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Dr. David
Dr. David, Board Certified MD
Category: Medical
Satisfied Customers: 46959
Experience:  Board Certified Physician
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My partner is suffering with an itchy, swollen bottom with

Customer Question

My partner is suffering with an itchy, swollen bottom with some discharge.
The past two years has been particularly stressful for him due to a divorce and he noticed he started to get an itchy bottom. However, this has become worse over the past two years and he now has swelling around the anus (at the opening) with some discharge although he says it is not painful, just itchy. He says the swelling comes and goes and is worse on some days. He says the swelling and itchiness are particularly bad when he has had stressful days.
When he went to the doctor a few months ago, they prescribed him pile tablets and cream which didn't appear to make any difference.
As time went on, the surrounding skin became cracked and bled which was worse at night, to which the doctor gave him steroid cream to clear it up externally. This has healed all his cracked, sore skin on the exterior however he hasn't as of yet had anything to treat the anus internally.
Any help would be greatly appreciated.
Submitted: 2 years ago.
Category: Medical
Expert:  Dr. David replied 2 years ago.
Dr. David :

This is Dr. David

Dr. David :

the itchiness in the area could be due to a fungal infection.

Dr. David :

if he has moisture problems around the anus or gluteal area, this can be a good setup for a fungal infection of the skin

Dr. David :

fungus like to grow in areas of darkness, warmth and moisture.

Dr. David :

using powder on the area can help dry the skin

Dr. David :

there are some over the counter antifungal creams he can try like clotrimazole.

JACUSTOMER-rhyvjy25- :

He has tried some over the counter fungal creams which he said relieved it slightly but it didn't go away. Would he need prescribed cream?

JACUSTOMER-rhyvjy25- :

Also, does a fungal infection cause discharge and swelling?

Dr. David :

antifungal creams have to be used for 3-6 weeks often.

Dr. David :

and they have to be used for 1 week even after the symptoms have resolved.

Dr. David :

so he might not be using the antifungal cream long enough.

Dr. David :

if he has moisture in the area from excessive sweating, he needs to use a powder to help dry the skin there.

Dr. David :

if he has anal discharge, he should make sure his stools are not liquidy

Dr. David :

more fiber in his diet can help that.

Dr. David :

also if his anal sphincter has weakness, he should be doing kegel exercises as well to help strengthen his anal sphincter to help prevent leakage as well.

JACUSTOMER-rhyvjy25- :

OK thank you. Is swelling normal? I have been worrying about anal cancer

JACUSTOMER-rhyvjy25- :

Although he says the swelling is worse on some days to others

Dr. David :

anal cancer usually bleeds and there is a mass which can be felt which bleeds

Dr. David :

anal cancer would not get better with steroid creams

Dr. David :

his swelling around the area sounds more likely to be hemorrhoid swelling or anal sphincter tissue swelling from inflammation or fungal infection.

Dr. David :

have him do the kegel exercises

Dr. David :

and use the baby powder.

Dr. David :

and antifungal cream again.

Dr. David :

and work on adding more fiber to his diet

Dr. David :

to prevent leakage

Dr. David :

and I bet his symptoms will get better.

JACUSTOMER-rhyvjy25- :

The cracked skin on the exterior healed up with steroid cream however he hasn't been given anything to use on the swelling internally.

Dr. David :

have him ask his doctor for a 25mg hydrocortisone suppository medication

Dr. David :

this can be used once a day internally dissolving to help reduce swelling and inflammation.

JACUSTOMER-rhyvjy25- :

That's great, thank you. Perhaps the cracked skin externally were a result of the scratching

Dr. David :

yes.

Dr. David :

if the area is very itchy.

Dr. David :

good luck

Dr. David :

let me know if you have other questions.

Dr. David :

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Dr. David :

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Dr. David :

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Dr. David :

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Dr. David :

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Dr. David :

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JACUSTOMER-rhyvjy25- :

Yes, thank you. Thanks for your help, will let you know if it clears up! Fingers crossed!

Dr. David :

thanks.

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