How to Treat a Sore Behind If You Have IBD? people with IBD are more likely to experience anal discomfort, especially during a flare. And they must handle those conditions in a different way than the rest of us.
In fact, a review article published in 2021 in Crohn’s & Colitis 360 discovered that although individuals with IBD do not exhibit higher rectal sensitivity than the general population when their disease is in remission, they do so twice as often when it is active.
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Perioral Dermatitis When IBD flares result in diarrhoea, skin irritation around the anus is rather typical. According to Cleveland Clinic colorectal surgeon Stefan Holubar, MD, patients are vulnerable to discomfort from overuse. They frequently wipe themselves due to their diarrhoea, which results in perianal dermatitis.
Furthermore, the pH of diarrhoea is acidic, which irritates the anus as it leaves. According to Dr Holubar, “the anus possesses a thin layer of protecting oil that can be rubbed away from usage.”
He also suggests using a bidet or peri bottle to clean the area instead of wiping it.
They occasionally leave blood in the stools. IBD is the exception, according to Holubar. “The key to treating IBD is keeping the diarrhoea and the inflammation under control with medicine since patients with IBD have low-pressure fissures from overuse and persistent diarrhoea.”
Dr. Wong points out that there is a higher risk of infection because there is continuing inflammation adjacent to an open wound.
Holubar suggests a sitz bath (a warm water bath you sit in to relieve discomfort) and a soothing cream to soothe inflammation.
It’s crucial to maintain a clean and dry environment at home, adds Wong.
Perianal Crohn’s disease or perianal fistulas Fistulas, which are microscopic tunnels that form between the anus and the skin around the orifice of the anus, are more likely to arise in people with Crohn’s disease than in those with ulcerative colitis. Fistulas can easily leak blood, faeces, or pus from an abscess since there is no sphincter muscle to restrict the opening. Additionally, because they are exposed, they are painful and readily infected.
Researchers discovered that patients with perianal Crohn’s disease had a 66 per cent higher risk of developing colorectal cancer than those with Crohn’s disease without perianal disease in a review article that was published in September 2022 in the Journal of Crohn’s and Colitis. 50% of the patients in the subgroup who had anal cancer also had perianal Crohn’s disease.
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According to Wong, the existence of perianal fistulas is a standalone predictor of disability, comorbidities, and worse outcomes. “They require medical attention from a qualified specialist since they can be harmful.”
A seton drain, which keeps the perianal fistula open and lets it drain while it heals, may be necessary for perianal fistulas. Any perianal abscesses in the fistula may also require draining by a physician.
Wong encourages patients who have perianal fistulas to control their Crohn’s disease and maintain contact with a colorectal surgeon. “Your medical team has to regularly monitor your development and look out for any worsening,” the doctor advised.