Monday, February 07, 2011

Hemorrhoids or Anusitis?

So I was chatting with my family doctor a few months ago, and said I really wanted a second opinion regarding my ongoing problem of hemorrhoids. I said I had been seeing a doctor who specializes in colonoscopies and he had told me that there was nothing he could do about my hemorrhoids.

I had been seeing this specialist for about 10 years now, and he has been doing my colonoscopies every two or three years. Why so frequently, when everyone else has them every 5 years? Well, the first time he found a polyp several cm in diameter; he removed it and found it was benign, but it seems when they find something, they opt to be on the safe side and do them more frequently. Believe me - if you ever had a colonoscopy, you really don't want to have them too frequently; the actual procedure itself is not so bad, since the patient is sedated and often does not feel anything. However, the prep the two days before is a killer - you spend nearly all the time on the porcelain throne and by the time you have pretty well purged yourself, the bum is raw and sore.

Anyway, I digress. My family doctor suggested I go to the Rudd Clinic in downtown Toronto. Apparently, they are the authority on all things bum and bowel related. I had to wait about a month or so to get in, but considering their reputation and specialization, that was really not that bad a wait. When I got there, I was surprised that I was seen by Dr. Warren Rudd himself.

I went into the exam room and he asked what the problem was. I said I had really bad hemorrhoids that hurt like hell and burned like hell. In fact, I had even taken a picture of them with my iPhone and took it out to show him. He did not seem surprised that I had a photo of my hemorrhoids, but after taking a look, he immediately said, "That's not hemorrhoids." I said, "What do you mean? Look at all those bulging bubbles there." At that point, he asked me to drop my pants so he could have a better look. Once again, he said it was not hemorrhoids. He said it is a condition called Anusitis, sometimes called Anal Itch, which is often caused by diet, and cured by changing diet. He asked if I drank coffee, and I said just decaf. He said it did not matter - caffeinated or decaf - I had to immediately stop drinking coffee and colas, as well as chocolate, and anything hot or spicy. He then asked if I read while on the toilet, and I said of course, whereupon he said I have to break that habit: never sit on the toilet more than 2 minutes!

He then asked if I read his book. What book? Knew nothing about it. I asked if he had one there, and he popped into his office and returned with a copy. I asked how much, and he said $20 - no tax. "Read chapter six", he said. Actually, he said read the whole book and especially chapter six, which deals with my specific condition of Anusitis.Click to enlargeHe then told me to go downstairs to the drugstore and buy a device called Anurex. He said it is small device, about 3 inches long and about half an inch in diameter, with a knob about an inch in diameter at the top. He said to put it into the freezer for about 2 hours and then insert it into my anus. It works like a cold compress that you would put onto your arm or leg if you sprained it. Only, this works 'internally' in the anal canal. The device is reusable - just wash it thoroughly afterwards, and put it back into its container and return it to the freezer. It comes with a small container of aloe lubricant, but that is a very small container, and he said I could get a tube of KY lubricant instead.Quite frankly, I think I still have hemorrhoids, but he claims differently, and he is the expert. What bothers me is that my colonoscopy doctor, and family doctor, both mis-diagnosed this problem, and I have been living in pain for over 15 years.

I have been using the Anurex device for several weeks now, and have also changed my diet to mostly bland foods. And, oh yes, I have a high fibre cereal (Fibre 1) each morning. He insisted on this - said this is the only cereal with 15 grams of fibre per serving, and that I needed this each day. For the first week I did not notice any difference, in fact, it seemed to make my more constipated, which aggravated the problem down below because it made me force each bowel movement. I called him up about this, saying it sort of negated the effect of the Annurx device if I had to exert so much force for a bowel movement. He asked if I was drinking water with the cereal - I said no. He then said that eating fibre is useless unless it is accompanied by a bottle of water. Apparently, water is the catalyst that makes the fibre work in the bowels. So, I started drinking water each morning with the cereal, and actually taking a bottle with each meal, and I can't believe the difference. I now have the recommended 2 to 3 firm, but not hard, bowel movements each day.

However, the 'hemorrhoids' are still there, and still as sore as ever. I have a followup appointment with him this Friday. I am not expecting miracles, but he did say it may take 3 to 4 months till the anusitis goes away.

24 comments:

Anonymous said...

Hi Anon, I was just wondering, did your symptoms clear up? I have a similar issue and went to see Dr. Rudd today.

Anon Emous said...

For the most part, yes it helped. However, I think the main cause of this condition was a combination of stress and diet. I tried to eliminate stress as best I could, but this is alsmost impossible in today's life.

