Burning Sensation Near Anus After Bowel Movements: Causes and Solutions

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

Hello, doctor.
I underwent a fistula excision surgery at the end of last year.
Postoperatively, my wound healing was not optimal due to excessive granulation tissue formation, so I received cryotherapy at a dermatology clinic, along with antibiotic and steroid ointments.
Currently, the wound has healed and has formed a fibrous scar.

I would like to ask you about a concern that arose about a month after 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 could be due to the clinic physician accidentally spraying the cryotherapy agent onto the adjacent normal skin.
The burning sensation only occurs after I wash my buttocks following a bowel movement (it does not happen before having a bowel movement).

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

Could you please advise if this situation is due to skin damage from the cryotherapy or the ointments, or if there might be another underlying issue? What steps can I take to improve this condition? (I have not used the steroid ointment for 25 days and have been rinsing 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 visual examination of the lesion is necessary for an accurate diagnosis.

Reply Date: 2020/07/07

More Info

The burning sensation near the anus after bowel movements can be a distressing symptom, especially following surgical procedures such as fistula excision. In your case, it appears that you have undergone a significant surgical intervention, and the subsequent treatments, including cryotherapy and the application of topical medications, may have contributed to your current discomfort.

Firstly, it’s important to understand that the healing process after any surgical procedure can be complex. The development of granulation tissue, which you mentioned, is a normal part of healing but can sometimes become excessive, leading to complications. The use of cryotherapy is intended to reduce this excess tissue, but it can also cause localized skin irritation or damage if not applied carefully. If the cryotherapy spray inadvertently affected the surrounding healthy skin, it could lead to the burning sensation you are experiencing.

The burning sensation that occurs specifically after bowel movements may be linked to several factors:
1. Skin Sensitivity: After surgery and subsequent treatments, the skin around the surgical site may become more sensitive. This heightened sensitivity can lead to discomfort when the area is cleaned or when stool passes through.

2. Topical Medications: The use of topical antibiotics and corticosteroids can sometimes cause skin irritation or allergic reactions, especially if used over an extended period. If you have recently stopped using these medications, it may take some time for the skin to return to its normal state.

3. Hygiene Practices: The method of cleaning after bowel movements can also impact the sensation. Using harsh soaps or wipes can irritate the sensitive skin. It’s advisable to use gentle, unscented products and to pat the area dry rather than rubbing it.

4. Underlying Conditions: Conditions such as anal fissures, hemorrhoids, or even infections can contribute to burning sensations. It’s essential to rule out these possibilities, especially if the symptoms persist.

To alleviate the burning sensation, consider the following recommendations:
- Gentle Cleaning: After bowel movements, use warm water to clean the area gently. Avoid using soaps that may irritate the skin. Pat the area dry with a soft towel.

- Moisturizing: Applying a gentle, hypoallergenic moisturizer to the affected area may help soothe irritation. Products containing aloe vera or calendula can be beneficial.

- Avoid Irritants: Stay away from scented products, harsh soaps, and any topical medications unless prescribed by your doctor.

- Dietary Adjustments: Ensure that your diet is high in fiber to prevent constipation and straining during bowel movements, which can exacerbate discomfort.

- Follow-Up Care: Since you have already consulted with a colorectal specialist, it’s crucial to maintain follow-up appointments to monitor your healing progress. If the burning sensation persists or worsens, further evaluation may be necessary to rule out any complications.

In conclusion, while the burning sensation you are experiencing may be related to the surgical procedure and subsequent treatments, it’s essential to approach this symptom holistically. By adopting gentle hygiene practices, avoiding irritants, and maintaining communication with your healthcare provider, you can work towards alleviating this discomfort. If symptoms persist, further investigation may be warranted to ensure there are no underlying issues contributing to your discomfort.

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