I'm sorry to hear that you're experiencing persistent burning after bowel movements despite using Zentel (an anti-parasitic medication) and Anovate Cream (which contains a steroid, a vasoconstrictor, and a local anesthetic). This discomfort can be quite distressing.

Here are some additional steps and treatments that might help provide quicker relief:

• Ensure proper hygiene: Gently clean the anal area with warm water after bowel movements. Avoid harsh soaps or wiping too hard, which can worsen irritation.
• Sitz baths: Soaking the anal area in warm water for 10-15 minutes several times a day can soothe inflammation and reduce pain.
• Dietary adjustments: Increase intake of fiber-rich foods such as whole grains, dals (lentils), vegetables, and fruits to soften stools and prevent straining. Drinking plenty of water is also important.
• Stool softeners or mild laxatives: These can help reduce strain during bowel movements.
• Avoid irritants: Limit spicy foods, alcohol, and caffeine, which may exacerbate burning sensations.
• Topical treatments: If Anovate Cream is not providing sufficient relief, your doctor might consider other topical options or prescribe medications to promote healing of any fissures or inflammation.
• Pain management: Over-the-counter pain relievers may help, but consult your doctor before use.

Since your symptoms have persisted for a month despite treatment, it is important to consult a gastroenterologist or a colorectal surgeon. They can perform a thorough examination to identify any underlying issues such as anal fissures, hemorrhoids, infections, or other conditions that may require targeted treatment.

If you experience worsening pain, bleeding, fever, or difficulty passing stools, seek medical attention promptly.

Wishing you relief and recovery soon.To narrow down potential causes, we will need some more information.I understand you're in pain. Could you please share your age and gender?