Pruritis ani is a condition in which itching around the rectum occurs. It is particularly bothersome at night and after evacuation.
Multiple causes of pruritis ani are present. However, excessive cleaning of the anal area is the most common cause. Moisture around the anus, associated with sweating or from passage of abnormal feces can also exacerbate or induce this problem.
Possible causes of pruritis ani include:
1. Pin worms
2. Psoriasis
3. Eczema
4. Dermatitis
5. Hemorrhoids
6. Anal fissures
7. Sexually transmitted diseases
When pruritis ani occurs, patients tend to wash the area repeatedly and vigorously. This can cause exacerbation of the underlying difficulty. Repeated cleansing of the area will damage the tissue and remove oil from the tissue.
Treatment of pruritis ani includes
1. Avoidance of vigorous perianal cleaning. Most physicians recommend utilization of wet toilet paper or baby wipes as a substitute for usual cleansing techniques. It is best to blot dry the area. Do not rub the area.
2. Avoidance of scratching the involved tissues is recommended.
3. Do not utilize any perfumed or deodorant powders. Rather, application of small cotton balls or gauze pads with a small amount of corn starch may improve symptoms significantly. This tends to dry the area without producing chemical irritation to the perianal tissues.
Prescription medications may be used in a sparing manner around this area. These should be used only at the recommendation of a physician.
Dietary changes are also recommended. Avoidance of alcoholic beverages, milk, citrus and fruit juices as well as caffeinated beverages are usually beneficial. Some food such as chocolates, tomatoes, nuts and popcorn can also exacerbate the problem.
Most patients experience significant relief within a week. Complete resolution of the problem usually occurs within 4-6 weeks.
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