Pruritus Ani: causes & management

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Itching in skin around anus could be humiliating enough especially when you are in a public place and there is no way to escape. It becomes more troublesome when a fellow is in a vicious cycle of itch – scratch – itch—-. Generally, pruritus ani is more intense in night so at times a fellow might scratch with nails while sleeping causing serious damage to skin around anus. To get rid of this itching; thorough search is necessary to find out the underlying cause. In this article we will find out the causes and management of pruritus ani.

Causes & management of Pruritus Ani:

Causes:

For convenience we can divide causes of pruritus Ani (itching in anal region) in different groups. The main groups are:

Causes in rectum & Anal Canal:

  • Haemorrhoids: there might be mucus discharge with prolapsed internal piles. Soakage with mucus may irritate the skin and cause itching.
  • Fissure: inflammation due to fissure-in-Ano may cause itching in the skin around anus.
  • Fistula: pus discharged from the external opening of fistulous tract might be responsible for pruritus ani.
  • Extra growths like Polyps, skin tags, peri anal warts, carcinoma or condylomata might be responsible for pruritus ani. etc.

Causes in the Vagina:

Vaginal discharge resulting from inflammation in vaginal wall, gonorrhoreal infection may also be responsible for itching in skin around anus.

Causes in the Skin:

Skin diseases like psoriasis, inflammation of skin due to contact with irritants or allergens etc. may also cause pruritus ani.

Due to infection:

Bacterial/ fungal/ parasitic (Pin worm, scabies etc.) infection in skin around anus is another factor responsible for pruritus Ani.

Other causes:

  • Poor hygiene: faecal matter in skin around anus may irritate and cause pruritus ani. It specially happens when a fellow is suffering from faecal/ urinary incontinence.
  • Psychoneurosis like anxiety/ stress etc.
  • Leakage of liquid paraffin from excessive use.
  • Skin irritation due to long use of soaps in anal area
  • Diseases pertaining to whole body like Diabetes, leukemia, lymphoma, thyroid disease, renal disease, liver disorders etc.

Management of Pruritus Ani:

For convenience we will divide management of pruritus Ani in two sub headings. Selfcare and management by an health care specialist.

Selfcare in pruritus ani:

  • Resist the urge to scratch. As said above; itching is more intense in night and a fellow might scratch with his nails while sleeping so it is better to trim your nails and wear clean, soft cotton gloves at bedtime to prevent irritation and infection.
  • Maintain the skin around anus clean and dry. Clear water should be preferred over soap or moistened toilet paper to clean the area after passing stool. A shower head is better than a jet as latter may cause damage to the skin in this area. If you are using toilet paper or a towel, gently pat or blot the area until it is completely dry.
  • Place a piece of cotton under your undergarments to keep the area dry during the day.
  • Avoid soap for cleansing the anal area
  • Do not scrub vigorously with toilet paper or a washcloth.
  • Avoid products that may cause irritation to the area like perfumed creams, lotions, bubble baths, powders, or other.
  • Eat a fiber rich diet. A healthy diet ensures regular bowel movements and help prevent diarrhoea or constipation.
  • Avoid spicy or acidic foods or caffeinated beverages as these foods might promote itching.
  • Wear cotton underwear. It helps to absorb moisture better than synthetic fabrics. Make sure underwear fits properly and change it frequently. Cloths should be washed with fragrance-free detergents.
  • Avoid wearing tight or constricting underwear.

If above said tips do not benefit a person suffering from pruritus ani should consult a health care specialist so as to arrive at a proper diagnosis and accordingly treatment.

Treatment of Pruritus Ani:

Usually treatment of Pruritus ani focusses on finding the cause and correcting it besides maintaining proper anal hygiene.

  • First you should consult an Ano rectal specialist to find and treat any underlying Ano rectal problem like Hemorrhoids/ fissure/ fistula etc.
  • If underlying cause is some other health problem as discussed above you might be referred to some other health expert.

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