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If the anus is burning: burning the anus
Afterburn is an extremely uncomfortable, but in most cases rather harmless symptoms. The burning sensation on the anus is not infrequently caused by incorrect cleaning or hygiene, whereby an excess rather than a lack of hygiene leads to skin irritation in the anus area. However, diseases such as hemorrhoidal disease (hemorrhoidal disease), pinworm infection (enterobiasis) or even anal cancer can also trigger the afterburn. A medical examination is therefore urgently required, especially if the anus continues to burn or recur regularly.
Symptoms of anus burning
Afterburn describes a burning pain in the area of the anal region, which is often accompanied by visible changes in the complexion. For example, irritation due to exaggerated or improper hygiene leads to reddening of the skin, hemorrhoids sometimes appear visibly swollen in the case of hemorrhoid disorders and so-called anal fissures can be recognized as tears in the area of the anoderm (anal mucosa). If those affected give in to the itching sensation, the skin injuries can cause eczema and abscesses. Depending on the triggers, extremely different accompanying symptoms can be observed, which are then described in more detail in connection with the causes.
The potential causes of burning after itching range from certain foods to mechanical irritation (e.g. from rough toilet paper) and allergic reactions (e.g. to soap or cream) to fungal infections, hemorrhagic disorders, anal fissures and pinworm infections. Diseases that are closely related to metabolism, such as diabetes mellitus or kidney problems, can also cause a burning itch in the anal area. In the worst case, the burning sensation in the anus can also be associated with cancer (colorectal cancer, anal cancer).
Improper hygiene as the cause of the afterburn
Inadequate as well as excessive hygiene can be cited as a possible cause of skin irritation in the anal area, although in this country the complaints are associated with excessive anal hygiene more often than with insufficient cleanliness. Excessive contact with the ingredients of soap and creams, but also with printed, fragrant toilet paper, often causes the sensitive anal mucosa to react with visible changes and increased itching. Here, allergic processes usually play a significant role (contact allergic anal eczema).
Mechanical irritation, for example from rough toilet paper, can also cause burning. Some manufacturers offer moist toilet paper that promises particularly gentle and thorough cleaning at the same time. However, wet wipes are only recommended to a limited extent, since they often contain preservatives and fragrances that can lead to an allergic reaction of the skin.
Skin irritation in the area of the anoderm can also result from inadequate anal hygiene. The remaining stool triggers inflammatory changes in the skin that can be accompanied by a painful burning sensation in the anal area.
One of the most common causes is hemorrhage. The hemorrhoids (also hemorrhoids) are a highly perfused, ring-shaped vascular pad, which serves to (fine) close the anus or prevent accidental leakage of stool or secretion. With increasing age, the tissue is often weakened, the hemorrhoids appear enlarged and so-called hemorrhoidal nodules form, which can appear to the outside. Although the clinical picture hemorrhoids is relatively widespread and treatment is well researched, the exact causes of the disease are still unclear. In general, hemorrhoidal disorders are divided into different degrees of severity, which range from completely invisible, completely reversible hemorrhoidal nodules to non-reversible, permanently escaping nodules.
In the case of hemorrhoid disorders, the anus burning is due to the weakening of the function of the vascular pad or the secretion that escapes as a result. This leads to inflammatory skin changes and the formation of anal eczema, which in turn causes a burning itch in the anal area.
The most striking feature of hemorrhoids is anal bleeding, which is visible on toilet paper after bowel movements. There may also be light red traces of blood on the surface of the stool. The color of the blood is crucial. While bright red speaks for a connection with a hemorrhoidal disease, dark red blood residues are often the result of a serious illness of the internal organs or the digestive tract. In severe hemorrhoidal disorders, the hemorrhoidal nodes in the area of the anus are clearly visible.
Burning of the anus can also take on a polyetiological form in the course of hemorrhoidal disease - that is, a symptoms caused by several factors. First of all, the escaping secretion causes anal eczema, which is then treated with common hemorrhagic agents, which in turn can cause an allergic reaction due to the allergens they contain, which in turn leads to increased itching and burning of the anus.
Anal fissures are tears in the anal mucosa, which can be extremely painful for those affected. Especially during and after defecation, an anal fissure often shows a severe burning sensation in the anus. The symptoms are usually caused by extremely hard stools, whereby the anoderm was often already weakened by a loss of elasticity. Certain sexual practices such as anal intercourse or the anal insertion of vibrators can also cause tears in the anal mucous membrane and corresponding afterburn. Due to the pain, those affected have considerable difficulty relinquishing the stool as usual during bowel movements. It is not uncommon for the stool to appear unusually small in diameter due to spasm in the sphincter. Occasionally, bright red blood residues can be observed on the stool or toilet paper.
