Managing Anal Pain: Should You Use Hemorrhoid Cream or Wound Ointment?

Regarding the use of Betamethasone for anal fissures?

Today, when I had a bowel movement, I noticed that since I only went once yesterday, my stool was quite hard, which caused pain in my anus.
The pain was sharp and lasted for about an hour and a half.
In fact, I had some discomfort yesterday as well, and I used warm water to clean myself, but today the pain has intensified.
After washing, every time I urinate, I feel a sharp sensation, and when I wipe with toilet paper, it feels very dry and like there is a lot of mucosa.
While showering today, I noticed that there seems to be a wound on the outside of my anus.
Although there is no bleeding, it feels like the skin is slightly broken.
I previously consulted a colorectal surgeon who prescribed me Proctosedyl, which is for hemorrhoids, because he mentioned that my hemorrhoids were quite swollen.
However, I am currently abroad and I am wondering if I can still apply Proctosedyl on the wound outside my anus, which is located in a folded area.
Should I instead buy a general ointment for wounds? But I am not sure if I currently have hemorrhoids! I haven't seen any blood during bowel movements, but I do feel a sensation similar to being cut (the reason I visited the colorectal surgeon previously was due to this sensation along with some bleeding, and after the examination, the doctor confirmed it was hemorrhoids, which improved after a week of treatment).
So, how should I care for this? Should I apply Proctosedyl or a general wound ointment? Thank you, doctor.

Ling, 20~29 year old female. Ask Date: 2014/03/21

Dr. Ke Fangxu reply Surgery

Based on your description, it seems to be an anal fissure characterized by pain and slight bleeding.
As long as you avoid constipation and take warm sitz baths, it should heal.
Oral pain relievers and hemorrhoid ointments can be used, but it is generally not recommended to use oily ointments meant for regular wounds.

Reply Date: 2014/03/21

More Info

When managing anal pain, especially in the context of hemorrhoids or potential anal fissures, it's essential to choose the right topical treatment. Based on your description, it seems you are experiencing discomfort likely due to a combination of hard stools and possibly an external anal injury or irritation.

Understanding Your Condition
From your symptoms, it appears you may be dealing with a few issues:
1. Hemorrhoids: These are swollen veins in the lower rectum and anus that can cause pain, discomfort, and sometimes bleeding. They can be internal or external.

2. Anal Fissures: These are small tears in the lining of the anus, often caused by passing hard stools. They can lead to sharp pain during bowel movements and may also cause a burning sensation afterward.

Treatment Options
1. Hemorrhoid Creams: Products like the one you mentioned (保痣寧) are typically formulated to reduce inflammation, relieve pain, and soothe the area. They often contain ingredients such as hydrocortisone, witch hazel, or lidocaine. If your previous doctor prescribed this for your hemorrhoids, it may still be beneficial for your current symptoms, especially if you suspect hemorrhoidal involvement.

2. Wound Ointments: If you have a visible injury or irritation around the anal area, a general wound ointment (such as those containing antibiotic properties) may help prevent infection and promote healing. However, these are not specifically designed for the sensitive anal area and may not provide the same relief as hemorrhoid creams.

Recommendations
Given your situation, here are some steps you can take:
- Use Hemorrhoid Cream: Since you have previously used 保痣寧 and it was effective for your hemorrhoids, it would be reasonable to apply it to the affected area, especially if you suspect that hemorrhoids are contributing to your pain. Ensure that the area is clean before application.

- Gentle Cleaning: Continue to wash the area gently with warm water after bowel movements. Avoid using harsh soaps or wipes that may irritate the skin further.

- Avoid Straining: To prevent further injury, try to avoid straining during bowel movements. Consider dietary changes to include more fiber, which can help soften stools and make them easier to pass.

- Sitz Baths: Taking warm sitz baths can provide relief from pain and help soothe the area. This can be particularly beneficial if you are experiencing discomfort after bowel movements.

- Monitor Symptoms: If you notice any signs of infection (such as increased redness, swelling, or discharge), or if your pain persists or worsens, it is crucial to seek medical attention.
- Consult a Healthcare Provider: If you are unsure about the nature of your symptoms or if they do not improve with over-the-counter treatments, it would be wise to consult a healthcare professional. They can provide a proper diagnosis and recommend appropriate treatments.

Conclusion
In summary, using the hemorrhoid cream you have may be beneficial for your current symptoms, especially if you suspect hemorrhoids are involved. However, if you notice any changes or if the pain persists, do not hesitate to seek medical advice. Proper management of your symptoms can significantly improve your comfort and quality of life.

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