Pruritus Anal (Rectal Itch)

Pruritis Ani (Rectal Itch)

WHAT CAUSES PRURITUS ANI?

Itching of the skin about the anus (opening of the rectum) is a common complaint. The skin is exposed to irritating digestive products in the stool; this may lead to an itchy rash, especially when stools are frequent. Often, the rash is worsened by vigorous use of toilet tissue or scrubbing with soap and water.

Anal itching is usually an isolated skin complaint in otherwise healthy persons, but in some people, it is part of a disorder involving other areas of the skin. Whether pruritus ani is an isolated problem or part of another skin disorder, irritation from stools and from cleansing after bowel movements keeps the rash going. You may find that coffee and spicy foods make it worse. These foods irritate the digestive tract and increase the number of stools or amount of mucus (liquid) secreted from the rectum.

TREATMENT

Treatment is intended to reduce irritation of the anal skin. Unfortunately, it is impossible to eliminate all irritation, because it is impossible to avoid contact of stool with the inflamed skin. Careful, thorough, gentle cleansing after bowel movements is very important; dry toilet paper does not cleanse as well and also irritates your skin. Never use soap on the anal area. Cleansing with plain water, in either the shower or bathtub, will do the job.  Pruritus Ani is very infrequent in cultures that use bidets.  It is now possible to purchase at home improvement stores portable bidets you attach to the water line of your toilet.  They are easy to install and well worth the cost ($100 to $150.

You will be given a soothing preparation, which you should apply thinly with your fingertips, as directed. Do not apply any other remedy, suppository, or medicine to your rash. Only the prescription medicine  should ever touch inflamed anal skin.

If your itching does not improve with these measures, eliminate coffee, beer, spicy foods, and any foods or beverages you might suspect for 2 weeks. If eliminating certain foods and beverages improves your pruritis ani, add them back one at a time at 1 to 2 week intervals to determine what aggravates your itching.

Pruritus ani is frequently stubborn and requires months of local medication and gentle skin care. Pruritus ani often recurs. Therefore, don’t throw your medicines away when you are free from itching; keep them on hand in case your trouble returns. Some persons need to continue using the medication once or twice daily indefinitely because the itching returns whenever they stop.

Copyright © 2001 by W.B. Saunders Company. All rights reserved.