Changing my diet to eliminate spicy foods and foods that are acidic helped a lot. I still have the occasional coffee or chocolate, but the next few days I pay for it. It seems to generate the leakage in the anus that burns around the outside. I am experimenting with taking antacids like Galvascon to combat the acidity in my system, and thus reduce the acidic leakage.

Anonymous said...

Thanks...did the swollen bumps ever go away? I've tried the anurex which seems to provide temporary relief, but it's not healing fast enough. I've cut out all those foods he's told me to cut out. Did you ever go see an allergist?

Anon Emous said...

Yes, the swollen bumps eventually disappeared.. it can take several months! However, anytime I have a difficult bowel movement, they usually come back. The trick is to avoid anything that will cause constipation.. like any meds with codine! Forcing the bowel movement is really bad - it has to come naturally. I eat Fibre 1 cereal each morning, followed by a full glass of water - this is VERY important! Without water, the fibre is useless - you MUST drink water after taking fibre cereal, and Fibre 1 is this only recommended brand, as it contains about 15% fibre.. read the labels.. other cereals don't have this much. (add some blueberries to help with the taste.) Then I eat 6 punes to help with a normal movement the next day. (You can buy a large bag of pitted prunes at Costco - will last you months!)

Ewerton said...

Hi anon, so in fact, you didn't get a cure, right? you still have those swollen bumps and sometimes they get sore, am I right? are you still using anurex everyday? Thank you for your post!

Anon Emous said...

Well, I don't think there is a definitive cure per se. Yes, the 'lumps' have deminished to a great extent. But, I think I will have to be careful with my diet, avoiding acidic and spicy foods, for the rest of my life.

And no, I am not using the 'plug' any more - it was primarily to reduce the swelling which I really don't have any more. It did the job.

Now, I have to watch what I eat, cause acidic and spicy foods cause leakage out of my anus, which in turn burns me down there. The key when this happens is to keep the area very clean. I find using flushable wet wipes ideal for cleaning the area of dirty leakage. And, although Dr. Rudd was quite emphatic that the area should be kept dry (he advocates baby powder with corn starch), my personal remedy is Noxima. Yeah, I know it is a cleansing cream, but I find the ingredients in it cool and bring relief when it is burning down there.

As for the swelling, it occasionally returns for a few days, but that is usually caused by forcing bowel movements, and thus forcing some of the anus lining out. The key is to eat a good fibre diet and a few prunes daily to help with an easy bowel movement. Maybe use some Softlax to soften the stool if you miss a day. Avoid anything that constipates, like medicines with codene or street drugs.

Anonymous said...

I am curious, how long did it take to have some relief. I have been battling with anusitis for 7 weeks now and its still aweful after every bowel movement even when its soft. I cant sleep at night and its almost impossible to avoid the temptation to scratch. Anurex seems to cause discomfort although i use it everyday, i have changed my diet entirely and because of such have even lost 29lbs. I am getting stressed out just dealing with this everyday. Any advice?!

Anon Emous said...

I am no expert, but I would suspect by 7 weeks you should have seen some improvement. Stress is a major factor, and if you are getting stressed, it may be contributing to the problem. At this point, I would suggest you seek medical help.

Anonymous said...

Thanks, i have been going to the Rudd Clinic, about 3 times in the last 6 weeks now, i should say i have minor improvement, except for the sleeping part.

Anonymous said...

For those who cannot sleep because of the itching! My gastroentorologist recomended to put cotton balls into a bag with one spoon of corn starch and shake them well. Put one cotton ball on the bumps between your cheeks. It helps the air circulate better and helps a lot with the itching. I was told that the area has to be kept as dry as possible.

Anonymous said...

Hi Anon,

I went to Rudd Clinic today to get a second opinion on my hemorrhoids problem for years, and was told by Dr Abraham pretty much the same thing as in your story, that I have anusitis due to drinking coffee and diet. I'm really happy to have found your story online. I'm going to cut back my coffee and follow the diet recommendations but it'll be challenging.

Anonymous said...

Thank you for posting your story here. I find this issue incredibly hard to deal with myself and am happy to hear a kindred experience. I also am not able to find a complete cure for myself 12 months in, but focus on diet to alleviate and hide the symptoms.

Anonymous said...

