Q. I have a recurrent burning sensation in my anal region, which cures by Lignocaine 2%. Please help.

Answered by
Dr. Vinod Kumar Atreya
and medically reviewed by Dr. Preetha J
This is a premium question & answer published on Oct 22, 2020

Hi doctor,

I am a 35-year-old male, who is 5.8 feet tall and weighs about 49 kg. I have constant burning in anal region from past 20 days though do not have fissure as checked by doctor. Current medication are Lox 2% (Lignocaine hydrochloride) jelly gel and Sitcom forte tablet for seven days. But it is not getting cured inspite of drinking four litres of water day and high fibre diet. After taking this, I feel that burning sensation came down. Now one week is over, and again burning sensation has started. It is agony since this is reccurring and often not getting out permanently. This happened ten years back, then five years, and again now. Previously it got cured but treatments took everytime for more then eight months to feel normal. In the past I used to take Sitcom ointment (Euphorbia Prostrata), Sitcom forte (Flavonoids and Tannins) tablet, Sucralcoat Ano (Sucralfate Lignocaine Hydrochloride) ointment, Rutin (Rutoside) tablet, and Sitzbath.

#

Hi,

Welcome to icliniq.com.

1. Your complaint is constant burning in the anus. It is recurrent. It occurred two times in the past ten years. Your age is 35 years, and weight is 49 kg, which is slightly less than normal.

2. As there are various causes like local skin lesions, anorectal disorders, and systemic lesions involving the anus.

3. To come to a diagnosis, there is still a need for detailed clinical history (complaints, history of any illness, etc.), general and local examination, and specific investigations.

4. Burning sensation in the anal region may be due to pinworm, skin diseases like psoriasis, chronic discharge due to local and systemic involvements, etc.

4. Burning is a symptom of some illness that maybe some simple skin disorder, worm infestations, local anal or rectal diseases to some systemic disorder like inflammatory bowel disorders, etc., and it is recurrent. It would help if you had a thorough consultation and work out.

5. So please discuss in detail to come to diagnosis and management.

Hi doctor,

Thank you for your reply.

I did not have any illness except this. I always feel healthy. Five years back, I checked with three laparoscopic surgeons for this burning sensation, and all have the opinion that they do not see any issue in me. They just suggested me to take plenty of water and high fiber diet along with medicines. It got cured, but it took for almost six months for a complete cure. Now again, it is back. Can you please suggest me how to solve this issue permanently?

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Hi,

Welcome back to icliniq.com.

Yes, that is why I am looking for some reasonable cause for the underlined complaint. See earlier; you were diagnosed with fissure four years back. The only somatic sensation having a part in the anal canal is the terminal half. So the burning sensation could be in this area and the perianal area, we have to decide it first.

Thanks and regards.


Treatment plan:

1. H S (Hidradenitis Suppurativa) bath.
2. Keep the part clean and dried.
3. Ointment Xylocaine (Lignocaine) before and after defecation.
4.Ointment Nifedipine locally two times a day
5. Liquid Lactulose.
6. Tablet Cetirizine 10 mg one tablet once daily.
For five days, and further evaluation to diagnose.

Hi doctor,

Thank you for your reply.

I did not have fissure before four years. But the name given was fissure related. After many medications, it got cured, and it took four to six months. Even the treating doctor was confused since it is back now. He told if I have fissure or piles or fistula, he can advise medicine and tell me how long it will take to get a cure. But my case is entirely different from other issues. Because of his checking, no problems are seen from outside as well as inside. Can you please elaborate on medicines? How many minutes gap should be there for applying ointment Xylocaine and Nifedipine, and concerning about Xylocaine, whether it is Xylocaine 2% jelly or Xylocaine 5% ointment. What does Cetirizine 10 means? Liquid lactulose is nothing but a Duphalac oral solution. Can you please confirm I have attached the images?

#

Hi,

Welcome back to icliniq.com.

  • Five minutes gap is sufficient between the two ointments.
  • It is ointment Xylocaine 5%.
  • OD means once in a day
  • Yes, it is Duphalac.

Thanks and regards.


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