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What Causes Rectal Burning Followed By Bowel Movement After Heart Surgery?
Question: My husband , a Type II diabetic whose sugar rarely goes higher than 123, had successful open heart surgery in 2012. Since that time, he has rectal burning following a bowel movement. In 2013 he had a severe case of cellulitis which nearly killed him. He claims this irritation is far worse than the heart surgery and the episode of cellulitis.
We have been to a dermatologist, gastroenterologist, internist, urologist and endocrinologist. They have prescribed meds & every OTC cream and none work for more than 3-4 days.
Since he claims the irritation is after a BM, I believe that it must come from something in his stool. I am researching such possibilities as candida other other intestinal issues. I don't even know if there are other specialists to see or not.
I feel so helpless in finding a solution at this point. I can't let this 77 year old spend the rest of his life suffering like this. Any suggestions? Thanks, XXXXXXX
We have been to a dermatologist, gastroenterologist, internist, urologist and endocrinologist. They have prescribed meds & every OTC cream and none work for more than 3-4 days.
Since he claims the irritation is after a BM, I believe that it must come from something in his stool. I am researching such possibilities as candida other other intestinal issues. I don't even know if there are other specialists to see or not.
I feel so helpless in finding a solution at this point. I can't let this 77 year old spend the rest of his life suffering like this. Any suggestions? Thanks, XXXXXXX
Brief Answer:
What tests have been done ?
Detailed Answer:
HI XXXXXXX
Greeting from Dr. Divakara.P
First of all thanks for choosing Healthcaremagic for posting your query.
I can understand your concern and will do my best to help your husband. The possibilities are Infections in the intestine , injury/ ulcers in the intestine or malabsorption.
Before advising for any tests I need to know what all tests have been done for him till now with respect to his rectal burning and what are his current medications.
Kindly let me know these details .
Looking forward for your reply.
Regards.
What tests have been done ?
Detailed Answer:
HI XXXXXXX
Greeting from Dr. Divakara.P
First of all thanks for choosing Healthcaremagic for posting your query.
I can understand your concern and will do my best to help your husband. The possibilities are Infections in the intestine , injury/ ulcers in the intestine or malabsorption.
Before advising for any tests I need to know what all tests have been done for him till now with respect to his rectal burning and what are his current medications.
Kindly let me know these details .
Looking forward for your reply.
Regards.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Gave prescriptions, most never looked at his rectum.
Rx:L Hydrocortisone Acetate 1% Pramoxine HCI 1% Cream;
Nystat/Triam cream ; Triacinolone Acetonide Cream 0.1%;
Lidocaine 3% Cream (this 1 cost $100); Santyl Ointment; Econazole Nitrate Cream 1%.
OTC: PrepH; Tricalm; Aloe; Hydrocortisone; Diaper Rash Cream
,etc.
Currently he is using Aloe and at my suggestion he is trying the Econazole Nitrate & PrepH.
Current Meds: Non-Prescription: Asprin 81 mg. x 3/wk ; Krill Oil 300mg; CoQ10 Ubiquinol 100mg; Magnesium 400mg; Iron; Tyenol PM x1
Rx:
Xarelto(Rivaroxaban) x 1 in pm
Nitrostat 0.4mg-As needed
Metoprolol Tart 100 mg x2
Losartan 100 mg x2
Insulin Novolog 70/30 15 units x2
Metformin ER 500 mg x4
Cardizem CO (Diltiazem) 180 mg x1
Crestor (Rosuvastatin CA) 5mg 3xweek
Furosemide Tab/Lasix 40mg x1
No tests have been ordered for this. He has quarterly visits to Cardiologist, internist & Endocrinologist with standard lab work, no significant findings. In April 2014, had colonoscopy with 1 polyp removed.
Rx:L Hydrocortisone Acetate 1% Pramoxine HCI 1% Cream;
Nystat/Triam cream ; Triacinolone Acetonide Cream 0.1%;
Lidocaine 3% Cream (this 1 cost $100); Santyl Ointment; Econazole Nitrate Cream 1%.
OTC: PrepH; Tricalm; Aloe; Hydrocortisone; Diaper Rash Cream
,etc.
Currently he is using Aloe and at my suggestion he is trying the Econazole Nitrate & PrepH.
Current Meds: Non-Prescription: Asprin 81 mg. x 3/wk ; Krill Oil 300mg; CoQ10 Ubiquinol 100mg; Magnesium 400mg; Iron; Tyenol PM x1
Rx:
Xarelto(Rivaroxaban) x 1 in pm
Nitrostat 0.4mg-As needed
Metoprolol Tart 100 mg x2
Losartan 100 mg x2
Insulin Novolog 70/30 15 units x2
Metformin ER 500 mg x4
Cardizem CO (Diltiazem) 180 mg x1
Crestor (Rosuvastatin CA) 5mg 3xweek
Furosemide Tab/Lasix 40mg x1
No tests have been ordered for this. He has quarterly visits to Cardiologist, internist & Endocrinologist with standard lab work, no significant findings. In April 2014, had colonoscopy with 1 polyp removed.
Brief Answer:
Could be due to Medication induced
Detailed Answer:
HI
Thanks for the follow up .
Well I see that a Colonoscopy has been done recently and found only a polyp and otherwise it's normal .
So the chances of infection or injury/ ulcer is less. I am suspecting either it is due to irritation due to certain drugs he is taking or it could be due to malabsorption.
The medications which could cause rectal burning are Aspirin , Metformin and Iron . I advise you stop his Iron tablets first and see the response . If his Iron levels are very low then you can get him Iron Injections but stop the Iron Tablets .
If no improvement then stop Metformin and ask your doctor to adjust the dose of Insulin and see the response . If no improvement with that also then stop Aspirin in consultation with his cardiologist and ask for an Alternative to aspirin ( Clopidogrel will do ).
Try this and if still no improvement we shall do certain evaluation for Malabsorption.
Also use Xylocaine Viscus mixed in water after consulting your Internist.
Hope you find this information useful.
Any clarifications or Queries feel free to ask.
Could be due to Medication induced
Detailed Answer:
HI
Thanks for the follow up .
Well I see that a Colonoscopy has been done recently and found only a polyp and otherwise it's normal .
So the chances of infection or injury/ ulcer is less. I am suspecting either it is due to irritation due to certain drugs he is taking or it could be due to malabsorption.
The medications which could cause rectal burning are Aspirin , Metformin and Iron . I advise you stop his Iron tablets first and see the response . If his Iron levels are very low then you can get him Iron Injections but stop the Iron Tablets .
If no improvement then stop Metformin and ask your doctor to adjust the dose of Insulin and see the response . If no improvement with that also then stop Aspirin in consultation with his cardiologist and ask for an Alternative to aspirin ( Clopidogrel will do ).
Try this and if still no improvement we shall do certain evaluation for Malabsorption.
Also use Xylocaine Viscus mixed in water after consulting your Internist.
Hope you find this information useful.
Any clarifications or Queries feel free to ask.
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Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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