DEAR MAYO CLINIC: I’ve had anal itching for some time. It’s an embarrassing topic that I’m reluctant to bring up with my doctor. Do you have any self-care tips?

ANSWER: Anal itching is an intense itching inside and around the opening of the anus. It’s potentially embarrassing, but bringing it up with your health care provider is recommended, especially if it has become persistent. That’s because there are a number of possible causes with specific treatments that likely will help. These causes include hemorrhoids, anal fissures, skin diseases, infections, fecal seepage and ongoing diarrhea. At the most serious end of the spectrum, cancer occasionally can cause these symptoms.

Less serious causes of anal itching, also called pruritis ani, may include dry skin, irritation from wiping too hard and too often, use of soaps or frequent cleaning of the area, and excess moisture due to sweating.

When no specific cause of anal itching is found, self-care steps successfully eliminate itching about 90% of the time. The first step is to gently clean the area with water and a mild, fragrance-free soap after each bowel movement. This may involve a quick shower, or using a soft washcloth or squeeze bottle. Avoid scrubbing, or using moist towelettes or wipes, abrasive cloths, or moist toilet paper.

Next, pat the area dry with a cloth, or dry the area with a hair dryer on the fan-only setting. Using the heat setting could further irritate this delicate area.

Wear nonconstricting cotton underwear to keep the area cool and dry. Apply zinc oxide or petroleum jelly to the anal area to provide a moisture barrier. If necessary, a cream of 1% hydrocortisone applied two to three times a day can be used for a week or two to stop itching.

Finally, avoid scratching the area as much as possible to minimize further irritation. It may even be necessary to wear cotton gloves to bed so that you don’t unknowingly scratch the area while sleeping.

Although anal itching may be a topic that’s uncomfortable to bring up to your health care provider, it is a common condition, and there are treatments that can give you some relief once the cause of the itching is determined. (adapted from Mayo Clinic Health Letter) — Dr. Stephanie Hansel, Gastroenterology, Mayo Clinic, Rochester, Minnesota

The post Mayo Clinic Q and A: Treating persistent anal itching appeared first on Mayo Clinic News Network.

ANSWER: It’s unlikely that hemorrhoids are the source of your pain. Instead, the painful bowel movements you’re experiencing are much more likely to be due to a condition called an anal fissure. Your health care provider can confirm that with an exam. Anal fissures usually don’t go away on their own, so it’s important to have the condition properly identified and treated.

It’s common for people to assume that their hemorrhoids are the cause of painful bowel movements. But, although hemorrhoids often cause itching, irritation, sensitivity and other discomfort around the affected area, hemorrhoids rarely lead to pain during a bowel movement.

Anal fissures, however, are a frequent source of pain with bowel movements. These small tears occur in the skin around the anus or in the thin tissue that lines the anus, called the anoderm. An anal fissure may develop when you pass hard or large stools during a bowel movement. Anal fissures typically cause pain and bleeding with bowel movements.

When an anal fissure occurs, the tear can expose the ring of muscle that holds your anus closed. This ring of muscle, called the internal sphincter muscle, lies underneath the anal skin and tissue. That exposure may trigger spasms in the sphincter muscle. The spasms often trigger more pain, and they also prevent the fissure from healing. This sets up a vicious cycle of continuing pain.

A physical exam is typically all that’s needed to diagnose an anal fissure accurately. Treatment is completed in stages. How much treatment you need depends on how severe the fissure is and how well it responds to the initial treatment.

The first step in treatment is to increase the amount of fluid and fiber in your diet to make stools softer and easier to pass. That eases pressure on the fissure during bowel movements. Taking a bulking agent, such as Metamucil, Benefiber or Citrucel, can help.

If the fissure doesn’t heal within several weeks, the next step is to use a topical medication that’s applied to the skin to increase blood flow to the fissure, promote healing and help the sphincter muscle relax, thereby decreasing spasms. A topical form of nitroglycerin or the calcium channel blocker nifedipine is often used for this purpose.

If the fissure persists despite these therapies, your health care provider may recommend an injection of botulinum toxin type A (Botox) into the internal sphincter muscle. That eases spasms by paralyzing the muscle.

