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Anus among others belong to the “taboo area” of human body. People often don’t want to talk about it and sometimes not even to medical professionals. In this post, I’m gonna walk you through possible causes of pain or discomfort “down there” with medical report and demonstration of how one could do self-examination. I wish this would help people get informed/educated and generally have a rough picture about the causes of the problems, but most importantly, I take myself as an example of showing there is nothing to be embarrased/shamed for problems down there and taking action to tackle concerns as early as possible.

2. What to expect for DRE by doctors

When you notice Rectal bleeding or blood in the stool, a change in bowel habits, discharge or bleeding from the urethra or a change in how your urine flows, you should contact your doctor as soon as possible. Normally, digital rectaal exam (DRE) is used for screening colorectal or prostate cancer. Although nowadays, on primary care setting, current medical consensus doesn’t recommend routinely DRE, your doctor might still do this. If your doctor would like to perform digital rectal exam (DRE), you will be asked to lie on your side on an exam table with knees pulled up to your chest. As they start the DRE, the doctor may ask you to relax and take a deep breath. Then they will gently insert a lubricated, gloved finger into your rectum to examine lower colon and rectum. For men, doctors may also do a your prostate gland check in the same session. They will also feel for bumps, soft or hard spots, or other abnormal areas.

3. Effectiveness of DRE

In a study conducted by multiple universities, a clinician skilled in performing digital ano-rectal exams (DARE) used a pelvic mannequin to train 200 men, aged 27–78 years, how to do a self-anal exam (SAE) for singles or a partner anal exam (PAE) for couples. They conclude that tumours of ≥3mm may be detectable by self- or partner palpation among MSM and encourage further investigation given literature suggesting a high cure rate for anal cancer tumours ≤10mm.  However, besides its effectiveness in small studies, very few guidelines for high risk groups such as HIV postive patients discuss or recommend DARE as a means of anal cancer screening. Good news is in this study and this study, it shows that incorporation of an early anal cancer detection programme into routine HIV clinical care for MSM living with HIV showed high patient acceptability. Doing Annual DAE to detect anal cancer was acceptable for patients, with minimal side effects. Strategies to increase HIV physician’s patient recruitment would be needed if DRE were to be implemented in anal cancer screening.

30 regional and national guidelines were included and examined in detail. Only 2 recommended DARE. The 'European AIDS Clinical Society Guidelines' recommends DARE every 1-3 years for HIV positive MSM whilst the 'US Guideline for prevention and treatment of opportunistic infections in HIV-infected adults and adolescents' recommends an annual DARE for the HIV + population in general. None of these guidelines specify the age of commencing screening. In each case, the highest level of evidence supporting these two recommendations was expert opinion.

Regional and national guideline recommendations for digital ano-rectal examination as a means for anal cancer screening in HIV positive men who have sex with men: a systematic reviewR Tweet

How to do self anal examination

A healthy rectum appears smooth and soft, while an unhealthy rectum may appear lumpy, stiff, congested, or even inflamed. Anal and perianal related diseases such as hemorrhoids, anal fistula, anal fissure disease, rectal cancer, anal canal cancer, melanoma, and other benign and malignant diseases of the anus can be detected through DRE. Do the following steps regularly :

Note: Please use a lot of lubricant because the anus is fragile. As you can see in 7th photo, after I did another half, my anus bruises for using too little lubricant (because it ran out). 

4. Other causes of anal discomfort

Other possible (less common) causes are listed below as well.

