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ANAL PRURITIS

Anal pruritus (also known as “pruritus ani”) is persistent itching of the skin around the anus. This desire to itch can be further exacerbated by increases in moisture, pressure, and rubbing caused by clothing and sitting. It is a benign condition but can cause intolerable discomfort. Regardless of cause, the problem is exacerbated by a self-escalating “itch-scratch-itch” cycle.

CAUSES
- Over cleaning can remove natural oils that protect the skin.
- Increased moisture due to difficulty cleaning or increased mucous irritates the skin. This can cause itching, bleeding, and pain. An over-growth of 'yeast' makes it worse.
- Rarer causes can include: psoriasis, allergy to laundry detergents, eczema, or dermatitis.
- Food and Drinks that have been associated with itching: Coffee (including decaffeinated), Beer, Bourbon, Scotch, Gin, Wine, Carbonated beverages, Tomatoes and tomatoes products like ketchup, Chocolate, Cheese and Nuts.
- Causes to be evaluated by a surgeon includes, hemorrhoids, rectal polyp, rectal prolapsed, proctitis, incontinence, warts, yeast infection, pre cancerous and cancerous conditions of the anal canal.






 

 

TREATMENT PLAN
1. Avoid Moisture (Moisture = Itch)
- Pat dry, leave small piece toilet paper to keep dry. (soft, unscented, white)
- Use cotton ball, Cornstarch powder
- Avoid using medicated, perfumed, deodorant powders
- Avoid synthetic underwear. Use cotton underwear.

2. Avoid further trauma to the affected area
- Do not use soap. If at all use Dove White or Neutrogena
- Do not scrub that area, not even with toilet paper
- For hygiene it is best to rinse with warm water and pat the area dry. Use wet toilet paper, baby wipes, or wet wash cloth to blot the area clean. NEVER RUB.
- AVOID SCRATCHING

3. Use medication only as prescribed by your doctor. Based on your condition you might be prescribed medications ranging from antihistamines, antifungals, skin protectants, steroids. Long term use of these medications has to be avoided. Stool modifying agents may be suggested.

4. Your surgeon will look for any underlying cause for itching such as hemorrhoids, polyp, fecal incontinence, prolapsed, yeast infection, warts and address it accordingly.

Most people will experience marked relief from symptoms within days. Once symptoms have subsided for 6 weeks then starting from 7th week onwards reintroduce 1 beverage at a time in your diet and add ONE at a time each following week. If itching recurs with one of these beverages it may be necessary to eliminate it permanently to control the problem. Coffee is often the worst offender.

Tension and emotional stress may aggravate your symptoms. Mild tranquilizers are often helpful.

Sometimes itching can be an early symptom of precancerous and cancerous condition of your anal canal. So for persistent itching do see your surgeon.


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