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Colorectal Diseases

Rectum does not wipe clean - soreness

05/02/2006

Question:

I am 26 and have a problem in the past 6 months or so that when I make a bowel movement, I cannot wipe my anal opening clean. This results in 2-4 returns to the bathroom to wipe again. This makes me very sore, and results in blood on the toilet paper. I don`t know what could cause this as nothing has changed in my diet. I drink about 6, 8oz glasses of water a day and have tried fiber supplements, but it always results in the same thing. My doctor had me use Butt Paste (diaper rash cream) but that did not work. Any suggestions/opinions?

Answer:

You may be prolapsing the lining of the anus after BM. This will cause mucus and occasionally loose stool to sit on the skin around the anus, which causes itching and irritation. First, be sure not to strain and push to pass a bowel movement; fiber supplements and certain stool softeners will help. Second, try not to be "too" fastidious with anal cleansing- this can actually worsen irritation as well. Wipes that contain witch hazel will do the same thing. Finally, is all else fails, se your local colorectal surgeon and see if elastic ligation of the mucosa over the internal hemorrhoids will be of benefit.

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Response by:

Janice Frederick Rafferty, MD Janice Frederick Rafferty, MD
Professor of Surgery
Chief of Colorectal Surgery Division
College of Medicine
University of Cincinnati