  • Levator syndrome ( levator ani syndrome is characterized by apparent spasms in the group of muscles that surround and support the anus. It is not known why it occurs, but it can be very painful and can last up to 20 minutes.)
  • Proctalgia fugax ( It is a sudden, brief and intense pain at the anal opening that usually only lasts for a minute or so, but can wake you up. It may occur in clusters, then go away and return weeks or months later.)
  • Abscess (An abscess is a collection of pus that has built up within the tissue of the body.)
  • Anorectal Fistula (Anal fistula is a chronic abnormal communication between the epithelialised surface of the anal canal and usually the perianal skin.)
  • Benign or Malignant Tumors.
  • Fecal Impaction (A fecal impaction is a large, hard mass of stool that gets stuck so badly in your colon or rectum that you can’t push it out.)
  • Foreign Bodies
  • Proctitis (Proctitis is a condition in which the lining tissue of the inner rectum becomes inflamed. )
  • Pruritus Ani (Pruritus ani is the irritation of the skin at the anus, causing the desire to scratch. The intensity of anal itching increases from moisture, pressure, and rubbing caused by clothing and sitting.)
  • Rectal Prolapse
  • STDs: Often accompanied with Bleeding, soreness, itching and discharge. The following diseases often comes with anal discomfort or pain : gonorrheachlamydiaherpessyphilis ,human papillomavirus

5. Gloves

Powdered vs. Powder-Free gloves

Powdered gloves help you get to work quickly due to their powdered insides which make them easy to slip on and off. More sensitive individuals, however, prefer non-powdered gloves, which are also mess-free, leaving none of the residue powdered gloves leave behind. Powder-free disposable gloves often offer better sterility and are used primarily in the medical field since they help to prevent infections and allergic reactions.

Vinyl vs. Nitrile vs. Latex gloves

Of all disposable gloves, latex gloves provide the highest level of comfort, flexibility and more. Latex rubber gloves provide excellent protection against bacteria and viruses. Because of their high tactile sensitivity, these gloves are preferred for precise or delicate work such as surgery.

If your skin is latex sensitive, however, latex-free gloves are for you. Of the different synthetic glove types available, gloves made of nitrile are often preferred, since disposable nitrile gloves provide comparable comfort and protection to that of latex gloves. Nitrile gloves also provide a high level of protection, with durable, puncture-resistant material that protects users from chemicals and viruses.

Another non-latex gloves option is vinyl plastic gloves, which are generally cheaper than their nitrile counterparts and offer a lower level of protection. Vinyl gloves are ideal for those who prefer a cost-efficient synthetic glove that is comfortable and offers protection against chemicals, such as housekeepers, gardeners, painters and mechanics.

Thickness of Disposable Gloves

Glove thickness is often measured in mils or thousandths of an inch. Gloves that are 5 mil or less are often used in the medical industry, as well as by caregivers to handle patients with incontinence problems. nitrile gloves are usually between 5 and 8 mils thick. Certain professionals, particularly those in the tattoo and piercing fields, use 8 mil gloves, and there are some radiologists who wear 18 mil gloves, which help to prevent exposure to chemotherapy drugs or other harsh chemicals. These thicker gloves are often made of latex.

Size of Disposable Glove

The primary purpose of any glove is to provide protection while maximizing dexterity. When choosing the right glove size, make sure that the gloves fit snugly and won’t slip off very easily (this is especially vital when the gloves are used in medical applications). For surgical measures and other hospital purposes, it is important to have a glove that can be put on smoothly, but fit snugly (although not too tight obviously). This will allow the wearer to have precision while still allowing him to have a firm grip on whatever tools he needs. There are several sizes available:

Small disposable gloves are often used by women since they have, on average, smaller hands. These are a great glove choice for adolescents, as well as other individuals with small hands.

As the name implies, medium-sized gloves exist between the small and large sizes. Those who struggle to fit appropriately into large and small should consider mediums.

Large disposable gloves are commonly worn by men of average size; however, that isn’t to say that women cannot benefit from them. If a person has a larger hand, or has medium-sized hands and wants a slightly looser fit, then this size may be ideal. Large gloves are one of the most widely used sizes in the industry.

Extra Large
If someone finds large gloves to be too snug, extra large gloves may be an effective alternative option. If someone with large hands would prefer a looser fit, or if, for whatever reason, an individual’s hands are swollen, then XL disposable gloves can be worn in to give additional room.