Viruses, bacteria and fungi as the cause of the afterburn
Infection with viruses, bacteria or fungi should also be considered as the cause, with fungal infections (mostly with Candida albicans) being a particularly widespread trigger of the symptoms. The infections usually affect the upper layers of the skin and the patient - irrespective of the location - is tormented by a violently itchy rash. The complexion appears changed, for example with redness, pustules, blisters or scaling. The bacteria that cause corresponding infections in the anal area more often include streptococci and staphylococci. Genital warts (caused by human papillomaviruses; HPV) are one of the most common viral infectious diseases that can lead to afterburn. Under certain circumstances, viral, bacterial and mycogenic infections can lead to serious inflammation, which in the worst case can lead to blood poisoning.
Infection with parasitic pinworms usually leads to severe itching in the area of the anus, which is caused by the egg laying of female pinworms in the area of the anus. The animals living in the intestine leave it in order to be able to lay their eggs in the anus area.
The strong itching leads to intense scratching, which has several disadvantages: On the one hand, the highly infectious eggs stick to the fingers and can thus be passed on to others or taken orally by those affected themselves. On the other hand, scratching causes injuries to the anoderm, which in turn lead to inflammatory processes and an increased afterburn. Abdominal pain, chronic diarrhea, rectal bleeding and symptoms of appendicitis such as fever, loss of appetite, nausea and vomiting can be observed as accompanying symptoms in the case of a severe pinworm infection.
Various other factors, such as excessive sweating in the anal fold or the intake of certain foods, can also play a role in the occurrence of afterburn. Long cycling or hiking can also cause mechanical irritation of the sensitive skin in the anal area, which can lead to skin irritation and an burning sensation in the anus. Longer-lasting diarrhea can also be mentioned as a potential trigger for the symptoms. Anatomical peculiarities such as a so-called skin tag (anal wrinkle) are another potential cause of afterburn.
In addition, hereditary skin diseases such as Darier's disease and non-hereditary skin diseases (for example lichen sclerosus) are to be considered as triggers of a burning itch in the anal area. The most serious possible cause of afterburn is cancer, such as anorectal melanoma or anal cancer.
Based on a detailed questioning of the patients about the symptoms, their occurrence and possible connections with the personal hygiene or food as well as a thorough external examination, causes of the afterburn like a hemorrid illness, wrong anal hygiene or anal fissures can usually be clearly diagnosed. A smear followed by a laboratory test can be carried out to detect bacterial, viral or mycogenic infections. A blood test provides important information for diagnosing causative systemic diseases. Examination of a stool sample can help determine if there is a pinworm infection. If cancer is suspected, a rectoscopy may be performed and a tissue sample taken for laboratory diagnosis. If the cancer is already well advanced and metastases may have developed, ultrasound examinations, computed tomography and magnetic resonance tomography are provided in order to clarify this.
First of all, regardless of the triggers, it is important that those affected do not scratch, as the symptoms can otherwise worsen significantly. Thereafter, the treatment should always be based on the causes. Irritation from the use of soap, creams and other care products can be alleviated by avoiding the corresponding products or by changing the anal hygiene. Acute inflammation of the skin is often treated locally in conventional medicine with so-called glucocorticoids (colloquially also called cortisone), but these involve a considerable risk of side effects, especially when used for a long time. They should therefore be replaced with gentler agents, such as ointments based on ammonium bituminosulfonate, for longer-term therapy needs.
Treatment of hemorrhagic disorders
Under (specialist) medical guidance, hemorrhoids are usually quite easy to treat, although a variety of different therapeutic options can be used. These range from a change in diet (for a softer stool consistency) to the application of certain hemorrhoidal agents (hemorrhoidals) to outpatient or even inpatient interventions. Hygiene measures to alleviate skin irritation in the anal area and reduce any excess weight that may exist are also provided as basic therapeutic care. In addition, those affected should avoid pressing hard when defecating.
While the outcomes for outpatient and inpatient measures (sclerotherapy, rubber band ligation and hemorrhage surgery) have been clearly proven to be effective against hemorrhagic disorders, there are no clinical studies available to date that scientifically confirm the effectiveness of the available hemorrhagic agents. The preparations can at best help to alleviate the symptoms and not cure them. Nevertheless, the use of hemorrhage drugs is quite common. These are available in various forms, such as suppositories, ointments, creams, multi-pads or anal tampons, over the counter in the pharmacy. However, self-therapy without medical support is strongly discouraged. The afterburn often decreases significantly after using hemorrhoidals, at least for a short time.
