Hemorrhoid Treatment and Skin Care for Anal Discomfort

Hemorrhoid treatment and topical medications for anal skin?

Hello, Doctor.
I visited the colorectal department two days ago, and the physician diagnosed me with internal and external hemorrhoids.
However, I am more concerned about the pain at the upper end of the anal area (near the vaginal opening) because the pain is more intense than the discomfort from the hemorrhoids.
After the examination, the doctor mentioned that it might be a skin tear infection due to scratching and prescribed me with Yizhi Kang suppositories and an external ointment called Fuhijing.
After using the medication for two days, I am unsure if the hemorrhoid issue has improved, but the original skin pain has changed; it now appears slightly red but without other abnormalities, and it has become noticeably swollen.
Touching it also causes discomfort.
Is this situation normal after using the medication? Is it possible that the Fuhijing is not effective, or could there be another underlying issue? Please help clarify this for me.
Thank you!

Xiao Jia, 20~29 year old female. Ask Date: 2014/04/28

Dr. Ke Fangxu reply Surgery

If there is swelling and pain around the anus, one should consider the possibility of an anal abscess or an anal fissure.
If there is a fever, the likelihood of an anal abscess is greater.
If pain occurs only during bowel movements, it may indicate an anal fissure.
The former requires antibiotic treatment or incision and drainage, while the latter can be managed with medication alone.
However, a definitive diagnosis should be made through a physical examination.
It is recommended that you consult a physician again for a confirmed diagnosis.

Reply Date: 2014/04/28

More Info

When dealing with hemorrhoids and associated skin discomfort, it is essential to understand both the treatment options available and the potential interactions between medications and skin care practices. Hemorrhoids, which can be internal or external, often lead to discomfort, pain, and sometimes skin irritation in the anal area.
In your case, the physician diagnosed you with both internal and external hemorrhoids and noted skin irritation near the anal area, which may have been exacerbated by scratching or other forms of irritation. The medications prescribed, including the topical ointment (膚即淨) and the suppository (益痔康), are commonly used to alleviate symptoms associated with hemorrhoids and skin irritation.

Understanding the Medications:
1. 益痔康 Suppository: This medication is typically used to reduce inflammation, relieve pain, and promote healing in the rectal area. It may contain ingredients that help soothe the mucous membranes and reduce swelling.

2. 膚即淨 Ointment: This topical treatment is designed to provide relief from skin irritation and inflammation. It may contain anti-inflammatory agents or soothing ingredients that can help with redness and discomfort.

Normal Reactions to Treatment:
It is not uncommon for patients to experience some degree of swelling or redness after starting treatment, especially if there was pre-existing irritation or if the area has been scratched. The medications may take some time to show significant improvement, and the initial reaction could include temporary swelling as the body responds to the treatment.

When to Seek Further Evaluation:
- Persistent Symptoms: If the swelling and discomfort do not improve after a few days of treatment, or if they worsen, it is crucial to follow up with your healthcare provider. This could indicate that the treatment is not effective, or that there may be an underlying infection or other issues that need to be addressed.

- Signs of Infection: If you notice increased redness, warmth, pus, or fever, these could be signs of an infection, and immediate medical attention is warranted.

Skin Care Recommendations:
1. Gentle Cleansing: Ensure that the area is kept clean but avoid harsh soaps or scrubbing, which can further irritate the skin.

2. Moisturizing: Consider using a gentle, fragrance-free moisturizer to keep the skin hydrated, which can help in the healing process.

3. Avoid Scratching: It is essential to avoid scratching the area, as this can lead to further irritation or infection.

4. Warm Sitz Baths: Taking warm sitz baths can help soothe the area and promote healing. This involves sitting in a few inches of warm water for about 15-20 minutes several times a day.

Conclusion:
In summary, while it is normal to experience some swelling and discomfort after starting treatment for hemorrhoids and associated skin irritation, it is essential to monitor your symptoms closely. If there is no improvement or if symptoms worsen, do not hesitate to consult your healthcare provider for further evaluation. They may need to reassess your condition and possibly adjust your treatment plan. Remember, effective management of hemorrhoids often requires a combination of medication, proper hygiene, and lifestyle adjustments.

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