My picks:

I use small vinyl, powdered gloves with thickness of 4 mil.  The reason of using gloves while doing self anal exam is to avoid direct contact with the feces and easier to check whether there’s abnormal discharge or blood on the gloves after exam. Latex makes my skin itchy and compared to nitrile, vinyl is more cost efficient. I use small (I’m a 172cm tall and around 60kg). Powder makes my hand dry and easier to take them off because my hands sweat a lot. In the following, I list possible combinations of materials, with or without powder with width from 3 to 5 mil. Some combinations don’t lead to many results and the products I found do not 100% meet my expectation. I have tried all the combinations (I search using the product title of the one I used. They may not be available. If they’re not there anymore, I’ll just show you the search result. You can pick some similar ones… however, in this case, I don’t know how well they do.) and I settle for small vinyl, powdered gloves. Oh~ and by the way, these links contain my affiliate links on Amazon so if you decide to buy them using my links, I’ll get a small commission. 😄 Hope it’ll save you some time of finding them. Remember to select the size or switch to the right size for you. 😉

Without Powder :
With Powder :

6. Lubricant

A lubricant is a liquid or gel that women and their partners can apply during sex to make the vulva, vagina, or anal area wetter. Lubricant can also be applied to a man’s penis or a sex toy to make them more slippery. There are several types of lubricants, each with advantages and disadvantages.

  • Water-based lubricants are usually inexpensive and easy to find. They also wash off easily. However, they may not last as long as a couple would like and may need to be reapplied during sex to maintain moisture. However, for anal examination, we only need it for several minutes. This is the best option for anal examination.
  • Silicone-based lubricants tend to last longer than water-based lubricants. Many use this for sex because of its long-lasting capability. However, they do not rinse as easily and irritate some people if they aren’t rinsed immediately after sex. It’s important to note that water- and silicone-based lubricants may contain glycerin, which can lead to inflammation and yeast infections. If this becomes a problem, lubricants without glycerin are available. 
  • Oil-based lubricants should be used with caution. These lubricants cannot be used with latex condoms, as they will weaken the latex, making the condom more likely to leak or break. In turn, this increases the risk of unplanned pregnancy (if used for vaginal sex) or transmission of a sexually-transmitted infection (STI). For anal examination purpose, if one use latex gloves, do NOT use oil-based lubricants.
  • Petroleum-based lubricants, such as those made from petroleum jelly, mineral oil, or baby oil, cause irritation or inflammation of the skin. I’ll avoid using them for medical purposes. 

Choosing a lubricant is a personal decision. You can try different types to see what works best for you, but in my opinion, water-based lubricant is the best choice. If a particular lubricant causes irritation or an allergic reaction, please stop using it and try another kind. You may want to consult your doctor if symptoms persist.

My picks:

5. Conclusion

“Self-examination, both externally and internally, is key for many body parts and the butt is no exception,” says anal surgeon and founder of Future Method Evan Goldstein, DO. One could just take a mirror and lie down with legs up to see those areas or one could snap a quick photo with one’s cellphone. Seeing the anus and perinum area as frequently allows for us to detect a small change sooner so the benefit of checking yourself out is early detection of curable problems, that, if left undiagnosed, can turn into a more serious issue. Notice out-of-nowhere discoloration, unevenness, bumps, or bulging. If one experiences persitent pain or blood(light red blood or dark red hue) in stool, then one should go see a doctor immediately.

In my next post, I’ll briefly talked about the two most commonly seen one and of course I will share my experience of how I tackle it. The first one is hemorrhoid. Anal pain or anal discomfort in general is a fairly common problem and can result from frequently seen conditions such as hemorrhoids or anal fissures, which I had experience of. 

Thank you guys for reading my blog posts. 😃😃😃 I'm glad if I could offer a sliiiightest help. Let me know what you think about this post~~ and don't forget to share share share 😃

6. References


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I'm Will. Normal student who loves to be naked.

1 Comment

will · March 26, 2021 at 8:35 am

This is a nice post

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