Dear doctor;

When I go to the toilet, I get a burning sensation during and for a short time afterwards in my anus. It is very painful and I am beginning to get it quite regularly. I do not eat much spicy food and I am not a heavy drinker, although I may have a couple of pints of Guinness a few nights a week after work. Is this about diet or there is some underlying health problem?

Jeremy, 27.

Dear Jeremy,

It seems that you are suffering from proctitis, that is, inflammation of the anus or rectum. This can manifest in various ways like pain during bowel movements, feeling of soreness or burning around anal area, feeling of incomplete evacuation of bowels, cramp like sensation while defecating and sometimes there may be a bloody discharge. It can also occur due to chronic constipation. Infections like sexually transmitted diseases can also cause burning pain in anal area, particularly in people indulging in anal sex. Other infections like salmonellosis, shigellosis, among others, are also  responsible for this condition. This problem can also occur due to inflammatory diseases of the bowel like Crohn’s disease, ulcerative colitis.

Treatment lies in treating the underlying cause. Avoid constipation, if present through dietary measures, avoid acquiring sexually transmitted diseases by adopting safe sex practices. A simple stool examination can help in detecting any infection which is treatable. Colonoscopy (visualising the colon by inserting a tube) can help to detect the cause if an inflammatory bowel disease is present. Spicy food and excess alcohol can cause dyspepsia but not anal itching. They are not very healthy to use, hence should be avoided.