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I have 37 year old pouch for UC and colon and rectal cancers.  Rather than have  butt burn on my skin on outside around the anus, I now have frequent but not all the time  burn/itch and feeling of  irritation low down Inside the anal canal. Colon/rectal  Doc examined me with analscope  and concluded it was coming from leakage from a stricture.  He offered to dialate me under anesthesia which i declined because I do not seem to have that much trouble emptying my pouch.  He agreed with me saying when I have real trouble emptying I will know it and dilation could be put off until such time.  My GI who did my last pouchoscopy in early Nov. says I have a stricture at the juncture of the afferent limb and pouch.  She recommended placing an axios stent  for 3 months  dilation but my C/R doc warned of the risks (perforation) of this as long as I am not having much trouble emptying, I should avoid it.

   My main concern  and question is with my prior cancer history, am I at greater risk for cancer in this rectum/ anal canal area because of the apparent irritation ? I imagine its something like a little ulcer in the area but no doc addressed this concern. I get scoped anually.  This discomfort comes and goes depending somewhat on the frequently of BMs and leakage which does vary from day to day.  I realize i really dont have much of a rectum left anyway so I think this may be to my advantage cancer wise?  I appreciate your imput very much!

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Hi Hattie,

I understand your concerns. I also suffer from occasional burning and itching in the lower anal canal. When this occurs I need to sit on the bidet and manually cleanse that area while the warm water is hitting that area. It’s not ideal, but if I am gentle, it gets the job done. I mentioned this to my surgeon during my final follow up visit and he suggested warm water enemas to help cleanse the area.

my understanding of future cancer risk as it relates to 2cm rectal cuff is that we are low risk. My layman’s understanding is that long term IBD inflammation is the precursor to low/high grade dysplasia which is the precursor to CRC. I think we would  need biopsies from that area to show ongoing disease which if left untreated could cause problems down the road. I personally do not worry that my anal canal irritation will cause future CRC risk.

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