Finally, if a fissure still doesn’t heal with the other treatments, you may need surgery. A procedure called lateral internal sphincterotomy typically is used to treat chronic anal fissures. It involves cutting a small area of the internal sphincter muscle to reduce spasms and pain. Research has shown that, for a fissure that doesn’t heal over time with medical treatment, surgery is often effective. The procedure does, however, carry a small risk of causing brief incontinence to gas.

Make an appointment to see your health care provider, and have your situation evaluated. If it is an anal fissure causing pain during bowel movements, it’s important to start treatment as soon as possible to promote healing and prevent further damage. — Dr. John Pemberton, Colon and Rectal Surgery, Mayo Clinic, Rochester, Minnesota

The post Mayo Clinic Q and A: Painful bowel movements may be due to anal fissure appeared first on Mayo Clinic News Network.

DEAR MAYO CLINIC: 

ANSWER: Hemorrhoids are quite common, and they often follow the pattern you describe. Making some lifestyle changes may lower your chances of developing hemorrhoids. But, if those changes aren’t enough to keep them from coming back, and the hemorrhoids cause you considerable discomfort, then consider making an appointment with your doctor for an evaluation to see if treatment may be necessary.

Hemorrhoidal cushions are part of the body’s natural anatomy in the anal canal. They help keep stool in and control continence. The problem with hemorrhoids develops when veins in those cushions become swollen and bulge. Hemorrhoids can occur inside the rectum. Those are called internal hemorrhoids. Or, they can happen under the skin around the anus. Those are called external hemorrhoids. Internal hemorrhoids don’t cause any pain and usually don’t require treatment unless they start to bleed. External hemorrhoids are the ones that typically lead to the pain and discomfort people often associate with hemorrhoids.

Hemorrhoids develop due to increased pressure on the pelvic floor. That pressure often comes from straining during bowel movements and sitting for long periods of time on the toilet. It also may be a result of chronic constipation or diarrhea, obesity or pregnancy. External hemorrhoids tend to occur in the pattern you mention, developing over a three- to four-day period and then slowly going away.

One of the key factors in preventing hemorrhoids is being able to pass stool regularly without straining. There are a number of lifestyle changes you can try to help make that happen. They include exercising regularly, eating a healthy diet that is high in fiber, drinking plenty of fluids, and avoiding sitting for long periods of time.

When painful external hemorrhoids develop, self-care steps usually can relieve the discomfort. Over-the-counter creams, ointments, suppositories or pads designed to treat hemorrhoids contain ingredients such as witch hazel or hydrocortisone that can lessen pain and itching. These products are often effective, but don't use them for more than a week at a time. If used too often or for too long, they may cause side effects, such as a skin rash, inflammation or skin thinning.

Soaking in a warm bath or a sitz bath with plain water 10 to 15 minutes, two or three times a day may reduce hemorrhoid swelling. Ice packs or cold compresses also can ease swelling and pain. Over-the-counter pain relievers, such as ibuprofen, aspirin or acetaminophen, may help relieve some discomfort, too.

If hemorrhoids last more than a week despite home remedies, or if they cause pain and discomfort, then it’s time to make an appointment with your doctor. You also should see your doctor if you’re experiencing painless rectal bleeding, so he or she can rule out other more serious conditions. If your symptoms are due to hemorrhoids, your doctor may recommend removing the hemorrhoids surgically. A variety of techniques can be used to accomplish this. Most of them can be done in your doctor’s office and do not require an overnight hospital stay.

Incorporating changes into your exercise and diet routines now may help you avoid hemorrhoids in the future. If they do come back, try the self-care steps listed above. In most cases, no further treatment will be needed. But, if hemorrhoids continue to cause significant pain, see your doctor. — Dr. John Pemberton, Colon and Rectal Surgery, Mayo Clinic, Rochester, Minnesota

The post Home Remedies: Relief from hemorrhoids appeared first on Mayo Clinic News Network.

Stroke: First aid
A stroke is an emergency. The sooner treatment is given, the more likely it is to minimize damage. Every moment counts. An easy way to remember the warning signs of a stroke is with the acronym FAST: Face, Arms, Speech and Time. Knowing what to look for could save someone's life. Here's what you should know.

EXPERT ANSWERS
Is there a connection between menopause and high blood pressure?
For many women, blood pressure rises after menopause. Discover the factors that may play a role and the healthy lifestyle choices that may control it.

Do you have any sleep tips for shift workers?
Humans naturally are wired to be awake during the day and sleep at night. Good daytime sleep is possible, though, if shift work is a necessary part of your work life. Try these tips to promote better sleep during the day.

PLUS ADDITIONAL HIGHLIGHTS
Bruxism (teeth grinding): An overview
Video: Home health hazards
Hand-washing do's and don'ts
Hemorrhoids: Diagnosis and treatment

HEALTHY RECIPES
Roasted red pepper pineapple salsa
Baked chicken and wild rice with onion and tarragon
Corn tamales with avocado-tomatillo salsa
Linguine with chickpeas and arugula

HEALTH TIP OF THE WEEK
Put a leash on anger
Do you find yourself fuming when someone cuts you off in traffic? Anger is a normal and healthy emotion, but it's important to deal with it in a positive way. Uncontrolled anger can take a toll on your health and your relationships. To get your anger under control, try these tips:

1. Take a break from the situation.
2. When you're calm, express your concern.
3. Use humor to defuse tensions. It may be challenging at first, but, with time and effort, healthy responses may come naturally.

Need practical advice on diet and exercise? Want creative solutions for stress and other lifestyle issues? Discover more healthy lifestyle topics at mayoclinic.org.

NOW BLOGGING
Nutrition-wise: Go nuts for good health
The word is out: Nuts are good for you. From managing your weight and blood pressure to heart health and healthy aging, there's growing research to support the role of nuts in your diet.

Receive a free e-subscription to Housecall and other health newsletters.

The post Housecall: Cataracts may be clouding your vision appeared first on Mayo Clinic News Network.

ANSWER: Hemorrhoids are quite common, and they often follow the pattern you describe. Making some lifestyle changes may lower your chances of developing hemorrhoids. But, if those changes aren’t enough to keep them from coming back, and the hemorrhoids cause you considerable discomfort, then consider making an appointment with your doctor for an evaluation to see if treatment may be necessary.

Hemorrhoidal cushions are part of the body’s natural anatomy in the anal canal. They help keep stool in and control continence. The problem with hemorrhoids develops when veins in those cushions become swollen and bulge. Hemorrhoids can occur inside the rectum. Those are called internal hemorrhoids. Or, they can happen under the skin around the anus. Those are called external hemorrhoids. Internal hemorrhoids don’t cause any pain and usually don’t require treatment unless they start to bleed. External hemorrhoids are the ones that typically lead to the pain and discomfort people often associate with hemorrhoids.

Hemorrhoids develop due to increased pressure on the pelvic floor. That pressure often comes from straining during bowel movements and sitting for long periods of time on the toilet. It also may be a result of chronic constipation or diarrhea, obesity or pregnancy. External hemorrhoids tend to occur in the pattern you mention, developing over a three- to four-day period and then slowly going away.

One of the key factors in preventing hemorrhoids is being able to pass stool regularly without straining. There are a number of lifestyle changes you can try to help make that happen. They include exercising regularly, eating a healthy diet that is high in fiber, drinking plenty of fluids, and avoiding sitting for long periods of time.

When painful external hemorrhoids develop, self-care steps usually can relieve the discomfort. Over-the-counter creams, ointments, suppositories or pads designed to treat hemorrhoids contain ingredients such as witch hazel or hydrocortisone that can lessen pain and itching. These products are often effective, but don't use them for more than a week at a time. If used too often or for too long, they may cause side effects, such as a skin rash, inflammation or skin thinning.

Soaking in a warm bath or a sitz bath with plain water 10 to 15 minutes, two or three times a day may reduce hemorrhoid swelling. Ice packs or cold compresses also can ease swelling and pain. Over-the-counter pain relievers, such as ibuprofen, aspirin or acetaminophen, may help relieve some discomfort, too.

If hemorrhoids last more than a week despite home remedies, or if they cause pain and discomfort, then it’s time to make an appointment with your doctor. You also should see your doctor if you’re experiencing painless rectal bleeding, so he or she can rule out other more serious conditions. If your symptoms are due to hemorrhoids, your doctor may recommend removing the hemorrhoids surgically. A variety of techniques can be used to accomplish this. Most of them can be done in your doctor’s office and do not require an overnight hospital stay.

