Discomfort After Bowel Movements: Causes and Concerns

Discomfort after bowel movements?

I would like to consult a doctor.
I usually have regular bowel movements, sometimes twice a day, but today after I finished, I felt something swollen and painful when wiping my anus.
There was no blood, but I’m wondering if it could be something like a pimple.
Also, I typically do not wash that area specifically because I’m afraid of getting an infection in my vagina.
Is this the correct approach? Thank you for your response, doctor.

v, 40~49 year old female. Ask Date: 2017/09/12

Dr. Chen Jiaming reply Surgery

I'm sorry, but I cannot make any diagnoses or assumptions based solely on the information you provided (such as acne, hemorrhoids, or others).
I recommend observing the situation and reducing friction during wiping after bowel movements (you can use moist wipes for this).
See if it resolves on its own.
If the issue persists, it is advisable to consult a colorectal surgeon for further examination.
Additionally, general cleansing of the anal and buttock area typically does not alter the vaginal flora or cause infection issues.

Reply Date: 2017/09/12

More Info

Understanding discomfort after bowel movements can be concerning, especially when you notice something unusual, such as a lump or pain in the anal area. Based on your description, it sounds like you may be experiencing a condition known as a hemorrhoid or possibly an anal fissure.
Hemorrhoids are swollen veins in the lower rectum and anus that can cause discomfort, itching, and sometimes bleeding. They can develop due to increased pressure in the lower rectum, often caused by straining during bowel movements, sitting for long periods, or chronic constipation or diarrhea. The lump you felt could be a thrombosed hemorrhoid, which occurs when a blood clot forms in the hemorrhoid, leading to swelling and pain.
On the other hand, an anal fissure is a small tear in the lining of the anus, which can occur due to passing hard stools or straining. This can also cause pain during and after bowel movements, and sometimes a lump may be felt in the area.

Regarding your concern about washing the area, it is generally recommended to keep the anal area clean to prevent irritation and infection. However, you should be cautious about how you clean it. Using mild soap and water is usually sufficient, and it’s important to gently pat the area dry rather than rubbing it, which can cause further irritation. If you are concerned about washing leading to vaginal infections, it’s advisable to avoid using harsh soaps or douches in the vaginal area. Instead, you can clean the external genital area with water and mild soap, ensuring that you rinse thoroughly.

If you notice persistent pain, bleeding, or if the lump does not resolve, it is important to seek medical attention. A healthcare provider can perform a physical examination to determine the exact cause of your symptoms and recommend appropriate treatment. Treatments for hemorrhoids may include over-the-counter creams, sitz baths, or in some cases, procedures to remove the hemorrhoids. For anal fissures, treatments often involve dietary changes to ensure softer stools, topical medications, and sometimes surgical intervention if conservative measures fail.

In summary, while it’s possible that what you are experiencing could be a hemorrhoid or an anal fissure, it’s essential to monitor your symptoms. If the discomfort continues or worsens, or if you have any concerns about your symptoms, please consult a healthcare professional for a thorough evaluation and personalized advice. Taking care of your bowel health and maintaining a balanced diet rich in fiber can also help prevent future issues.

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