Question: I have had pain around the anal opening for two months. This started during a bowel movement has the bow pass through the opening I felt a prickly pins and needles sensation. It is mostly on the left side and it goes up into the skin slightly of the left butt cheek and perineal area. I have had anal Fisher surgery 20 years ago and have suffered hemorrhoids on and off. I saw a colorectal specialist who look within anocope and did not see anything that should cause me pain. He only saw two small internal hemorrhoids and the scar tissue from the fisssure surgery I had 20 years ago. He prescribed Proctofoam HC 1% with no relief. I am now using triamcinolone acetonide cream 0.1% twice a day and clotrimizole amd betamethasone twice a day as well. Also soaking in sitz baths twice to three times a day. The pain is much worse while sitting as if spreading of the skin is causing the pain. Also while walking it feels as though the skin is rubbing against something and causing pain. I am very uncomfortable and am looking for any type of suggestions for relief. Since the anoscope and rectal physical exam did not show anything I am not sure what else to do. They just prescribed these creams to see if they might be of assistance with my pain. I had a colonoscopy done exactly one year ago with nothing abnormal.

The pain started with a bowel movement. However it no longer hurts during a bowel movement. I use baby moist wipes, but sometimes I do you have pain when wiping. There is no blood and they tested my stool and there was no blood. I take fiber supplements every day and have for years and I also take myrolax every day and have for years. I do get relief after lying in bed on my back for a while, however after sitting for just a few minutes the pain returns. When I spread the opening of the anal area the skin on the left outside is very painful however they did not find a fiissure and the two small internal hemorrhoids were not thrombosed. They did not find a fungal infection but prescribed medicine just in case. I do on occasion fill a very slight discomfort in the left lower abdomen/pelvic Area but it is very slight and barely noticeable. There is no loan in that area Nothing has seemed to help. I understand that you have not physically examined me but from my explanation and from my doctors bindings what do you think is the cause of my pain? Do you think the medications they have prescribed will eventually help?

Thank you. It feels like the problem is a sore, tender left anal sphincter muscle that is tender when pressed on with a finger pr streched. Escpescially when pressure and streching of the muscle is made worse when sitting. Could a tight dphincter cause this? Are there any specific treatments or exercises i can try at home to see of this is the issue. Hoedully this makes sense. Thank you so much for your help.