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Have Anal Fissure, External Hemorrhoids Including Rectum Prolapse. Suggested Candid And Tenovate. Advise?

Posted on Fri, 23 Aug 2013

Question: Hi I am Indian male,46. Suffer fm anal fissure for about 1 month but external hemorrhoids for past 20 years including rectum prolapse. But a first is severe anal itch & on groin area - this never happened before. Usually anal itch starts around 3-4am & groin itch whenever my mind if unoccupied. Doc suggested Candid (Clotrimazole) cream but didn't help. Another doc recommended Tenovate - it seems to be working. Incidentally, there is occasional anal bleeding whenever there is a spasm when I push the rectum in. I can feel blood coming out like a jet due to the spasm. Right now the itch is the worry. Any advise? Thank you.

Answered by Dr. Dr. Rahul Kumar (1 hour later)

Hello.
Thanks for the query.
The itch is mainly due to fecal protease. These are enzymes present in stool. Due to prolapse this fluid is coming in contact with skin and causing irritation. Tenovate is an steroid and will help you. Instead of clotrimazole cream you can use clotrimazole powder. This will help in keeping the area dry and hence will prevent irritation. Also take an anti histamine like cetrizine tablet daily for a week. These all measures are temporary and only permanent solution is surgery for the prolapse. Let me know if you have any other doubts. Thank you.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr. Rahul Kumar (23 hours later)

Thx Doc. After applying Tenovate, anal itch & groin itch stopped. Should I continue? For how long? Incidentally Xyloproct & Sheild cream did not reduce the itch which was advised for anal bleeding as well as reducing the itch. Another question - why should the groin area itch so badly? Is it the rainy Mumbai weather?

Answered by Dr. Dr. Rahul Kumar (10 hours later)

Hello XXXXXXX
Thanks for the follow up.
Xyloproct is a topical anaesthetic. It can reduce itch to only some extent while tenovate is a steroid. It can control itch as well as inflammation and hence more effective.
You should continue it for atleast another 15 days.
Yes the rainy weather can increase the itch as it induces fungal growth.
That is why i asked you to apply powder daily. Let me know if you have any other doubts. Thank you

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar