When I go to the bathroom to poop, there is a good burning sensation when I eject. I've already tried Anusol suppositories. What should I do?

Question

Alexandre Chagnon · Accepted Answer

Hello sir, Aburning sensation upon ejection of feces is a common symptom of hemorrhoids . 😞 Other signs/symptoms of hemorrhoids include: Itching, irritation, swelling in the anus ; Slight clear blood on toilet paper or in the toilet; Episode(s) of constipation or diarrhea concomitantly --> constipation and diarrhea are commonly associated with hemorrhoids. In general, here are some tips and tricks (including non-pharmacological measures) that may help relieve your possibly hemorrhoid-related burning sensation: Treat constipation, if it's present --> your neighborhood pharmacist can also help you on the side by prescribing various pharmacological agents; Continue to hydrate well and eat healthily , eating enough fiber-rich foods; 🥗 Clean your anus after each bowel movement with water and mild soap; 🧼 Don't hold back your urge to have a bowel movement and when you do go to the bathroom, avoid standing on the toilet bowl for too long. 🚽 To treat/relieve your symptoms, the first-line treatment is to apply a product containing hydrocortisone (0.5% to 1%) to decrease the inflammation . It is also recommended to choose a product containing (in addition to hydrocortisone)zinc sulfate , which is abarrier agent to decrease inflammation and friction. Also, if the pain is significant, the product chosen might contain alocal anesthetic (e.g., dibucaine, lidocaine, pramoxine). It is generally advisable to prefer pramoxine as a local anesthetic because it has a lower risk of developing an allergic reaction (and adverse effects in general). Since suppositories are less effective than topical products (cream/ointment) since they go "beyond" the area to be treated, I would therefore advise you to prefer a cream or ointment (containing the ingredients mentioned above). Also, since hemorrhoid products containing hydrocortisone are only available with a doctor's prescription, you could, for example, combine Anusol Plus (pramoxine + zinc sulfate) with a 0.5-1% hydrocortisone ointment, both of which are available over the counter without a prescription. These would be to apply twice daily and after each bowel movement for up to 7 days as self-treatment for the following reasons: Use beyond 7-14 days of hydrocortisone , without medical advice, increases the risk of anal skin thinning ; Use beyond 7 days of a local anesthetic (eg, local anesthetic ) may increase the risk of decreasing the risk of anaesthetic : pramoxine) may mask a more serious complication or health problem (eg, anal fistula, abscess, fissure, etc.) and increases therisk of developing an allergic skin reaction secondary to prolonged exposure. Finally, the following conditions should further direct you to consult a physician : Use of over-the-counter products for 7 days or more without relief ; Rectum coming out of the anus during defecation; Significant/persistent bleeding on defecation; Black stools ; Fecal incontinence and/or abdominal cramping ; Significant/violent pain on defecation; Fever . I would also like to advise you that if you have ever been diagnosed with hemorrhoids in the last 2 and a doctor has prescribed a treatment, the pharmacist (based on his or her assessment) may re-prescribe it for you, even if it wasn't on the OTC shelves. So don't hesitate to let your local pharmacist know if this is the case. I hope this information helps. Please feel free to contact us with any other questions! 😊 Marc-Antoine Dufresne, pharmacy intern (Pharm.D), supervised by Alexandre Chagnon, pharmacist.