Perineal/Anal Irritation, burning, itching, mostly after a bowel movement...

First off, I think the posters are describing a few different afflictions; ranging from hemorrhoids to herpes, to fissures, to whatever. To be clear, what I am occasionally afflicted with is anal pain and itching, around the anus, perineum and on the butt cheeks. This is accompanied by obvious redness, rashes and some minor bleeding, especially during bowel movements or when cleaning afterward. My advice assumes that a person is not suffering anything more serious than this; and doesn't have some grievous underlying illness.

This is caused by a skin irritation; usually something bad in the poop. The irritation allows opportunistic bacteria or yeast to make the problem worse. I've found it to be caused by drinking too much beer, wine, or coffee; or anything else that causes flatulence or soft poop.

What works for me is this:

1. Eat yogurt every day. This encourages the proper balance of flora in the gut, reduces yeast, and promotes healthy pooping. Avoid the foods that irritate the butt. Reduce intake of carbs that encourage yeasties.

2. Clean with unscented baby wipes after bowel movements. Keep the area clean, clean, clean.

3. Keep the area dry. After using the baby wipes, allow the butt to dry - maybe pat dry with toilet paper and apply unscented talc.

4. Avoid using creams. They provide some temporary relief; but don't allow the area to dry.

5. Don't irritate the area more by scratching, wiping vigorously with TP, using harsh soap, or anything else nasty.

Hope this helps!

I have been having the same symptoms. It is worrisome and also embarassing to talk about. I have thought maybe it is hemmorhoids, but I am now leaning more toward diet. Has anyone considered coffee being a cause?

I too suffer from this and I have identified a few things that might be the cause.

Keep in mind I am lactose intolerant for the most part. I can have some cheese without problems but milk or anything cream-based is out of the question.

One thing I've noticed FOR SURE is Red Wine; If I have red wine in the evening, the next day but butt is very red, irritated and uncomfortable. The problem is not alcohol in general - I can have beer, vodka, scotch, etc without any problems at all.

When the redness / itchiness occurs, I usually just apply Vaseline and wait until the next day.

Every since I started avoiding red wine, I've been much much more comfortable.

Now today I have this problem again, and the only thing I can say for sure I ate out of the ordinary yesterday was a BANANA.

I can't say for certain if it was the banana until I do more self-tests, but perhaps there is some common ingredient in bananas and the grapes that make up red wine? Perhaps an acidity level?

I seem to recall this maybe happening after drinking orange juice as well, although I haven't had orange juice in months so I'll have to test that again.

I've had the burning and itching for years as well. I know I don't have an STD, I know my diet does not affect it, eating yogurt doesn't help, preperation h doesn't help, drinking water doesnt help. I haven't had a cup of coffee in over a year, so I'm not coffee doesn't affect it. I have a BM pretty often, about 2-4 times a day; Always soft, never hard.
To respond to some posts already:
Anal fissures is basically a cut and goes away in a few weeks. This a burning and itching that last for years, for some.
Someone mentioned some kind of worm, which would explain the itching. But not the horrible burning.
Someone also mentioned Ulcerative Colitis, I dont know why, it has no symptoms of burning ot itching.
The only suggestion worth looking into so far is Candida Albican - a type of parasitic yeastlike fungus that inhabits the intestines, genital tract, mouth, esophagus, and throat. Because of its many and varied symptoms, this disorder is often misdiagnosed. Easily treated with Candida Forte, pills. But I dont think that's it. Still, worth a shot.
bodyandfitness.com/Information/Womenhealth/infection.htm

25, M.
Doctor prescribed Biaxin XL (antibiotic) after a trial of penicillin failed to treat a lung/throat infection. At the end of the prescription of biaxin (1 week), my digestion had gone completely upside down. Symptoms re-occur several times per month for the past 4 months.

