Anal Disorders

Anal disorders typically cause pain and itching, especially during or after bowel movements. Most often, the problem is due to an infection, an injury, pinworms, or simply poor hygiene. In some cases, anal discomfort is caused by a more serious problem. This might be a fissure, an ulcerated tear in the anal wall; a fistula, an abnormal opening from the rectum to the skin’s surface or a nearby organ; or an abscess.

Diagnostic Studies and Procedures

A doctor can diagnose most anal disorders simply by examining the area. Identifying the size and location of a fistula, however, may require an internal examination with a sigmoidoscope, a tube with magnifying and lighting devices. Additional tests may be needed to identify its cause.

Medical Treatments

Treatment of anal disorders varies according to the underlying problem.

Anal Fissures

A medicated cream may be prescribed to alleviate irritation of the area. Severe cases may require surgery to remove the ulceration. This is a last resort treatment because it can result in fecal incontinence.

Anorectal Abscesses

These usually require lancing with a sharp instrument, and then draining of the pus. If the abscess is large, a wick impregnated with antibiotics may be inserted temporarily into the pocket.

Anorectal Fistulas

Because fistulas don’t disappear on their own, surgical repair is invariably necessary. The operation, which will be performed under general or local anesthesia, involves either opening or excising the fistula tract. The underlying cause of the fistula should also be treated.

Anal Itching

When this problem, known medically as pruritus ani, is due to pinworms, a prescription medicine quickly eliminates them. Pinworms are most common in children, but a doctor may advocate treating an entire family to prevent the spread and reinfection of the worms .

Alternative Therapies

Herbal Medicine to promote healing of an anal fissure, herbalists recommend compresses soaked in warm echinacea tea or witch hazel; this last also alleviates itching.

Naturopathy and Nutrition Therapy

Most anal fissures are due to chronic constipation, a condition that usually can be remedied by a high-fiber diet, increased exercise, and adequate fluid intake. Many naturopaths advocate adding 1 tablespoon of blackstrap molasses to a cup of warm water and drinking the mixture. Some suggest applying vitamin E oil to a fissure to hasten healing. To relieve anal itching, naturopaths recommend soaking a cotton pad in apple cider vinegar and placing it on the affected area. This may burn at first, especially if the area is raw. Leave the pad on overnight, holding it in place with a sanitary napkin.

Self Treatment

With the exception of fistulas and some abscesses, most anal disorders can be controlled with proper self care. First and foremost, avoid straining during bowel movements. If necessary, use a stool softener or suppository. Some people find that squatting makes bowel movements easier, but it’s a difficult position to achieve on an ordinary toilet. Try placing your feet on a stool and drawing your knees upward. Most anal itching is due to poor hygiene or a reaction to chemicals in soap or toilet paper. Wipe carefully after bowel movements, but avoid excessive rubbing. A moistened wipe is gentler than toilet paper. Pat the area dry after cleaning and apply unscented talcum powder. Soaking in a warm sits bath relieves itching and irritation. To increase the effectiveness, add a half cup of baking soda to the water. Avoid scratching; this only makes matters worse. Nonprescription medications that contain mild anesthetics, such as benzocaine or pramoxine hydrochloride, can relieve irritation and itching, as can hydrocortisone creams and ointments in 0.5 percent strength. Make sure that these topical medications are applied only to the external skin and not to the inside of the rectum itself. A small abscess can sometimes be healed by applying warm compresses. Don’t attempt to lance it yourself, as this can lead to a serious infection. Caffeine, alcohol, high doses of vitamin C, and certain spicy foods may cause anal irritation. Try a eliminating all such culprits from your diet for a few days and see if this helps. Return each suspect one by one. If symptoms return, you will know what foods to avoid in the future. Anal itching caused by an allergic response to a personal product can be alleviated by using plain, unscented, or hypo allergenic products and wearing loose fitting cotton underwear. Anyone with an anal fissure, fistula, or abscess should avoid anal inter course. Similarly, forego enemas or the insertion of any object in the anal canal.

Other Causes of Anal Discomfort

Hemorrhoids often cause anal itching and irritation, so do fungal infections and certain digestive disorders, as well as some medications.