The pain in my behind just won’t go away

Dr Flo,

I experience aching in the anus that started in 2016. I underwent tests for haemorrhoids but the tests were negative. I was given Anusol tablets to insert. The problem went away for some time but it keeps recurring. Last year, I was given Anusol cream to use and, as usual, the problem abated. But since this year began, the problem has come back again. What can I do to treat this problem once and for all? Kindly advise.

Dan

Dear Dan,

Pain in the anus can be caused by:
- Anal fissure, which is a tear in the lining of the anus caused by passing large or hard faeces
- Haemorrhoids or piles: these are bulging veins in the lower part of the rectum and anus
- Anal fistula: this is a small tunnel that develops from the inner lining of the anus to the skin, usually caused by an infection leading to accumulation of pus (abscess)
- Muscle spasms
- Trauma
- Inflammation of the lining of the anus and rectum
- Infection
- Diarrhoea or constipation
- Ulcer in the lining of the rectum
- Cancer (rare)

Since the problem is recurring, it would be good to see a surgeon so that a proper examination of the lower part of the gastrointestinal tract can be done. Treatment depends on the cause.

Medication like Anusol has a pain reliever that helps with the symptoms. In addition, prevent constipation by taking a lot of fluid and high-fibre diet every day. Also, exercise, schedule time each day for a bowel movement, and take your time. Use baby wipes instead of toilet paper, and you can also take a sitz bath – by sitting in warm water for about 20 minutes twice a day – to help soothe the injured tissue. There are fibre supplements which you can take to help with stool texture.

Dr Flo,
I have been experiencing severe pain in my abdomen after an induced abortion two weeks ago. What might be the problem?
Mary

Dear Mary,
The severe abdominal pain may be due to infection or due to incomplete abortion, or due to a tear or damage to the reproductive organs. This may lead to a life-threatening infection and/or heavy bleeding. You need to urgently see a gynaecologist for a comprehensive physical examination, including genital examination and an ultrasound scan. Other tests may be done including a blood test, urine test and examination of any remnants from the uterus. You will be put on antibiotics and painkillers, and other treatment will depend on what is found.

Dr Flo,
I hope you can help me. I have been a picky eater since childhood. I was a bit chubby during childhood, but now I am thin and underweight and I don’t like how I look. I am 30 years old and I don’t have hips or a bum or any curves like people my age. I don’t have children and someone told me that I need to be over 50 kilogrammes for a safe pregnancy. I don’t really have a good appetite and taking appetite syrup and vitamin tablets doesn’t give me an appetite. What can I do to get a normal appetite and to gain weight so that I can look my age? Is there hope for me or am I stuck with this thin body for life? 

Hello reader,

Normal BMI is 18 to 25. Whereas some people add or lose weight easily depending on diet and prevailing circumstances, others do not change their weight easily. This is mostly due to genetics, which, unfortunately, cannot be changed. It is actually healthier to have a body weight that does not fluctuate much. As you grow older, it will become easier to add weight as your metabolism slows down. The notion that to be healthy you have to be “fat” is not right. If your weight is consistent at a healthy level, and you do not have any other health concerns like getting sick frequently, then there is no cause for alarm. Focus on eating a balanced diet, take frequent small meals, exercise and avoid unhealthy practices like smoking or taking too much alcohol.

While it is advisable to get pregnant while at a healthy BMI, this should not keep you from getting pregnant currently, since the low weight has been present for a long time. As long as you eat healthy during pregnancy and get any supplements you may require along the way and you do not have any other concerns, there should be no issues.

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