Treatment anal fissures
First of all, an adjustment of the diet is also on the agenda for the anal fissures in order to achieve a soft stool consistency and to avoid further stress on the torn tissue during bowel movements. A high fiber content and sufficient fluid intake are particularly important here. For the acute pain, ointments with a local anesthetic can be used.
Similar recommendations apply to gentle but thorough anal hygiene, as is the case with hemorrhagic disorders. Although anal fissures are an extremely annoying symptom, they usually heal completely after a maximum of eight weeks with appropriate care, so that the burning sensation in the anus also disappears afterwards. In some cases, however, the current treatment methods fail to cure, so surgery may be the last option.
Treatment of viral, bacterial and mycogenic infections
Bacterial skin diseases are usually treated with the external use of antibiotic agents that are applied to affected areas. If these do not achieve the desired success, oral antibiotics can also be used for systemic treatment. In the case of fungal infections, external treatment is also carried out, but here on the basis of so-called antifungals. The treatment of viral infections is usually much more difficult, since the drugs used here (antivirals, cytostatics, caustic agents and drugs to strengthen the immune system) often do not show the required effectiveness. Despite increased delays in the healing process, however, the viral causes of afterburn can usually be successfully treated or they can be alleviated to the extent that symptoms no longer occur.
Pinworm infection treatment
The standard treatment for an infection with pinworms is based on the administration of so-called anthelmintics (worming agents), which are supposed to cause the worms to die, and on adherence to strict hygiene regulations to prevent a renewed oral intake. The hygiene measures provide that, for example, the underwear is changed several times a day, contact with the anus area is avoided as far as possible and the hands are cleaned particularly thoroughly after using the toilet and before each meal.
The fingernails should also be cut as short as possible so that the eggs of the pinworms do not stick here. Thorough cleaning with a hand brush is also recommended after defecation. Ideally, the bedding is also changed daily and the bedding or underwear should be cleaned at a temperature of at least 60 degrees to avoid any risk of transmission of the pinworms in this way.
Treatment approaches against further triggers of the afterburn
Anti-inflammatory and healing ointments can generally have an extremely positive effect on (hereditary) skin diseases and help to relieve the afterburn. This also applies to anal eczema due to mechanical irritation caused by long cycling or hiking. Other triggers of afterburn, such as anatomical peculiarities in the form of a skin tag, must be surgically removed in an emergency. This also applies to cancer such as anorectal melanoma or anal carcinoma. If the cancer cannot be successfully removed by surgery, radiation therapy is also provided here.
Naturopathy for afterburn
Naturopathy offers different starting points for treatment, whereby here, too, the therapy must always be based on the causes of the complaints. For example, naturopathic therapy for hemorrhoids relies on marigold ointment, extracts from witch hazel (witch hazel) and hip baths from oak bark extract, chamomile or tin herb. But according to their holistic approach, other complaints such as constipation or a possible acidity of the organism are also considered as potential triggers of the hemorrhoids in the course of the therapy. Homeopathy uses active substances such as witch hazel, aloe, aesculus and nux vomica for hemorrhoids. If accompanying anal fissures can be observed, Ratanhia is used as a homeopathic remedy. Sulfur on a homeopathic basis is also used against the itching and burning of the anus.
Naturopathy or, in particular, herbal medicine has a number of other options available which have a positive effect on skin irritation in the anal area and corresponding afterburn. For example, ointments with a combination of arnica, horse chestnut and marigold can provide relief from such complaints.
If an afterburn connection is suspected with a possible vitamin deficiency, orthomolecular medicine is also increasingly being used, which tries to remedy the symptoms by administering high-dose vitamin preparations. In order to select the individually appropriate method from the multitude of naturopathic starting points for treating the afterburn, an extensive medical history should be available at the beginning of naturopathic therapy, which also takes apparently independent symptoms into account in order to do justice to its holistic approach. Naturopathy, such as anatomical features or cancer, often only offers the option of accompanying therapy. (fp)
Author and source information
This text corresponds to the requirements of the medical literature, medical guidelines and current studies and has been checked by medical doctors.
Dipl. Geogr. Fabian Peters, Barbara Schindewolf-Lensch
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