I have had a lot of problems in this region, which involve constant pain because of rectal constriction, and including great difficulty in having BMs without straining. I take Milk of Magnesia and a stool softener, but this does not totally help, and I strain too much. I am seeing a specialist about this but not for three months.
Anyway, I have felt a 'bare' area next to my anus, where I have had sores which have come and gone on a regular basis. The sores are due to Behcet's Disease. Yesterday, I felt the spot, which in extent is about the size of a 25c piece (though the sores are never that size), and I felt that the skin was terribly thin there, and immediately started to panic as this is exactly where I have had internal rectal pain and a sense of an internal itch and pain in my buttock. The bare area is also slightly indented, or maybe that is just the thinning effect.
Could the skin split open there? I am terribly worried about this, as have no idea how thin/thick the skin usually is in that part of the body, but realize now that this is the place internally that seems to take all the straining to pass very thin/sometimes flat BMs.
Welcome to the Dermatology Expert Forum and thank you for your question.
If perianal skin is affected by recurrent (Morbus Behcet related) ulcers (”sores”) development of fissures is possible. Difficulties with passing stools could be additional risk factor (if stretching of skin/mucosa is present). Ulcerous area may feel slightly indented because epidermal layers (most superficial layers of skin) are missing, plus there could be some indented scaring tissue that had formed after healing of previous ulcers. Pain and even itchiness most often accompany these ulcerations.
However, if causative disorder is treated, skin/mucosa should heal.
I assume that your diagnosis was confirmed by establishing presence of well-defined criteria for Behcet’s disease. Your doctor has probably already talked with you about various possible clinical manifestation of Behcet syndrome (including gastrointestinal ones) and different treatment protocols available. In addition to taking therapy, discuss with your doctor ways of changing your diet (more fibers, prebiotics and probiotics, digestive enzymes, etc.) That should provide relief (more regular and painless bowel movements).
Wishing You Optimal Health,
Dr. Jasmina Jankicevic
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