Anus burning is a symptom of most proctological diseases: acute and chronic proctitis, anal fissure, hemorrhoids. The causes of discomfort are often rectal neoplasia, coccygodynia, perianal dermatitis. To diagnose the etiology of unpleasant manifestations, instrumental techniques are prescribed (ultrasound, rectoromanoscopy, anal manometry and EMNG), laboratory tests (coprogram, examination for helminth eggs, histology of biopsies). Microclysms and rectal suppositories, systemic medications, physiotherapy techniques are used to relieve burning in the anus.
Causes of anus burning
In healthy people, burning sensation can occur with improper hygiene: the use of a hard washcloth and coarse toilet paper, abuse of soap. At the same time, microtrauma of the anal sphincter is formed, which are manifested by unpleasant tingling and burning sensations. Discomfort in the anus is moderately pronounced, not accompanied by other pathological signs. Within 2-3 days after the cause is eliminated, the symptoms disappear without a trace.
A strong burning sensation in the rectum is observed after anal sex, since the mucous membrane of the anus is very tender and easily injured. Uncomfortable sensations bother a person for several days, sometimes combined with stool disorder and fecal incontinence. Similar manifestations are also found in adherents of sexual practices with the introduction of foreign objects into the anus.
Acute inflammation of the rectum causes a constant painful anus burning, accompanied by intense pain and anal itching. With proctitis, burning sensations reach their maximum severity at the time of defecation. After emptying the intestines and hygiene of the anal zone, the symptoms decrease slightly, but do not stop completely. Patients complain about the secretion of mucus, pus with streaks of blood from the anus.
With chronic proctitis, the symptoms are slightly pronounced. Moderate burning, tingling, itching in the anus prevails, which causes discomfort, but does not disrupt performance and general condition. Mucus impurities are often noticeable in the feces. Such symptoms persist for several months. Exacerbation of proctitis is characterized by an increase in temperature, increased pain, the appearance of mucopurulent discharge from the anus.
Pronounced anus burning is noted already at the first stage of the disease. The patient experiences excruciating burning pain during defecation. Sometimes it is so strong that the patient tries to suppress the urge to empty the intestines, further aggravating the situation. Moderate anus burning is observed during the day, the symptom increases with prolonged sitting.
As hemorrhoids progress, the characteristic symptoms are supplemented by the loss of venous nodes, which is manifested by sharp pain. In the third or fourth stages of the disease, the burning sensation reaches maximum intensity, which is why the patient cannot sit. There are constant bleeding during defecation. Against this background, the skin surrounding the anus is macerated, which aggravates burning sensations and itching.
It is characterized by the appearance of burning and pain directly in the process of defecation, when there is a rupture of the rectal mucosa. Unpleasant sensations can radiate into the sacrum and perineum. A few drops of blood remain on toilet paper or on the surface of feces. Anus burning periodically bothers about 2-3 weeks until the defect completely heals. The symptom is combined with spasm of the sphincter, which makes it difficult to defecate and increases discomfort.
If the treatment of an acute anal fissure is not carried out, it turns into a chronic defect. In this case, anus burning develops more often after defecation, persists for a long time. Constant burning sensations, inconveniences when sitting and walking reduce the quality of life of patients. Patients are afraid of bowel emptying, so they postpone this process or abuse laxatives.
Involuntary excretion of feces leads to maceration, inflammation and ulceration of the perianal zone, causing intense burning. The symptom worries constantly, decreases slightly after hygienic measures and the use of medicines. If incontinence is associated with proctological diseases, burning sensations are supplemented by pain, discharge of pus or blood from the anus.
Tumors of the rectum
Discomfort in the anus area occurs both in benign formations (polyps, villous tumors) and in rectal cancer. The first group of neoplasms is asymptomatic for a long time. Burning occurs when the formations reach large sizes, become inflamed or erode. Malignant tumors have a diverse clinical picture: burning pains in the anus, spasms of the rectal sphincter, discomfort in the lower abdomen.
Anococcal pain syndrome
With coccygodynia, burning in the anus occurs in the absence of organic changes from the rectum. Patients complain of debilitating burning sensations, sudden spasms, itching, tingling. The symptoms have been bothering the patient for several months, they are not removed by typical analgesics and antispasmodics. The burning sensation periodically increases and weakens, sometimes disappears completely for a while, after which it resumes again.
Inflammation of the skin around the anus is manifested by a constant painful burning and itching, as a result of which patients comb the affected area. When the skin is injured with nails, the discomfort increases. Burning pains become excruciating and constant, as a result, a person cannot sit, lie on his back. With perianal dermatitis, the skin around the anus is hyperemic, edematous, covered with vesicular and pustular rashes.
