Pain in the bum (literally)

[Pansypath]

I have had a painful bum for a few weeks now. As in pain and itching by anus. For the first week I used over the counter stuff. Then I saw GP who was quite dismissive, doing an examination and saying actually not too bad up there just one haemorrhoid, and suggested I was over exaggerating the pain. She said it wasn't a fissure. But she gave me prescription suppositories and a cream and also an anti fungal. For the first few days it was getting better but is now worse to the point where it woke me up absolutely burning last night in the middle of the night. I will make another appointment to talk to GP but any suggestions please. It is a constant problem though I can be distracted. If i touch the area there is nothing protruding (there was for the first week).

Is the pain and itching usually at night? In that case, you might have thread worms. They are extremely common and not associated with poor hygiene. You could ask your pharmacist for medication, which should be taken by everyone in the family. It's often a good idea to take a second dose two weeks after the first. You would also need to damp dust and vacuum your house, to get rid of the microscopic eggs which can cause reinfection. Everybody in the household should also wash their bottoms each morning (as the female worms emerge at night and deposit eggs and itchy mucus around the anus).

If the itching is not confined to night time, you could have Pruritus Ani. This is really just the symptom of itching and burning, and can have many causes apart from the haemorrhoids and fissures that your GP mentioned. Other common causes are psoriasis, eczema, allergy to soaps or scented/dyed loo paper, and leakage of mucus or faeces (sometimes such small amounts that you are not aware). Possible solutions include washing the area after bowel movements, using plain water, and patting dry with a towel. You could also try some hypoallergenic ointment from the chemist.

No it is all day. Yesterday was the first time at night it had woken me.

Ok, prob not worms then. I suggest cleaning with water after a bowel movement and patting dry with a soft towel. You could carry some damp cotton wool in a ziplock bag for when you're out. Hopefully these measures will help.

If you are still having a problem, you could use a very gentle ointment. You said that the creams and lotions helped at first but then made it worse, so you may be sensitive to some of the ingredients. You will need to speak to a pharmacist and ask for an ointment that is formulated to have a low risk of sensitisation/for sensitive skin.

This is a common problem (although rarely spoken of) and usually not caused by anything serious, although it is very uncomfortable. I hope these suggestions help.

Have you looked in a mirror at the area ?
I ask because I get this sometimes, got my dh to take a look and he called me a monkey bum ! ( i.e. looked very red )
I propped up a mirror to see and yes it was red. I do get eczema and hydrocortisone cleared it up so I assume that's what it was.

Thank you so helpful. I saw a different gp again today and this time they said there was an abrasion (not as bad as a fissure) that they think is cause. And gave me some licodaine numbing cream which is def taking the edge off. Also my stool test from abdominal pains a few weeks ago came back clear thank goodness.