Hi. Thanks for your query. Noted the history and understood the concerns Burning and pain around the anus are usually due to perianal skin infection, dermatitis or fissure-in-ano. This can be diagnosed by clinical examination preferably by a General Surgeon and thus get a correct diagnosis. I would advise you the following in such a situation: Clean the area while taking Sitz bath in a tub with warm water. Make it dry and apply liquid povidone iodine. Get the stool, blood and urine tested. If there is any evidence of infection get a course of an antibiotic, metronidazole and probiotics to hasten the control of infection and healing. Further management as per the clinical findings. Continue Omeprazole, Naproxen and Levothyroxine; get a review of thyroid functions and other tests to get the dosages adjusted.