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For almost 2 months I have had horrendous anal itching. I have tried Diflucan (5days), Preparation H, Vagisil cream, Lotrimin & Nystatin with no relief. I called Dr.Shen & told me to take Probiotic 10 & Flagyl (5 days). Has not given me any relief!  I called the gastro I use (when I am not able to travel to see Dr.Shen) & the nurse was going to talk to the dr, but she never called me back.  I don’t know if it’s a yeast/fungal issue? I do have occasional leaking & will fold a tissue & place between the cheeks to prevent it from sitting on my skin. I  also use medicated wipes after every bm.
I am going insane with this itching!  Can anyone help me to find something to, at the very least, ease it? Thank you! 

Original Post

I got hemorrhoids soon after take down and they caused major itching. Over 3 years later, I still have an issue with hemorrhoids but have the symptoms under control. A combination of Ilex paste, using special bath salts (Better Bath Better Body sitz) and using baby wipes instead of toilet paper has really helped with itching. If I start to feel itchy, I just put on some Ilex paste and feel better almost immediately.

If it’s fungal the treatments can take a couple of weeks to work, and you have to work very hard to keep the area dry. That folded tissue may need to be changed frequently. I’m not a big fan of wipes, medicated or otherwise - when did you start using them? Two things to think hard about: 1) is there *anything* that changed shortly before the itching started that might be causing it, and 2) is there anything you’re doing to treat the itching that might be causing it to persist?

Good luck!

Thanks for responding. I will have to try & find the paste, hopefully that will help. 

I do change the tissue frequently when I resort to doing the tissue placement. I try not to have to use that too often.  The itching started when I visited a family member. Thought it might be due to the use of a different soap when I showered. Returned home & itching still continued. I began using all that I mentioned, so not sure if one or the other might be causing it. Guess I’ll have to eliminate it all & start with one to see if that’s the culprit. 

Waiting to hear back from md. 
Thanks for your help, much appreciated!

It's the most horrible pain I experience too. Almost all the time. I too use the ilex paste especially at night. It's hard to get off so be careful not to make it worse. Very warm water on a soft cloth will remove. Do not use wipes. I know it doesn't make sense because you think cleaner is better but those wipes can cause a ton of irritating skin. I use baby aquaphor on t. p. Then wipe after b. m. Also apply on after clean. Have you been checked for anal fissures? Go on ilex paste website ask for free samples they sent me 5 small tubes. A little goes a long way. Sorry to hear about this.. I know what you are struggling with. 

I finally got the Calmoseptine (sp?) & it has helped tremendously! Wish I had tried it earlier. Talked with Dr. Shen today & he thinks it could all be due to other things. He wants me to come to NY for 3 procedures. I’m nervous about going to NY. He thinks it’s safe to go there now. I’m not sold on the idea & said I’d think about going the end of June. As long as the calmoseptine is working, I’m thinking to just hold off on NY. Thoughts anyone?? Thanks!

Using a bidet will change your life for the better. It's one of those things you buy and you wonder how you got along before, using dry toilet paper or wipes. Even if you buy a simple, inexpensive bidet bottle (around $12) with the angled tip to spray water, it will clean the area of stool residue, which causes terrible itch and pain if any is left behind by toilet paper or wipes. Remember to dry your skin thoroughly before applying barrier cream. Don't seal in the moisture. I bought a toilet attachment online shortly after my takedown, and a bidet bottle for use when I'm out. I couldn't have managed without them and I remember how painful and uncomfortable it was.

Calmiseptine paste has Botb Calming ingredients plus the zinc so it helps tremendously with itching. I tried all others with minimal success. It’s the calming agent and it’s thicker consistency that does the trick. Also not always on store shelf. Costco has but it’s behind pharmacy counter even though not an Rx you have to ask. Rite Aid etc some have or some will special order. Costco around $5 tube others upward to $9 but helps tremendously. 
also consider dabbing with TP, don’t wipe. When skin is really bad Use 100 percent cotton ball and gently wipe skin clean with witch hazel to get rid of any residue before applying Calmoseptine paste.  Clean area well before going to bed to give skin a chance to heal and rest. 

consider possibility of a food allergy causing irritation and document what type of food might be the cause.  Spices onion garlic acidic foods wheat or insoluble fiber (pieces of undigested food) were NOT my friends when healing. I stuck to bland, digestible food, using herbs, not spices, steamed vegetables, fruit smoothies blended but ALWAYS drank Konsyl brand psyllium fiber husk powder mixed with water before every meal to bind most undigested food, irritants and acids which burn and in turn will itch. 
In the beginning during healing the itch was much worse than now and on observation they found an open fissure was causing it. However all the above will help on a daily maintenance regardless. 
When really bad it also helps to take a warm bath before bed soaking 20 min. Dab area dry. Apply the witch hazel and apply Calmoseptine  before bed. Most pharmacies will order it for you if you live in a rural town. 

Also Doctors unfortunately I don’t realize how much diet can effect your symptoms. In fact I was sent home with a pamphlet indicating that in a few months I could probably eat most anything. I could add about 20 foods to their list Of problematic and it’s 20 years later. Acidic foods (you can search Google if acidic foods). Particles undigested such as whole wheat, whole grains of any kind, acidic beverages where fruit syrups or carbonation exist). Drink electrolyte water daily. Onion garlic spices skins(tomato), oils, nut fiber are NOT.good. Not that you won’t have it ever, but I try to blend my fruits in a blender in the morning with a milk alternative like oat milk or make/buy a green smoothie to help with nutrition. . For me eliminating dairy helped so I got traded out regular butter sour cream yogurt milk to vegan alternatives   

Choose softer easily digested meals. Steamed white fish, stick to white bread (softer than grain). Sweet potato with vegan butter. Salt, no pepper. Steamed carrots with herbs. Oatmeal in morning(I cook the fruit right in it to soften it). There are many recipes where fruits are steamed  to easily digest and even then if there are peels I discard them after cooking.  If I do soups stews that call for onion garlic etc I either put them in bound gauze while cooking so it still flavors the broth and then discard pieces and use noodles/pasta no meats- especially red meat.  Stick to chicken or fish. 
I hope at least one of these ideas helps people. 

The Calmoseptine did the trick! I’ve been using it ever since & it pretty cleared up the issue. I used it religiously after every bathroom visit & now only have to use it occasionally. 

i ended up not going to NY. Just didn’t think it was safe enough to travel there, so I’m probably not going to see Dr. Shen until sometime next year. Dr. Shen has been really great with the telemed, so I feel good about waiting.

Thanks everyone for all your help! It is much appreciated!

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