Symptoms include:
- sudden urgency to defecate
- stool consistency in urgent situations is often either a) oozy, b) runny, or c) practically undigested (comes out like it went through a shredder)
- in all 3 situations, stool feels extremely "acidic" -- the kind of feeling you get after having indigestion from a spicy meal, except much more intense
- occasional clear/slightly yellow leakage leading to temporary itching, redness, and a pinkish tint when wiped
- degree of "pinkish-ness" increases with time between leakage to wiping

- on a larger scale, stool will jump between the above symptoms vs. coming out like small hard pellets -- fairly easy to pass
- on 2 occasions a large pellet will have a long (2-3") stringy tail hanging off

- condition seems exaggerated when drinking coffee, tea, or beer. Wine and milk appear to have little impact.
- condition seems mitigated if consuming regular quantities of yogurt

Self diagnosis:
- frequency of bowel movement may be related to overproduction of stomach acid
- suspect possible bacterial or fungal overgrowth condition


Does this sound familiar to anyone? I'm betting the Biaxin screwed up my natural internal flora, so I'm trying to get things back in order, preferably without getting the runaround through fifty billion expensive prescriptions.
Still... it's rather annoying to keep having these relapses.

Nice to know I am not alone. I too suffered bad burning and itching, mild bleeding. My Doc finally said I had elements of Puritis Ani. He handed me a printout from www.skinsite.com/info_puritis_ani.htm that was very helpful.

I seem to be free of the symptoms. Here is what worked for me:

Keep are very clean, (even after flatulence).
Be very gentle when cleaning. Use wet wipes.
Mix half & half Cortisone creme and Lotrimin Ultra, and apply after every cleaning (several time a day).

The symptoms were significantly reduced within a couple days. Pretty much gone after a couple weeks. I still use the cremes. I hope this helps someone.

raw oates wth fresh oranges every morning will cure the problem in 2 weeks im living proof

Its been over a year now. After taking the prescriptions, and being told to stop, it always comes back, starting with tenderness and itching around the anus, then the perenium, then small bumps or lesions form in the pereneum area and down to the top of the vagina, and then the lesions spread all around the cheeks of the anal cavity in scaly, scablike lesions which produce mucus when picked, and which spead, and within the anal cavity there is a sore of maybe 1/4 inch diameter at the top of the area which bleeds. Sometimes there is small spotting of blood at the anus when wiping after a BM. There is a kind of strange numbness in the area.

The itching is so horrible it wakes you up, and there is almost a crawling feeling around the area. It is worse when you lay down; I hate to lay down now, I dread it.

I had a colonoscopy and a polyp removal, a hemorroidectomy, and biopsy, tests for parasites; I've had ketoconizol, Nystatin, Fluconozol, diflorisone diacetate, Acetone, hydrocortisone and lodoquinol in various combinations and it ALWAYS just comes right back.

I've got one doctor telling me this could develop into cancer and another telling me no cancer ever happens in these cases, and the four of them have NEVER taken an adequate culture, one tried but I had been taking the Nystatin so how could anything be there?

SOMETHING is causing this, but they seem to be garishly certain that, for instance, I am scratching my buttox in my sleep (which I am not). The only things which changed that I can think of is that (1) a dermatologist prescribed betamethazone valerate for itchy scalp after which I had the first rash on my anus I ever had in my LIFE; (2) around that time I started a new CPAP machine (I have sleep apnea); and (3) at the time the rash started I had lost 75 pounds, which I imagine caused the cheeks of my bottox to sag.

So I have decided that I have to find a way to live with this...I am using vinegar, which I feel is safe since my mother and aunts used to talk of vinegar douches. I am also using Tea Treee Oil for the itching, which is more experimental. Both cause tenderness and a small amount of pain for about 15 minutes after application, BUT the itching goes away and stays away for up to 8 hours.

I am also using Neem Oil soap, since Neem is a biocide and has been used for centuries for healthy skin in India, and it does seem to help my overall skin. I also use Neem oil, but while it does stop the itching its only for a few hours.

I am also trying a cream called Hua Tuo creme, which can be bought on Amazon.com but its expensive to ship; if there is a China Town near you, you might get it there. I do not use it at the anus, but only on the cheeks where the scaly stuff develope, a half hour or more after I use the vinegar and Tea Treee Oil, and in the lower "skin to skin" area which has become infected with whatever it is we have.

I am also using acidopholus x 3; selenium x 2 once a day and activated charcoal x 2 after each meal.

