some days are better than others. But generally it seems to be worse after a bowel movement, though definitely not isolated to then. Most days during the midday (while shopping or on the computer or whatever) I will get intense discomfort and burning itching sensations with an incredible urge to rub the area. Its discomfort and lack of understanding at what is causing it is adding immense stress and unpleasantness to my life. (I also lost my job a couple months back , so that added stress probably doesn't help). Two weeks back I made an advanced effort to combat what I thought may be the root of the hemorrhoid....by drinking water throughout the day and eating a lot more fiber. Around the same time, I started applying some Lamisil jock itch cream just in case the previous jock itch had quietly spread there over the last year, even though I didn't see any obvious symptoms on the skin. Within a couple days, the irritation seemed to subside some. I had one day of almost no discomfort. I continued the cream until the container was gone, about six days, but during that duration the intense pain still came back so I thought maybe it wasn't helping. I have continued to drink lots of water and eat more fiber throughout. About four days ago, i noticed what looked like it could be signs of jock itch, some minor chafing of skin just outside the anal canal, and some general redness and discoloration in general ( though it's hard to examine this hard to see area myself completely). With the pain continuing...and thinking back to the best day I felt was immediately after using the jock itch cream...I began applying more jock itch cream (this time Lotrimin Ultra). Minor improvement again, but the discomfort is still there. Today as example I had a bowel movement this morning without many issues. Then went out and a couple hours later had intense discomfort, itch and burning. I came home and had another bowel movement and had again intense burning. I showered and cleaned the area and applied more Lotrimin. Hasn't bothered me the rest of the day so far. So my thinking is perhaps I am having issues with both jock itch not clearing AND the hemorrhoid? There are days/times when the roid is definitely sensitive to the touch and irritable. But the other persistent symptoms don't seem related to it. Likewise with the jock itch, all of the symptoms don't seem to add up. Can jock itch get in and around anal canal? Does it cause burning after bowel movement. What on earth do you think is going on with me? Also, on a side note, yesterday I noticed some redness and burning/irritation on my knuckles, though I didn't do anything to aggravate them that i know of (other than constant washing of my hands and using Purell cause I keep touching my arse). Could this be jock itch spread to my hands or am I just going crazy? One final note: during a couple bowel movements, though not in the last couple weeks, I noticed a very tiny almost rock like pebble in my stool while wiping. Okay, there's pretty much everything that could be related to all of this. Please advise.

Hello Dr. Thanks for your response . Why do you think jock itch is not contributing to this issue? The antifungal creams seem to have offered the most relief yet. And I did have a fairly active case last year. There also seems to be improvement on the surrounding skin with usage the last couple days. You suggest hyydrocortisone, but I had tried Cortizone with hyrdrocortisone for a couple days a few weeks back with no effects of any relief from that. If this is an anal infection, what type of infection do you suspect? Perhaps it is a yeast infection and the antifungal was helping that? Is there anything I can do at home to rule out pin worms? Would they cause this pain during the day. I thought they mostly added discomfort during the night.

Hi: Do I need a prescription for Oral antifungal agents and oral broad spectrum antibiotics? Today I thought the problem was almost gone...but then discomfort started right before I had to have a bowel movement and burning in the anal area after. Does that sound consistent with the fungal infection? I also seem to be rather moist in my anus area generally, which may contribute to the itchiness. Thank you for your insight. RB