Anal itching, likewise known as pruritus ani, is the persistent and frequent itching of the anus and around the anus. The anus is the exit point of the rectum. It is the last part of the digestive tract, and it is 2 inches long. It is supported by the pelvic muscles and the two anal sphincters; internal and external.
When the rectum is full with the waste product (feces), the body feels the intense urge to have bowel movements, the internal anal sphincter muscles relax and pushes the feces from the rectum into the anal canal then the external sphincter muscle relaxes, and the feces is pushed out of the body through the anus.
Anal itching is estimated to affect 5% of the population, and more common in men . The intensity of itch can be worsened by several factors such as:
- Moistness around the anus.
- Clothe rubbing against the already itching areas.
What causes anal itching (pruritus ani)?
There are two types of pruritus ani according to underlying cause:
Primary anal itching
In the primary, there is no known cause. It is sometimes assumed to be caused by poor hygiene or washing the anal region too much/ too often.
Secondary anal itching
Pruritus ani can be a symptom of so many disorders and bodily functions such as:
- Diarrhea (frequent liquid stool)
- Anal sweating
- Fecal incontinence
- Flatulence: a small quantity of stool may be excreted during the passing of gas without the person being aware, and this stool can cause itching after a period of time
- Yeast infection (candidiasis)
- Anal tears (fissures)
- Psoriasis (red, dry, scaly, itchy patches of the skin that can be triggered by stress, infections, and cold)
- Intestinal fistula formation (an abnormal opening that forms between the skin and the intestine)
- Hemorrhoids (piles).
- Acrochordon (also known as skin tag is a small benign tumor growth of skin in the anal region, neck, armpit, eyelids, and groin. The irritation of skin tag can cause itching)
- Inflammatory bowel disease (Ulcerative colitis and Crohn’s disease)
- Intestinal parasitic infections (Enterobius vermicularis “pinworm,” entamoeba histolytica, Guardia lamblia, ancyclostoma diuodenale, and necator Americanus): the anal itching caused by parasites are so severe, and it presents with rashes such as hives.
- Contact dermatitis
- Atopic dermatitis (Eczema)
The risk of suffering from anal itching increases in people with specific diseases and the use of certain drugs:
- Antibiotics use (this disrupt the natural balance of intestinal flora and cause perianal yeast infection “thrush”)
- Being Diabetic
- HIV infections (decrease the immune system and increase the growth of fungus)
- Weakened immune system
Diagnosis Of Anal Itching include:
Anal itching is usually self-diagnosed, but in order to know the underlying cause, several diagnostic methods can be carried out as well.
Treatment of anal itching
- Keep the anal region clean and dry
- Avoid scratching to prevent bleeding and the itch-scratch-itch cycle
- Avoid using products that irritate the skin areas around the anus such as wipes or soaps
- Anti-itch cream (hydrocortisone cream)
Treatment of anal itching underlying cause include:
- Antibiotics for bacterial etiology
- Treatment of hemorrhoids (increase fiber intake, take a stool softener and steroids)
- Antifungal medication for fungal infections
- Increase fiber intake and take two tablets of loperamide whenever you have diarrhea
Prevention of anal itching
To prevent anal itching, you should consider careful washing and cleaning your anus with plain water or soap every day. Don’t scratch your anal and avoid anything that will irritants it