PRURITIS ANI / SEVERE PERIANAL ITCH

What is Pruritus Ani?
Itching around the anal and the perianal area is called pruritus ani.
The condition usually causes a compelling urge to scratch.

What causes this to happen?
There are various factors.
The most common cause is usually excessive moisture in the anal &perianal area. Moisture may be due to perspiration/ sweating or asmall amount of residual stool around the anal area.
Pruritis ani may be a symptom of other common anal conditions suchas hemorrhoids, anal fissures and skin tags. The initial condition canbe made worse by scratching, vigorous cleaning of the area or overuse of topical and herbal remedies. In some individuals, It is noted that the itching may be caused by eating certain type of foods, smoking and drinking alcoholic beverages, especially beer and wine.

Some common food items that have been associated with severe itching around the anus include:

Coffee, Tea
Carbonated beverages( Fizzy drinks)
Milk products
Tomatoes and tomato products such as Ketchup
Cheese
Chocolate
Nuts

Does Pruritus Ani result from lack of cleanliness?

Cleanliness has never been proven as one of the issues. However, the natural tendency once a person develops this itching is to wash the area vigorously and frequently with soap and a washcloth. This almost always makes the problem worse by damaging the skin and washing away protective natural oils. Hence these things should be discouraged.

What can be done to make this itching go away?
A careful examination by a Colorectal surgeon or other physician may help in identifying a definite cause for the itch. Your physician can recommend treatment to eliminate the specific problem.

Treatment of pruritus ani often include addressing a few important points.

• Avoid moisture in the anal area:
• Keep the area Dry at all times.
• Avoid all medicated, perfumed and deodorant powders.
• Avoid further trauma to the affected area:
• Do not use soap of any kind on the anal area.
• Do not scrub the anal area with anything – even toilet paper.
• For hygiene, it is best to rinse with warm water and pat the area dry with clean dry towel. Please do not rub.
• Often clean and dry fresh cotton panties/ brief are useful
• Try not to scratch the itchy area. Scratching produces more damage, which in turn makes the itching worse.

USE ONLY MEDICATIONS AS DIRECTED BY YOUR Surgeon/Doctor

Apply prescription medications sparingly to the skin around the anal area and avoid rubbing. Prolonged use of prescribed or over the counter topical medications and herbal medications may result in irritation or skin dryness that can make the condition worse.

How long does this treatment usually take?
Most people experience some relief from itching within a week. If symptoms do not resolve after 6 weeks, a follow-up appointment with your colon and rectal surgeon may be needed. It is also worthwhile to note sometimes these things can be frustrating and can take some time to get relief. You should consider seeking help from a Colorectal surgeon sooner if this continues for some time.

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