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Suggest treatment for burning sensation in my anal area inspite of having history for irritable bowel syndrome and hemorrhoids

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Internal Medicine Specialist
Practicing since : 2004
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I am a52 year old woman with history of irritable bowel syndrome. I had completely normal colonoscopy 7 years ago. I visited my GI 4 times in the last 3 months and he felt my stomach every time and said everything feels normal. He also did a rectal exam and said that I have hemorrhoids which I knew. Bu I have this sensation in my anal area and a feeling of burning which bothers me. I suffer from anxiety and I think my mind is all the time focused on my anal area. At this point I am embarrassed to go to him for fifth time in less then 4 months because he was firm that apart from hemorrhoids everything is normal. He also says it is still early for a new colonoscopy because first one was normal and I have no family history. But I keep on thinking about this sensation all the time. I do not have any blood and he also did the blood in stool which was negative as well as stool culture which was all negative. What would your advice be? I cannot stress enough that I have health anxiety and always focused on my anal area. What shall I do? Thank you in advance.
Posted Wed, 19 Mar 2014 in Digestion and Bowels
Answered by Dr. Enrique Molina 5 hours later
Brief Answer: go to a specialist Detailed Answer: hi, i understand your anxiety, as the anal area is a very sensitive area and it is embarrassing for patients to talk about it. keep in mind that a digital rectal examination provides very limited information in terms of causes of anal pain. The most common cause of anal pain is an anal fissure, however this is usually due to trauma to the area. A colorectal surgeon can do an "anoscopy" and have a better look and better view to the anus compared to a standard colonoscopy (a different technique and equipment is used). If there has not been any trauma or manipulation of the rectal area before the pain started, then other considerations are muscle spasms and hypersensitivity to the anal nerves. This can be related to stress; i see that you suffer from anxiety and depression, so it could be related. Traditional treatments include warms baths and even warm water enemas. There are medications available that can be used to relax the anal sphincter muscles and relieve the pressure and pain, however you should see a specialist first, and i suggest you visiting a colorectal surgeon. Hope that helped, let me know if you have any further questions or concerns.
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