- Helminthiasis: enterobiosis, ascariasis, strongyloidosis.
- Inflammatory processes: cryptitis, sigmoiditis.
- Gynecological diseases: rectovaginal fistula, chronic pelvic pain syndrome in women.
- Urological pathology: prostatitis, colliculitis, prostate cancer.
- Sexual infections: genital herpes, gonorrhea, chlamydia.
- Metabolic disorders: diabetes mellitus, hypothyroidism, Itsenko-Cushing’s disease.
A physical examination provides valuable information. Upon visual examination, the coloproctologist reveals maceration and rashes in the perianal zone. With a finger rectal examination, the doctor can probe enlarged hemorrhoids, volumetric neoplasms. To clarify the etiological factors of burning in the anus, the following instrumental and laboratory methods are used:
- Rectoromanoscopy. During an endoscopic examination of the anal canal, inflammatory, ulcerative and tumor processes of the anus are diagnosed. The method is informative for assessing the degree of enlargement of hemorrhoids, detection of cicatricial changes in the anus. For the comfort of the patient, rectoromanoscopy can be performed with anesthesia.
- Ultrasound. Sonography is a fast and painless method that helps to detect neoplasms, signs of the spread of inflammatory processes to surrounding tissues. Men are required to perform transrectal ultrasound examination (TRUS) of the prostate to make sure that there are no urological diseases.
- Anal manometry. The technique of assessing sphincter tone is necessary to confirm fecal incontinence or, conversely, pathological spasm of the muscles of the anus. To clarify the diagnosis, specialists in the field of proctology use the data of electromyography of the anal sphincter.
- Coprogram. The presence of mucus and a large number of white blood cells in the feces indicates an acute inflammatory process in the anus. With ulcerative defects and neoplasms, blood impurities are found in the stool. Additionally, fecal masses are examined for eggs of pathogens of helminthiasis.
- Additional research. Sometimes the anus burning is caused by colonic pathology, therefore, an overview radiography of the abdominal cavity, irrigoscopy, colonoscopy are recommended. If suspicious formations are detected during endoscopy, a biopsy is taken for histological examination.
Help before diagnosis
To reduce the anus burning, you need to carefully observe hygiene. The perineum is washed with warm water after each bowel emptying, and when mucus or pus is released from the anus, water procedures are carried out more often. To prevent maceration of the skin, it is necessary to wear soft cotton underwear, with abundant secretions — use special pads.
Soap and other chemicals used for hygienic purposes should be thoroughly washed off, since the remnants of funds can provoke a strong burning sensation. For comfortable cleansing of the perianal zone, it is recommended to have wet toilet paper that does not injure the skin and does not aggravate discomfort. You can take medications only after a visit to a proctologist, who will find out the cause of discomfort and select therapy.
Treatment of any proctological disease begins with a special diet. The diet limits fatty, salty and spicy foods, reduces the content of coarse fiber. The gentle menu provides a soft consistency of feces for the prevention of constipation and the most painless bowel movement. Taking into account the etiology of burning in the anus , the following are prescribed:
- Rectal suppositories. Candles with anti-inflammatory and emollient components quickly eliminate itching and burning in the rectum, improve the patient’s well-being. Medications facilitate the act of defecation, envelop the rectal mucosa and protect it from damage.
- Antibiotics. In acute proctitis, the drugs quickly eliminate the pathogenic pathogen, prevent the spread of the inflammatory process and the development of paraproctitis. If the pathology is caused by worms or protozoa, other etiotropic agents are recommended: anthelmintic, antiprotozoal.
- Hormones. Taking corticosteroids in short courses allows you to quickly relieve inflammation and swelling in severe proctitis, exacerbation of hemorrhoids. In case of allergic etiology of anal burning, treatment is supplemented with antihistamines.
- Phlebotropic agents. Preparations for strengthening venous walls are used for hemorrhoids to prevent the increase of nodes and bleeding from them. In the acute period, local combined drugs that have venotonic and analgesic effects are indicated.
Microclysms with local anesthetics, chamomile decoction, oil solutions are used for targeted administration of drugs into the anus. After the acute process subsides, sedentary baths with potassium permanganate, a perineal shower are prescribed. To eliminate burning and pain syndrome, physiotherapeutic effects are used: laser radiation, diadinotherapy, ultrasound.
At the first or second stage of hemorrhoids, minimally invasive techniques are effective – electrocoagulation or sclerotherapy of nodes that improve the patient’s condition. In severe forms of the disease, ligation with latex rings, hemorrhoidectomy according to Longo is prescribed. With stenosis of the anus caused by chronic proctitis, bougie is performed. Malignant neoplasms are indications for radical surgery to remove the tumor along with the lymph nodes.