I eat a high fiber diet, no red meat, only whole grains, and very little of that, drink lots of water, eat almost no sugar (I use Stevia) or anything with a high glycemic load, and yet this rampages on and on in my body. I do not drink, smoke, and am not sexually active. I walk 1/2 hour a day at least.

P.S. I was paying $80 co-payment for that dermatological betamethzone valerate for dandruff itch, which may have caused all this for me, and I've been using VINEGAR and it works much, much better. Google "effects of vinegar" and you will be surprised at all its many uses, it goes back to Plato!

Ive had this for about 2 months now and been given anti inflammatory creams and tablets to get of diarohhea (excuse the spelling) it worked okay and it was so much better and then last week it came back... with vengence!
Ive got a small tear which I can feel, but not see, it feels like I'm passing hot cause and it is SO painful!
Recently I havent been eating anything spicy but it came back anyway and now it feels like Ive burnt my insides... everything hurts!
=(

Fellow sufferers! I have found something that eases the pain for me. But before I tell you, let's just run through the typical symptoms again.

Symptoms
What has mostly been described in this forum is an insane itch and/or burning sensation like curry sauce (chilli sauce) in the perineal area around and forward of the anus, up to the scrotum or vagina, depending on your sex. It can be present during the day and at night, when it can ruin your sleep. On looking at the area in a mirror there are no obvious signs of anything such as a rash, except, maybe, your scratch marks. Creams for treating thrush or hemorrhoids do not have any effect. Doctors do not seem to know what it is. People in the forum who have consulted them have had all sorts of treatments prescribed, most of which don't work either.

What helped me
A pea-sized amount of ibuprofen gel rubbed into the area stops the itching and burning within minutes and the relief lasts for many hours. Ibuprofen gel is easy to obtain and is used to reduce pain in rheumatism and sports injuries, like sprains.

Why does it help?
I'm not a doctor but I think it works by dulling the pudendal nerve that supplies this area with sensation. I discovered this after other internet searches and reading a website about pudendal nerve entrapment (PNE). A burning sensation is reported there as one of the early symptoms. Relieving the pressure on the area when you sit (I sit at my computer for long periods) also apparently helps prevent it from worsening.

Other things to check out
It seems to me from reading this forum topic that if you suffer these sorts of irritations, there are some other things you should check out if the above does not work for you or fit what you are experiencing. Do internet searches for more information on them. In ascending order of difficulty to diagnose and treat, and for the need for medical involvement:
1. Threadworms (aka pinworms). Easy to treat with a one-off tablet.
2. Anal fissures and haemorrhoids.
3. Thrush or other yeast-like infections on the surface of the skin.
4. Sexually transmitted diseases (STIs)
5. Skin rashes and other dermatological problems.
6. Intolerance to various foodstuffs such as those containing yeast.

Best wishes to you all,

Val

I suppose to add to the list of things to check out one should mention pubic lice (aka 'crabs').

Val

I CAN"T BELIEVE THERE IS NO DEFINTIVE CURE. I've been suffering from this unbelievable itch in my anus and sometimes my rectum for the last 3 months. It has been an everyday occurrence. I have tried everything!

- hydrocortizone
- preparation H
- witch hazel
- hydragen peroxide
- suppositories (for rectal itch)
- apple cider vinegar
- lydocaine (which is suppose to numb the area)
- aveeno baths
- aloe vera wipes
- vasoline

NONE OF THIS HAS WORKED. In some cases it made it worse. I have no idea what is going on down there. At first I thought it was torn skin, then i thought it was a anal fissure, then i thought it was pinworms, then i thought it was candida, then I thought a yeast infection, that a caffeine sensitivity, then i thought it was sugar. This has really been a problem.

FOR THE LAST THREE DAYS, I have been applying zinc oxide and nothing else to affected area. The results have been mostly positive. The itch decreases w/ only on/off light itch once in a while. I just applied some a little while ago and the itch has definately decreased which tells me its irritated skin. However, I will be going on a daily plan effective tomorrow of applying Zinc Oxide every four hours accompanied by lotramin ultra (sp?) in the morning and at night.

