WHEN TO SEE YOUR DOCTOR
* You're bleeding from the anus.
* You're in severe pain.
* You have a fever.
* The swelling isn't painful, but it has persisted and gradually grown larger during the past two weeks.
What Your Symptom Is Telling You
Few things can put a damper on a swell time like a swollen tush. No doubt about it, it's really hard to rumba when your rump feels as big as a rutabaga.
Anal swelling is usually caused by a hemorrhoid that has become clotted with blood. "That baby isn't subtle. It's usually a lump and can be quite painful," says James Harig, M.D., associate professor of medicine in the Department of Digestive and Liver Diseases at the University of Illinois College of Medicine in Chicago.
Swelling also can be a sign that you have fissures (cracks in the skin surrounding the anus), a cyst, an abscess or even a sexually transmitted disease.
In most cases anal swelling will slowly subside over two to three days. But here are a few things you can do to speed the process along or prevent it from happening in the first place.
Mix a potion. Soak a cloth in equal amounts of glycerin and witch hazel and then apply it to the swollen area for about an hour, says Eugene Sullivan, M.D., a colon and rectal surgeon in Portland, Oregon. The glycerin will help relieve the swelling, and the witch hazel, an astringent that has a puckering effect, will soothe the skin. Both are available over-the-counter in most drugstores.
Cool it. "Sometimes ice is just the ticket," Dr. Sullivan says. "Ice is good for acute swelling that comes on suddenly. Heat is more for chronic swelling. Some of my patients put crushed ice into a rubber glove and apply it that way. But one woman just takes a bag of frozen peas or carrots out of her freezer and sits on it."
Sitz down and soothe it. Soaking your tush in a sitz bath—three to four inches of 110° to 115°F water—for 15 minutes two or three times a day also may help reduce swelling. Relax your legs on the sides of the tub to allow the water to get to the sore spot.
Count on hydrocortisone. Over-the-counter hydrocortisone creams and ointments can help deflate swelling. "Hydrocortisone is safe and useful for patients who apply it properly," says Eric G. Anderson, M.D., a family practice physician in La Jolla, California. However, you don't need an overwhelming amount of hydrocortisone to get the job done.
"You should try to get a product that has the least strength of hydrocortisone available and use it as directed," Dr. Anderson advises.
Leave the magazines in the living room. Sitting on the toilet reading your favorite book or newspaper may be a nice diversion, but it also puts unwanted strain on your anal muscles and leaves you vulnerable to discomfort caused by swelling.
"If the bathroom is the only place in the house where you can find privacy, and you do like to read in there, then be sure to put down the toilet seat cover and use it as a chair," says Bruce Orkin, M.D., an assistant professor of colon and rectal surgery at the George Washington University School of Medicine and Health Sciences in Washington, D.C.
Fill up on fiber. Excessive straining during a bowel movement can cause swelling. Doctors recommend regularly eating high-fiber foods such as beans, raw fruits, leafy vegetables and whole-grain breads and cereals that can help soften stools and hasten their voyage through your digestive tract.