Discomfort Around Anus

[Stan Cooke]

Hi, I wonder if you can help?

Since the beginning of March I have been experiencing discomfort around my anus.  This appears to heighten and then lessen almost day to day.  The symptoms I am experiencing include a burning sensation around the opening of my anus which on inspection can look red and feel chaffed.  This is causing discomfort when I sit and also when I walk around.

I have no pain passing stools or blood present at any time although I do have a nagging itch inside my anus which appears to occur almost every time I walk any distance.

Initially I was concerned about STD's as I was involved in unprotected sex at the beginning of March around a week before the symptoms began to show.  I don't however have any other symptoms on or near the penis and I am a hetrosexual male and the incident did not involve any anal contact.  Also, since then I have been to the STD clinic and tests for chlamydia and gonnorea came back negative.

I decribed the anal discomfort on that visit but the doctor could not see anything untoward (as that day the redness had temporarily subsided so there was nothing to see)  I also made an appointment with my GP who saw me on 27th April and once again, he simply suggested changing soap, toilet paper etc all of which I have already tried.

The day after visiting the GP, the discomfort and burning is back with a vengence and I can clearly see an area of red which almost feels and looks like the skin is raw.  This is now bordering on 2 months since I first experienced this and I'm very concerned that It may be something serious.  I would value your advice as I can't keep taking time off work etc to visit doctors when I can only get appointments weeks in advance and there is no guarantee (as happened previously) that the symptoms are at their worst.

Any ideas what this could be? I was also concerned that stress may have caused it as I have quite a stressful couple of months however I am normally a very happy, calm individual and I doubt I could be stressing enough to keep a condition like this up for a month and a half!

There is no actual pain present in the area, just a mildly burning redness around the opening and an itch inside the anus when I walk a distance and occasionally at other times.  When the redness isn't present I am still aware of a general discomfort around the anal opening e.g when I clench.

thanks

[Kevin Pho, MD]

Things that can lead to your symptoms can include hemorrhoids or a anal fissure amongst others.  

I would certainly consider a thorough physical exam of the area.  An anoscopy can be done to visualize any hemorrhoids.  An anal fissure can be visualized during exam.

Hemorrhoids can be treated with steroid suppositories.  If an anal fissure is suspected, things like topical nitroglycerin, botox injections and calcium channel blocks can all be considered.

If these diagnoses have been ruled out, a more thorough diagnostic study like a sigmoidoscopy or colonoscopy can be considered.

These options can be discussed with your personal physician.

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
Medical Weblog:
kevinmd_b

[yoshi]

could this be a fungal infection?
if so,try smearing some yogurt with live culture on it.

[Biskie2]

You may have a beginning of a fistula developing which can feel like it comes and goes, itches, gets red and sore, fills up with fluid, etc. Or you may not be wiping as well, as fecal matter burns outside the body. Best thing to do is make an appointment with a gastroenterologist and have a sigmoidoscopy to determine what is going on. A GP is ok, but the Gastro guys know what this is. Good luck!

[pipermcgee]

I'm a 50 yr old female, with Crohn's disease, who's had similar sypmtoms.  Do you also have leakage evident by staining?  I call them LBJ (leaking butt juices).  As the Doctor in this column suggested, my situation WAS internal hemmoroids (hemorrhoids).  A quick form of relief from the external discomfort of the internal hemmorids is an over the counter product called Balneol.  (Spelling may be incorrect).  It's a lotion-like cleanser you dab onto toilet paper and wipe yourself with AFTER the initial wipe.  As a previous contributor mentions, small amounts of fecal matter can contribute to the problem.  My problem rarely flares up.  A simple in-office sigmoidoscopy can detect internal hemmoriods.  Check with your pharmacist for an OTC anal cleaner/lotion in the meantime.  Good luck.

[striferx1]

A related discussion, red anas was started.