If you thought a bowel surgeon spent their time seeing the dirtiest people in the community then you should think again!
Over cleaning the Anus leads to anal irritation and disease
Many people would think that a bowel and anus surgeon spends most of his time seeing the dirtiest people in the community. However, this could not be further from the truth because I actually spend most of my time in the clinic seeing the cleanest people in the community!
It is important to remember that for many thousands of years primitive humans did not have bathrooms or toilet paper and the human anus evolved to be used to being dirty.
The skin of the anus is very thin, similar to the lips, and the anus should not be subjected to anything that the skin of the lips couldn’t handle.
Many people cannot bear the thought of a dirty anus and they go to great lengths to keep their anus spotlessly clean using large amounts of toilet paper and vigorously washing the area, especially after defaecation. Unfortunately this breaks down the fragile anal skin and then this usually effective barrier to bacteria lets in microbes to the surrounding tissues. This is very irritating to local nerves and people then get in to a viscious cycle because they get itchy, feeling the need to clean the anus even more, which breaks down the anal skin barrier even further. Therefore it is ironically and usually the cleanest people that end up in my specialist bowel surgery clinic rather than the dirtiest!
The first thing to do is to break the vicious cycle and I recommend that people tone down their anal cleaning routine. Fingernails and abrasive materials such as rough toilet paper should be kept away from the anus. Non-scented baby wipes or luxury toilet tissue are usually the kindest and most effective ways of wiping the bottom after opening the bowels. Running water is the best way to wash the anal surfaces.
Often people think that they must keep on wiping their bottom with toilet paper until they do not see any more brown smears on the toilet paper but this can cause significant damage. Instead people should stop wiping when the brown smears have lessened but before they rub their fragile anal skin raw.
If the anal skin has been broken and the area is very itchy then asking an experienced pharmacist at the local chemist for their most popular haemorrhoid cream can help to give a thin barrier film to the anal surface until the anal skin has healed.
The pants or knickers should be regularly changed to prevent the build up of fluff around the anus which is also irritating leading to harmful scratching.
If the anus is not worked too hard with constipation or straining and not damaged by over-zealous wiping or scratching then most anal conditions settle down over two to six weeks. If you have tried to do this for a few weeks and you still have anal symptoms then that is the time to ask for help from a doctor. The doctor should examine the anal area properly which normally includes inserting a gloved finger in to the anal canal to gain information about the low rectal surfaces.