Open The Refrigerator For Relief of Rectal Irritation

By Dr. W. Gifford Jones

Have you given up hope of ever getting rid of rectal irritation? Every year I see patients who have tried an array of over-the-counter preparations. They've consulted a variety of physicians to no avail. And some have undergone a hemorrhoidectomy operation without relief of symptoms.

But for many of these patients relief is as close as the refrigerator door. "Anurex", a cold rectal probe, is one of the best kept secrets for treating this irritating problem.

Rectal irritation may be associated with poor hygiene and hemorrhoids. But there's another condition called "anusitis" which is often the culprit. And I doubt that one patient in a thousand has ever heard of this diagnosis.

But they're not alone. Dr. William Rudd, Director of the Rudd Clinic for Colon and Rectal Surgery, in Toronto, claims that for years doctors have failed to diagnose anusitis.

Anusitis causes a slight amount of discharge around the anal area. This constant wetness macerates the skin and causes multiple tiny cracks which trigger itching. It starts a vicious cycle. The more patients scratch the more they itch.

A major complaint is a burning sensation inside and outside the anus. There is no swelling, but blood is often found on toilet paper and occasionally considerable bleeding occurs. Inserting a finger into the anus causes pain.

Dr. Rudd and his colleagues examined 100 consecutive patients who were referred to the clinic for rectal problems. Both the referring doctors and the patients believed their symptoms were due to hemorrhoids. But only 31 per cent actually had this problem. 34 per cent suffered from anusitis. The rest had a variety of anal and rectal troubles.

It's logical to ask, "how could so many physicians fail to notice this inflamed area just inside the anus?" According to Dr. Rudd it's as easy as falling off a log, for several reasons.

The anal canal, Rudd explains, is the bowel's "no-man's land". It's only 3.0 centimeters (1.2 inches) in length. Moreover, unlike the higher rectal area, the anal canal is always collapsed. And a collapsed bowel isn't as easy to see as one that's dilated.

There's also an important technical problem which makes diagnosis difficult. During sigmoidoscopic examination doctors insert a lighted instrument into the large bowel searching for polyps, inflammation or malignancy. During insertion and withdrawal of the sigmoidoscope it passes through the short, collapsed anal canal so quickly that anusitis goes undetected.

What causes anusitis? Dr. Rudd claims the main offenders are coffee, beer, colas, pizza and garlic. Antibiotics, diarrhea and tension can be factors. And on rare occasions smoking and food allergies.

A change in dietary lifestyle is the long term answer for treating anusitis. But immediate relief is as close as the refrigerator's freezer.

There's nothing new about the application of cold temperature (cryotherapy) to relieve swelling and pain of sports injuries. And it's often used to treat premalignant conditions in gynecology. But until recently no one thought of using cryotherapy to soothe the symptoms of anal irritation.

"Anurex", which contains a cold retaining gel, is cooled in the refrigerator's freezer for a minimum of one hour. A water soluble lubricant is applied to the Anurex probe and anus. It's then inserted into the anus like a rectal suppository.

Cooling quickly decreases the local blood flow, inflammation and swelling. This relieves the pain, discharge and bleeding. And since Anurex acts directly on the anal canal it is much safer than a chemical or steroid.

The Anurex probe is left in the rectum for six minutes, removed, washed, placed back in the Anurex container and then back in the freezer. A deep freeze is too cold.

In mild cases Anurex should be used once daily. For severe cases it's needed twice a day for two weeks. The best approach is to continue to use Anurex for a few days after the symptoms have gone.

The first few times Anurex is used it feels quite cold. One must persist to take advantage of its soothing effect.

Anurex gives good results. In a series of 220 patients 90 per cent were relieved of itching and burning within one to two days. It also helps those who say, "I have a leakage that stains my underwear." Small wonder that some patients call it their "magic wand".

The best protection against anusitis is a healthy lifestyle. This means a high fiber diet and ample amounts of water which keeps bowel movements soft like toothpaste. Soft stools don't irritate the bowel's sensitive lining and they guard against constipation.

W. Gifford-Jones M.D is the pen name of Dr. Ken Walker graduate of Harvard. Dr. Walker's website is: Docgiff.com

My book, �90 + How I Got There� can be obtained by sending $19.95 to:

Giff Holdings, 525 Balliol St, Unit # 6,Toronto, Ontario, M4S 1E1

Pre-2008 articles by Gifford Jones

Canada Free Press, CFP Editor Judi McLeod