Post-Bowel Movement Burning Sensation: Causes and Solutions

After bowel movements, there is a burning sensation around the anal area?

Hello Doctor, I had a fistula excision surgery at the end of last year.
Postoperatively, my wound did not heal well due to excessive granulation tissue, so I underwent cryotherapy at a dermatology clinic, along with applying antibiotic and steroid ointments.
Currently, the wound has healed and is in a fibrous scar state.

I would like to ask you, after about a month of starting cryotherapy, I noticed that the skin on the opposite side of the wound (near the fold) began to experience a stinging and burning sensation.
I am unsure if this is due to the clinic physician accidentally spraying the cryotherapy agent onto the normal skin on the other side.
The burning sensation only occurs after I wash my buttocks following a bowel movement (it does not happen before having a bowel movement).

I have also visited a colorectal specialist who examined the wound and informed me that there were no significant issues with the original surgical site, and that the burning sensation might be a side effect of the medication I was applying.

Could you please advise if this situation is due to skin damage from the cryotherapy or the ointments, or if there might be another issue? What steps can I take to improve this condition? (I have not applied steroid ointment for 25 days and I rinse with water after using the restroom.) Thank you for your assistance!

Xiao Mi, 30~39 year old female. Ask Date: 2020/07/07

Dr. Wu Yuxin reply Dermatology

Without seeing the lesion, it is impossible to determine the issue.
A thorough examination is necessary for an accurate diagnosis.

Reply Date: 2020/07/07

More Info

The burning sensation you are experiencing post-bowel movement, particularly after your recent surgery and subsequent treatments, can be attributed to several factors. Given your history of surgery for a fistula and the treatments you have undergone, it is essential to consider both the physical changes in the area and the potential effects of the medications used.

Firstly, the burning sensation you feel after bowel movements could be related to irritation of the skin surrounding the surgical site. This irritation can occur due to several reasons:
1. Skin Sensitivity: After surgery, the skin in the affected area can become more sensitive. The healing process, especially with the presence of scar tissue, can lead to altered sensation, making the skin more reactive to stimuli such as moisture, friction, or even the temperature of water used during cleaning.

2. Irritation from Cleaning: The act of cleaning the area after a bowel movement can sometimes cause irritation, especially if the skin is already sensitive. If you are using wipes or toilet paper that are not gentle or are scented, this could exacerbate the burning sensation.

3. Medication Side Effects: You mentioned using steroid ointments and antibiotics. While these medications are intended to promote healing, they can also lead to skin thinning or irritation if used over an extended period. If you have recently stopped using the steroid ointment, your skin may still be adjusting, which could contribute to the burning sensation.

4. Cold Therapy Effects: The cryotherapy (freezing treatment) you received could potentially have affected the surrounding skin. If the spray inadvertently contacted normal skin, it might have caused localized damage or irritation, leading to the symptoms you are experiencing.

5. Nerve Sensitivity: Post-surgical changes can also lead to nerve sensitivity in the area. This can manifest as burning or tingling sensations, particularly when the area is stimulated (like during bowel movements).

To address your concerns and improve your symptoms, consider the following recommendations:
- Gentle Cleaning: Use lukewarm water and a gentle, unscented soap to clean the area after bowel movements. Avoid vigorous scrubbing and opt for patting the area dry instead of rubbing.

- Moisturizing: Applying a gentle, hypoallergenic moisturizer to the area may help soothe the skin and reduce irritation. Look for products that are free from fragrances and harsh chemicals.

- Avoid Irritants: Be cautious with any products you apply to the area, including wipes or creams. If you suspect that a particular product is causing irritation, discontinue its use.

- Follow-Up with Your Doctor: Since you have already consulted with a colorectal specialist, it may be beneficial to follow up if the burning sensation persists or worsens. They may recommend further evaluation or alternative treatments to address your symptoms.

- Consider a Dermatological Consultation: If the burning sensation continues, a dermatologist may provide insights into whether there is an underlying skin condition or sensitivity that needs to be addressed.

In summary, while the burning sensation you are experiencing could be related to the surgical site and the treatments you have undergone, it is essential to monitor your symptoms closely and consult with healthcare professionals as needed. Proper care and attention to the affected area can help alleviate discomfort and promote healing.

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