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Dr. Andrew Rynne
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Dr. Andrew Rynne

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Suggest treatment for severe diarrhea and itching in anus

Answered by
Dr.
Dr. T Chandrakant

General Surgeon

Practicing since :1984

Answered : 17748 Questions

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Posted on Thu, 7 Jul 2016 in Lump
Question: Hi, I've had a chronic problem with my anus. Around 4 months ago i had very bad diarrhoea and sickness. Ever since i started to feel a burning and itching in my anus. I have now had it for 4 months. Every time i have a bowel moment which is normally around 9am each day, it hurts afterwards. It especially hurts when i walk for an amount of time or if i move around in any way. I have already seen a doctor and they said its more than likely puritis ani. He gave me a series of things to do to help the situation, for example loose underwear, wash with water after every movement and don't wipe with paper, also advised me not to use cream. I followed this religiously for 4 weeks and its not improved. The itching is unbearable sometimes. I am experiencing a lot of fecal matter for hours after each movement which the only way to control is to put cotton wool balls there to stop it. It appears that the leakage is causing the irritation. I have been treated for pin worms in case, I've also changed my diet so its high in fibre and i have followed my doctors advice, I'm at whits end with this problem please advise.
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Answered by Dr. T Chandrakant 53 minutes later
Brief Answer:
Clinical evaluation, investigations and proper treatment

Detailed Answer:
Hi.
Thanks for your query.
To recapitulate salient points: Male/37 - diarrhea and sickness 4 months ago - BM 9 am - pains - Doctor - more than pruritus ani - followed his advise - got treated for pin-worms - itching unbearable sometimes - fecal matter for hours after each movement - so put cotton balls - seems that leakage is causing irritation - at wits end....

My opinion and advise as from the history you have provided:
- If you can, post clear pictures as it helps for on-the-spot diagnosis.
- Tests of stool for 3 consecutive days.
- Tests of blood to rule out diabetes, thyroid function, CBC and other as indicated
- Therapeutic trial of an antibiotic and metronidazole to ward off any intestinal and local peri-anal infection/dermatitis.
- Probiotics and other symptomatic therapy.
- Ultrasonography of the abdomen.
- Clinical evaluation and an actual per-rectal digital examination to see the tone of the sphincters, any fissure, hemorrhoid and anything that causes concerns like a polyp.
Proctoscopy and colonoscopy
CT scan of the abdomen if needed.
Continue your treatment as before. And add probiotics and multivitamins, therapeutic dosages of Vitamin A and D.
Treatment of any medical disorders found during the course of investigations and treatment.
This will help to correlate the findings and have a plan of proper treatment.

Please discuss this with your Doctor, get an appointment of a Gastroenterologist or General Surgeon and get the most proper diagnosis and treatment, please feel free to ask for further relevant queries if you feel that there is a gap of communication.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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