I WILL POST MY RESULTS every three days and pretty much journal this problem. No one should have to suffer this embarrasing problem i've had for the last three months. Sometimes I'll be sitting there at work and can feel it come on real bad. I get really flustered, problem turn red, start to sweat, so i definately have an anxiety about my itch. There was a time where I was running to the bathroom 8 times a day just to itch it.

I WILL BEAT THIS, I refuse to live like this. As God as my witness I will defeat this problem once and for all. No one should have to suffer like this. I truly believe, from experience, that to every problem there is a resolution. THERE WILL BE A RESOLUTION TO THIS!

Hi psbwsc, did you read my post, two above? You don't seem to have tried the ibuprofen get that is working for me. I wouldn't say it's cured it, but it has reduced over a few days to almost nothing.

Val

Hey Folks, yet another sufferer here. 36, M.

I have small, external hemorrhoids. I had a chronic anal fissure a couple of years ago, the result of the Atkins diet without fiber. My fissure was serious business, and was misdiagnosed by my PCP as a large hemorrhoid.

When he finally sent me to an arse specialist, the guy recognized it right away as a very serious, chronic fissure. He tried a round of sitz baths and a couple of creams to relax the sphincter muscles enough for it to heal - no dice, this was a major tear.

I had a Lateral internal sphincterotomy to correct the fissure, and it worked quite well. Ever since then, however, I've been dealing with the problem we're discussing here. Mine rarely manifested itself as anal itching until recently, and Prep H takes care of that.

My MAJOR issue is severe itching in the perineum, and often the testicles as well. Like most of you, I've seen two doctors - tried every cream in the book, and none of it *cured* the problem.

Did you read Val's post on Page 6? I believe I can tell you why it works. First off, I've been using only Neosporin + Pain Relief for a couple months now (as someone else mentioned too), and it works great...for a few hours. Nighttime is the worst for me, and nothing has gotten me through the night except a fat bowl, with one exception - and this is why I'm posting.

My current PCP decided to treat some shoulder joint pain I've been having with Prednisone, an oral steroid. He told me not to take Aleve, or any other ANTI-INFLAMMATORY because that's basically what the steroid is and they don't mix well.

The week I was on Prednisone, I was in heaven. NO itching whatsoever - slept like a baby for the first time in almost three years without pot.

The point of this post - I'm positive the reason Val's ibuprofen gel works is it's an ANTI-INFLAMMATORY. I'm going to run out and get some after I finish typing this up. I can't answer why an anti-inflammatory works though.

I truly believe what I have (this may not pertain to you all) is PRURITUS ANI, which has also been mentioned in this thread a few times. Anal problems such as fissures, hemorrhoids, etc. can cause it. Note, however, that it is a SYMPTOM, and rarely diagnosed as a root-cause illness. I have no doubt this developed in me after my arse exploded, and it was compounded by the surgery. It started immediately after I finished the pain and anti-inflammatory meds the specialist gave me.

Now that I've put all this together, I'm going to print out all the info I have a take it to my PCP. He's genuinely bothered that he hasn't been able to get rid of this and has no clue what it is. Neither did I until I was thinking about it in my bath this afternoon - then it donned on me - the fissure surgery, that's when this all started.

Sorry for the huge wall of text. I hope this helps. In summary, these are the things that have given me relief:

* Neosporin + Pain Relief
* Prednisone (oral steroid)
* Tea Tree Oil
* Sitz bath
* Bathe FREQUENTLY, twice a day if I'm sweating
* Witchhazel
* Prep H Soothing Gel
* Pot (although this doesn't help the itching much, it does help me sleep through the night)

Here's some more info on PRURITUS ANI
http://wiserwiki.com/Anorectal_Disorders

A final word about the Prednisone - it comes with very serious side effects if taken for extended periods, hence it is not an option for me for extended treatment. I encourage you to do some research on it before considering it as a treatment for yourself.

Good luck!

Val, you must live in the UK (I've read it's everywhere there). Ibuprofen Gel is not easy to find in the US, and I spoke to three pharmacists that didn't even know topical ibuprofen existed.

That said, I did find it online, but I'm going to speak with my doctor before I order it.