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What could be the reason for experiencing mild burning and irritation around my anus?

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Practicing since : 2000
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If you read my previous questions I was dealing with an irritation around my anus earlier this year. Some doctors thought it fungal, other hemorroids and still others had no idea. I have come to believe that the irritation itself may have certainly been aggravated if not caused by the multitude of creams I was applying including Lotrimin, Prep H, Butt Paste and I used combinations of these for over a month when we are told not to use steroid creams longer than a week. I found some relief with Tucks spray in July and it seemed to have rescinded since then. For about 3 weeks now it has returned although not as bad as before. I spray occasionally with tucks and prep H but I don't use it in excess. It seems worse after a bowel movement. Here is a clear photo from today. You may also view some of the previous photos. Can you identify this condition and offer a solution? It is simple Hemorroids? It does not itch at all but it does mildly burn and it's uncomfortable for me to sit at times especially for long periods. It seems better in the morning since I spent the whole night not in a sittle position. I should again point out I am not a XXXXXXX man and there has been no sexual contact of any kind in or around my anus
Posted Sun, 5 Jan 2014 in General Health
Answered by Dr. Amit Jain 2 hours later
Brief Answer: Please see the details Detailed Answer: Hello! Thanks for putting your query in XXXXXXX I am a Gastroenterologist (DM). I hope I have answered your query and this will help you. If you have any further query I will be happy to answer that too. Remain in touch and get-well soon. There are many causes for this like malignancy, Pagets disease, crohns disease, infection, diet induced, dermatitis, leakage of stool or mucus, rectal prolapse, diabetes mellitus, candidiasis. So I will advise you to visit a Gastroenterologist and Dermatologist. They may take a detail history and may advise for colonoscopy, skin biopsy, some blood tests. However many a times there are no cause for it. Meanwhile what you should do which I found very useful in my patients are: 1.Avoid coffee, cola, or chocolates, dairy products,citrus fruits, beer. 2.modify your cleansing habits that is stop polishing (rubbing while cleaning) anus 3.Wipe it gently with wet facial tissue or baby wipes 4.Avoiding soap and a washcloth in the shower and use plain water and hand to wash the perineum in the tub or shower. 5.Creams or emulsifying ointments may be used instead of soap. 6.Perfumed soaps and astringents (such as witch hazel) should be avoided. 7.Tissue paper or a cotton ball placed by the anus and changed several times a day will absorb moisture and create a drier environment. 8. A diet high in fiber with plenty of fluids 9.A limited amount of 1% hydrocortisone cream can be used. 10.Intradermal injection of methylene blue should be used as last resort 11. Take one tablet of Albendazole and repeat it after 14 days I hope I have answered your query and this will help you. If you have any further query I will be happy to answer that too. Remain in touch and get-well soon.
Above answer was peer-reviewed by
Follow-up: What could be the reason for experiencing mild burning and irritation around my anus? 35 hours later
Those are quite a few possibilities. The Albendazole concerns me. Do you feel there is a liklihood of parasites of some kind? Are parasites sexually transmitted via kissing or other? I have been using moistened toilet paper or wipies for some time. I have read perhaps a thin coating of Vaseline around the anus may be helpful? Would this qualify as an "emulsifying ointment"? TUcks annd Prep H do have witch XXXXXXX so I will avoid those going forward. I read the symptoms of Pagets and Chrohns and it doesn't seem to fit with me. Cadiddiasis in fungal and in the previous episode I used several antifungals to no avail so I am not sure that is what I have. Is there a reason you suggest a GI rather than a colo rectal specialist (proctologist)? Here is a more recent photo from this morning. The area seems improved and there is less discomfort.
Answered by Dr. Amit Jain 48 minutes later
Brief Answer: Please see the the details Detailed Answer: Hello! No doubt it appears to be better 1. It can be parasite infection as there are few parasites like enterobius vermicularis etc which spread by contact. Moreover there is no harm in taking albendazole. And it's very cheap also. Since the diagnosis is not confirmed I will like to treat it empirically. 2. Emulsifying agent i MEAN PETROLLEUM jelly 3. Sometimes a lesion in anywhere in colon may be responsible for this all. That's why I suggested to visit a GI specialist. All the symptoms mentioned in a disease is not an an absolute. Since it is persisting for a long time we should find out the cause. I hope I have answered your query. If you do not have any further query , you can close the discussion and rate the answer. Wish you a good health.
Above answer was peer-reviewed by
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