I am a 43-year-old female (178 centimeters in height and 75 kilograms in weight) suffering from anal itching for the past 9 to 12 months. It is intense after giving stool, during or after having intercourse or anal masturbation, and at night. I also have a few lumps on my anus ring that seem to grow outside my anus hole as an extended piece of flesh, and it is very sensitive and really troubles me. I noted that sometimes the itching goes away when I am giving stool; thus, an intense itch is like a signal, but I am confused about my condition. My queries are:
1. Can you please inspect the pictures I am attaching and give me your expert advice and diagnosis?
2. How can I treat this condition?
3. Do I need special diet and lifestyle modifications to treat this condition?
4. What special creams should I apply to avoid itching?
5. Can you please suggest instructions on how to clean the area?
6. Can I continue having anal intercourse with this condition?
7. Are there any specific rules I need to follow for anal intercourse?
Welcome to icliniq.com.
I read your query and understand your concern.
I have reviewed the attached images (attachments removed to protect the patient's identity), and I suggest you consult a surgeon and get it physically examined as the picture looks like a case of external piles. Physically examination is essential to rule out piles, and sigmoidoscopy has to be done to rule out rectal prolapse. Therefore, I suggest you do the following.
1. Avoid shaving the area till symptoms improve.
2. Avoid anal intercourse till symptoms recover as it will give it time to heal.
3. Maintain proper hygiene and clean the area while bathing with soap and water.
4. After intercourse or passing stool, make sure to clean the area properly with water or soapy water.
5. Change your underclothes twice a day.
6. Take a fiber-rich diet with green vegetables, fresh fruits, juice, and salad.
7. Avoid spicy and fried food items.
8. Avoid excessive consumption of tea and coffee.
9. Drink plenty of water or fluids.
(Consult a specialist doctor, talk with them and take medications with their consent.)
10. Start tablet Norfloxacin and Tinidazole combination, 400 mg twice daily after meals for five days.
11. Tablet Albendazole after dinner, three consecutive nights, for three days for deworming.
12. Start tablet Pantoprazole 40 mg daily empty stomach in the morning with a glass of water.
13. Take a laxative like Sodium picosulfate syrup, one teaspoon at bedtime.
14. Apply Gentamicin and Beclomethasone combination ointment to the anal area after proper cleaning twice a day.
15. Use protective measures like a condom or diaphragm during intercourse.
If there is any history of bleeding or blood-stained stool or blood spots, get it investigated with a complete blood examination, stool routine examination, blood sugar levels, and urine examination. Kindly answer the following questions and consult again for further suggestions.
1. Are you having constipation?
2. What is the consistency of your stool? Is it loose or normal or constipated?
3. Do you pass motion regularly?
4. How often do you have pain or abdominal cramps while passing stool?
5. I guess you must have achieved menopause. If not, please specify.
6. Do you have any urinary symptoms?
7. Do you have any past surgical history of medical conditions?
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