Thanks for your sharing your story Anon, and all of you others as well. I have been dealing with anusitis for about 8 months now and am scheduled to go see a dermatologist in a few days. I know it's anusitis and now know I need to cut out soda (I have never drank coffee), as well as changin up my diet a bit (I can't do spicy foods due to acid reflux). But the nighttime itching has been he worst. I scratch and scratch until it bleeds. And the anal canal is always sopping wet at night. I have tried to keep folded toilet paper in between my cheeks to help absorb some of the moistness but the itching takes over and I remove the tp to scratch. It's painful and frustrating because it has affected my sleep so much. I have been using Anurex for about 2 weeks now but have noticed no relief, other than the instant cooling sensation from the plug. But it wears off after about 5 minutes and then burns and itches all over again. It's a bit comforting to know there are others out there who understand what I am going through. This is a terrible thing to have to deal with and I hope some day they come up with a true cure for it.

Anonymous said...

How do they differentiate ebetween this and actual hemorrhoids then? All of the causes/exacerbations and all of the 'cures' for this anusitis can be the same with hemorrhoids. Frankly, I'm surprised colorectal specialists didn't have these people cutting of caffeine and acids, upping fiber, etc., in the first place.

I just came across while researching hemmorlids and am curious.

Anon Emous said...

Honestly, I don't know the answer.. You should consult a doctor or specialist. Sorry.

Anonymous said...

Anon Emous, it's now two years after your initial posts. Did your symptoms ever truly clear up?

Anonymous said...

I have been dealing with anusitis as well for a few years. My doctor (specialist) is convinced that hemmoroids and anusitis are the same thing. I am on a low insoluable fibre diet and I take psyllium husk for fibre. It's like night and day since I started this diet. My symptoms are completely gone if I stick to the diet. I have added back a few of the items that various blogs say you cannot eat such as: tomatoes (not cooked); soda (except cola); red wine. adding these have not given me any problem. I only have problems with coffee, garlic and spice of any kind (though not so much to pepper). it's a big adjustment and the medical community says I will have this for the rest of my life. not sure about that, I am using self-hynosis to try to get rid of it and I saw a homeopath who gave me a remedy that I can use when I do eat something and have symptoms (it has worked every time) though my medical doctor is wary of the product.

Anonymous said...

Destin may help keeping it dry. I have something similar going on. Last night I couldn't relieve my bowels. The lumps got bigger, the destin helped bring the swelling down. It helped a little.

Anonymous said...

i heard an unknown bacteria may be the cause. Anyone know more about it?

Anonymous said...

That would make sense if there is a bacteria causing it. I find if I don't completely empty on bowl movements , the remaing pieces stuck in the rectum canal close to the exit bring on the pain. However, the diet recommended by the Rudd close clinic helps . It probably starves the bacteria that is there. It would be great if they put some funds towards this incredibly pain and find out if in deed there is bacteria causing it.

Anonymous said...

I would be very wary of using the Anurex. My wife used this on the advice of Rudd but the frozen stick (used twice a day for six months) essentially caused frost-bite damage to the sensitive tissue, ultimately resulting in an ano-vaginal fistula. Two surgeries later in attempts to fix this serious damage; no other colorectal doctors in the Toronto area have ever heard of the Anurex. Rudd is a dangerous self-promoting cowboy.

Anonymous said...

I'm just sharing this since I feel it helped take down the swelling of my external lump of something. I used calmoseptine for a week and noticed a difference. When I started a huge lump was covering my hole and after a week I was actully able to see my hole. I have been trying many things the past two years and this seems to really help. I have used prep h, diltiazam, gtn, and few other cream which just cause irritation. I read that some people use vick vapor rub and Know this cream also has menthol which give your anus a cooling effect. Good luck!

Anonymous said...

I've had two hemorrhoid sugeries and they keep coming back 6 months after each surgery. I was severely constipated in the last couple of years and I didn't even notice that. I tried everything to keep my stool soft but nothing helped.
I tried to eliminate certain foods, even gluten, nothing.
Then I eliminated milk products, so no more butter, cheese or something like that. On day two I've had normal stool. Ongoing for 4 weeks now. I've had severe insomnia for the first 2 weeks and I read that this might be due to the action of casein, so it was some sort of withdrawal. However, my body seems to regenerate, every day I feel better and my chronic anusitis seems to be gone.

Anonymous said...

Hi everyone: hoping this blog might still be active. I’ve been suffering from the same conditions for years and only now starting to get some diagnosis on it. I suffer from all the same issues, drinking coffee and eating spicy food just rips me a apart. So they’ve been cut out. The other big problem is walking after a bowel movement, for anything more that 10min, gets very uncomfortable and can start leaking down there. Has anyone experienced this? I’m wondering if it is a separate condition as my family doc can’t seem to get to the bottom of it.