Incorporating changes into your exercise and diet routines now may help you avoid hemorrhoids in the future. If they do come back, try the self-care steps listed above. In most cases, no further treatment will be needed. But, if hemorrhoids continue to cause significant pain, see your doctor. — Dr. John Pemberton, Colon and Rectal Surgery, Mayo Clinic, Rochester, Minnesota

The post How do I reduce or avoid hemorrhoid pain? appeared first on Mayo Clinic News Network.

Here's the Mayo Clinic Radio podcast.

The post Hepatitis C / Food Allergies / Hemorrhoids / Cancer and Luck: Mayo Clinic Radio appeared first on Mayo Clinic News Network.

On Mayo Clinic Radio, infectious diseases specialist Dr. Stacey Rizza outlines the risk factors for contracting hepatitis C, especially for people born between 1945 and 1965. Also on the program, allergy specialist Dr. Rohit Divekar explains why it's important to diagnose food allergies before they lead to life-threatening reactions. Colorectal surgeon Dr. John Pemberton discusses the causes of hemorrhoids and how they're treated. And, does luck play a role in whether or not you get cancer? Oncologist Dr. Timothy Moynihan reviews studies that analyze luck and cancer risk.

The post 4/16/16 #MayoClinicRadio Podcast: Hep C, Food Allergies, Hemorrhoids appeared first on Mayo Clinic News Network.

Myth or Matter-of-Fact: Hepatitis C is one of the leading causes of liver cancer, and the primary reason for liver transplant.

Listen to the program on Saturday, April 16, at 9:05 a.m. CDT, and follow #MayoClinicRadio.

Mayo Clinic Radio is on iHeartRadio.

Access archived shows.

Mayo Clinic Radio is a weekly one-hour radio program highlighting health and medical information from Mayo Clinic.

The post Mayo Clinic Radio: Hepatitis C / Food Allergies / Hemorrhoids / Cancer and Luck appeared first on Mayo Clinic News Network.

Myth or Matter-of-Fact: Hepatitis C is one of the leading causes of liver cancer, and the primary reason for liver transplant.

Listen to the program on Saturday, April 16, at 9:05 a.m. CDT.

Miss the show?  Here's the Mayo Clinic Radio podcast.

Follow #MayoClinicRadio, and tweet your questions.

Mayo Clinic Radio is on iHeartRadio.

Mayo Clinic Radio is a weekly one-hour radio program highlighting health and medical information from Mayo Clinic.

Access archived shows.

The post Mayo Clinic Radio: Hepatitis C / Food Allergies / Hemorrhoids / Cancer and Luck appeared first on Mayo Clinic News Network.

THIS WEEK'S TOP STORIES
Warning signs of Alzheimer's
Know the difference between the warning signs of Alzheimer's and typical age-related behavior.

Sodium: How to tame your salt habit
Getting too much sodium can raise your blood pressure and cause other health problems. See how to cut back on salt.

EXPERT ANSWERS
Whitening toothpaste: Does it whiten teeth?
Find out how whitening toothpaste works and whether it's effective.

Warm-mist vs. cool-mist humidifiers: Which is better for a cold?
Warm-mist and cool-mist humidifiers are equally effective in humidifying the air.

HEALTHY RECIPES
Chicken brats
Spicy red cabbage
Pork tenderloin with fennel sauce

HEALTH TIP OF THE WEEK
Eating out? Watch for trans fat
Have you been trying to keep foods that contain trans fat out of your kitchen? Good move! But what about when you're eating in a restaurant? Some restaurants still use trans fat when frying food. For example, a large serving of french fries at some fast-food restaurants might contain 5 grams or more of trans fat. When dining out, read menu labels or ask the staff for nutritional information. Arm yourself with the details you need to order wisely.

Click here to get a free e-subscription to the Housecall newsletter.

PLUS ADDITIONAL HIGHLIGHTS
Infidelity: Mending your marriage after an affair
Hemorrhoids
Prescription weight-loss drugs: Can they help you?
Common headache types

NOW BLOGGING
Nutrition-wise: Food insecurity still a problem for many
Many in the U.S. are unable to acquire or are uncertain of having enough food to meet their needs. See what you can do to help.

The post Monday’s Housecall appeared first on Mayo Clinic News Network.