Anal Itching

1 What is Anal Itching?

Anal itching, pruritus ani or itchy bottom, is a very common condition characterized by a strong urge to scratch in and around the anal region.

It is caused by a number of conditions like

Scratching causes pain and burning sensation in the area. Physical examination and tests help to identify the underlying cause of the condition.

Treatment depends on the cause of itching. Anal itching may not need specific treatment. Most cases resolve with home remedies and self-care measures.

If the condition persists, it is important to get medical advice for controlling the condition.

2 Symptoms

Strong urge to scratch the perianal region is the most common symptom of anal itching. It is also associated with redness and soreness in and around anus.

The irritation may be temporary, while in some it may be persistent. Scratching increases itching and leads to inflammation of the area. Excess moisture in and around anus also increases itching.

Soreness and burning sensation may increase with bowel movements. In some people bleeding is also noted. Bleeding requires medical attention as it may be a sign of gastrointestinal bleeding or a more serious medical condition. 

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3 Causes

Infections are one of the most common causes of anal itching. Pinworm and other parasitic infections, sexually transmitted infections, and yeast infections cause persistent and intense itching.

Certain habits like washing the area too often, cleaning too little, and using cleaning tissues with perfumes may irritate the anal region, resulting in itching. 

Some skin conditions like atopic dermatitis as psoriasis cause anal itching. 

Some medical conditions also irritate and lead to itching. This includes 

Certain foods like beverages, some spices, and sauces are linked to anal itching.

Some medications like laxatives and other drugs that cause diarrhea are also associated with itchy bottom.

4 Making a Diagnosis

Anal itching is diagnosed based on symptoms, personal habits, and medical history.

Physical examination reveals underlying conditions like hemorrhoids, fissures, skin tags, and excess moisture.

Rectal tumors that cause anal itching is identified through rectal examination.

Pinworm test is recommended if pinworm infection is suspected. In this test, eggs and worms are recovered from the perianal region using transparent adhesive tape.

Proctoscope is a short tube used to visualize the rectal region to check for abnormalities.

Doctors may refer to specialists like dermatologist or colorectal surgeon for further investigation. 

5 Treatment

Treatment of anal itching is based on the cause of the problem. Most of the cases are resolved by self-care measures and over-the-counter anti-itch creams.

Antifungal and antiparasitic medications are used to control infections. Steroid-based medications help to reduce itching and inflammation of the perianal region.

More invasive procedures like surgical removal or banding, a method that shrinks the hemorrhoids, is needed for reducing itching caused by hemorrhoids.

Protectants like cocoa butter, glycerin, and aluminium hydroxide gel provides a physical barrier to the skin from irritating fluids, thus reducing itching and inflammation.

Astringents are used to promote dryness of the skin in the region, thus controlling itching and burning. 

6 Prevention

Controlling the underlying cause of itching is the best way to prevent anal itching.

Avoiding irritating foods and medications that cause itching helps to control the symptoms.

Controlling medical conditions that lead to anal itching helps to prevent the soreness and pain in the region. 

7 Alternative and Homeopathic Remedies

Some of the alternative and homeopathic remedies for anal itching based on the underlying cause are:

  • Agaricus,
  • Aloe Soc,
  • Calcaria Sulph,
  • Causticum,
  • Cina,
  • Fluoric Acid,
  • Graphites,
  • Kali Carb,
  • Kali Sulph,
  • Lycopodium,
  • Nux Vomica,
  • Phosphorous,
  • Sulphur,
  • Allium Cepa,
  • Alumina,
  • Ammonium Mur,
  • Antim Crud,
  • Argentum Nitricum,
  • Colchicum, Dulcamara,
  • Ignatia,
  • Ipecauc,
  • Lachesis,
  • Muriatic Acid,
  • Petroleum,
  • and Natrum Mur.

Common home remedies that help in reducing symptoms of itchy bottom:

  • Apple cider vinegar,
  • coconut oil,
  • aloe vera,
  • oatmeal,
  • and yoghurt.

8 Lifestyle and Coping

Hygienic habits that keep the anal region clean and dry is very important in coping with anal itching. Some self-care measures that help to control itching are

  • Gentle cleansing with water and mild soap
  • Thorough drying with towel or toilet paper
  • Avoiding scratching to prevent inflammation
  • Wearing loose and comfortable clothing to keep the area dry
  • Avoiding irritants like perfurmes, dyes, and soaps that leads to itching
  • Protecting skin by applying ointments and gels
  • Maintaining healthy diet for smooth, and regular bowel movements

9 Risk and Complications

There are several risks and complications of anal itching.

Itchy bottom may lead to formation of thick and leathery skin in the anal region, a condition called lichenification.

It may also cause ulceration of the skin in the region.

As the top layer of skin is removed by scratching, it may lead to infection. 

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