Unnecessarily frequent use of the warm water washing toilet seat can damage the anal area. The overuse of a washing toilet seat seems not to be related to the development of hemorrhoids (piles) or anal fistula but may have a detrimental effect on anal fissure. Strong water pressure will irritate the anus. Excessive cleansing of the anus may lead to the complete elimination of indigenous bacteria around the anus. In such a case, the immunity of the anus may deteriorate, leading to diseases such as anal candidiasis. Excessive use of a washing toilet seat may increase the risk of anal fissure. So, it is recommended to apply warm water spray to the anus for only a few seconds and stop the spray when no fecal matter is found on the toilet paper. Too much washing with solid soap during bathing or too much cleansing with disinfectant may also cause sores or itching around the anus or anal fissure due to skin fragility, so caution should be exercised.
Fecal incontinence may also lead to hemorrhoids. Since the skin is weakly acidic and the intestinal fluid is relatively strongly alkaline, prolonged contact of stools with the skin may cause erosion of the anus and perianal skin. In such a case, pain will become severe and, therefore caution must be exercised. Fecal incontinence may be caused by anal disorders or may occur not in association with anal disorders. Therefore, treatment should be given after the cause of fecal incontinence has been determined. In the latter case, the cause is the functional problem of imbalance between rectal and anal movements. Various measures can be taken for patients who are suffering from incontinence while awake. Patients who are suffering from passive incontinence while asleep are severe cases. For these patients, conservative therapy, such as oral medications and rehabilitation, is performed. If such therapy is not effective, "sacral neuromodulation" is performed. This is a method to suppress incontinence using a device implanted in the buttock to deliver electrical stimulation to the sacral nerve. In Japan, it has been covered by insurance since 2014.
"Functional anorectal pain" is included in anorectal disorders. This is a condition in which intense pain often occurs at night, but not every night; the frequency differs among patients, such as once weekly, monthly, or yearly. The cause remains unknown, and it is difficult for patients to receive a diagnosis of this pain at a hospital where there is no specialist available. In many cases, non-specialists may say “no pain exists and it is the patient’s imagination.” However, what is common to all these patients is that the pain is so intense that they want to call an ambulance; it lasts for about 15 minutes. It is said that excessive anal muscle contractions and the pudendal nerves are involved, but such pain is hardly known as a disease. I am currently treating some patients suffering from this pain. Some of them felt relieved and symptoms were also relieved after the establishment of a diagnosis of this pain. Specialists can provide patients with the abovementioned information on this pain even if they cannot treat or cure this condition. Consult with a specialist.
