Pruritus ani is the Latin and at the same time medical term for a partly inflammatory itching in the area of the anus. Pruritus ani is only a symptom and received the number L29.9 in the ICD-10 classification.
What is pruritus ani?
Pruritus ani can occur in both the anal and perianal regions. Depending on the severity, it is accompanied by severe redness, inflamed skin areas and a burning pain. If left untreated, pruritus ani quickly takes on the form of a chronic condition that severely limits the quality of life of those affected. See whicheverhealth for Hearing Loss Meanings.
But even acute cases are stressful and uncomfortable for the patient due to the mostly sluggish healing process. Although persistent itching is one of the most common signs in proctology, which focuses on diseases of the rectum, it affects only about one to five percent of the population.
A possible bias in view of the body region, however, suggests a higher number of unreported cases. Furthermore, the dermatological symptom is often accepted as insignificant and given. Pruritus ani usually appears between the ages of 30 and 60, with women being significantly less affected.
Causes
In most cases, the pruritus ani is based on a disease. In every second person affected, this is haemorrhoidal disease or so-called anal fistulas or abscesses. Cracks in the anal skin (fissures), anal or colon cancer, and fungal, viral, and bacterial infections can also cause itching.
There is also the possibility that diseases independent of the intestinal and anal area act as a cause. These include diabetes mellitus, deficits in the functioning of the liver and kidneys, leukemia or HIV. Even patients with psoriasis or taking antibiotics are at risk of pruritus ani. In rare cases, the itching has psychological reasons.
It then occurs in connection with depression, anxiety or stressful situations. However, a causal connection with an allergic reaction is more likely. Perfumed soaps, creams, flavored toilet paper and wet wipes are increasingly triggering contact allergic anal eczema, which leads to pruritus ani.
The same applies to insufficient or excessive hygiene in this area. Certain foods are often cited as the reason for the itching. However, no medical proof of this has been provided to date.
Symptoms, Ailments & Signs
Going to the doctor is of great importance in the case of pruritus ani. A possible feeling of shame should be overcome and the family doctor, dermatologist or proctologist should be consulted. Due to the now more than one hundred known causes and the risk of a disease that has not yet been diagnosed, a detailed diagnosis is essential.
The diagnosis, which is usually very complex, is initially carried out by means of a clarifying discussion in which customs regarding hygiene and defecation, taking tablets and possible allergies are discussed. This is followed by an inspection, a palpation, possible smears, biopsies or blood tests. It is also sometimes useful to carry out an allergy test, an endoscopy of the rectum or a colonoscopy.
In some cases, no cause can be determined despite intensive diagnostics. Such an idiopathic pruritus ani should still be taken seriously and is just as curable. Not every itching in the area of the anus is pruritus ani. However, a visit to the doctor is recommended after a reasonable observation period. This is the only way to prevent the pruritus from becoming chronic and causing the symptoms to intensify.
Complications
If your anus itches from time to time, that’s normal. Constant itching caused by pruritus in the anal region can lead to a scratched anal region and subsequent complications. This happens especially when the affected person cannot stop the itching and scratches. This could be the case, for example, at night during sleep. In order to avoid complications, the affected person should have the causes clarified if the itching in the anal region persists.
The sore scratched skin on the anus makes it easier for bacterial infections to develop. In the long term, this can lead to scarring and skin damage around the anus. The skin damage can manifest itself, for example, as fine and painful anal fissures. The fissures deepen by pressing. The itching in the anal region can also become chronic. It is then a recurrent pruritus ani.
Pruritus ani that has become chronic multiplies the possibility of infectious and parasitic sequelae in the anal region. Skin fungi can easily settle due to the warm, humid skin climate, contact with intestinal germs and faecal excretions, as well as through the sorely scratched skin areas. In addition, viruses can nest in the irritated skin folds of the anus. Since pruritus ani is usually an accompanying symptom of various diseases, complications can be prevented by treating the cause.
When should you go to the doctor?
Pruritus ani is a phenomenon that can have many different causes, ranging from harmless to cancer. For this reason, it is always advisable to get to the bottom of the cause. A doctor should be consulted for this. However, there are indications, the occurrence of which makes an immediate visit to the doctor necessary. These include, for example, palpable changes in the anal region. As soon as those affected by pruritus ani feel bump-like symptoms, a doctor should be consulted immediately. Increased bleeding can also be a warning sign that should not be ignored. It should also be noted whether the pruritus ani occurs in combination with other symptoms. If this is the case, it is always advisable to seek professional advice
Treatment is also advisable in the case of severely increased itching, which means that those affected are severely restricted in everyday life. Overall, pruritus ani can often be completely cured in the course of medical treatment, but can usually be alleviated in any case.
Treatment & Therapy
The treatment of pruritus ani is twofold. The focus is on combating the actual cause. Accordingly, the respective underlying disease is first healed in order to take the basis of the itching. In general, a rapid relief of the symptoms can be observed afterwards.
The symptoms caused by the pruritus ani itself can also be treated. This is particularly the case when the underlying disease is severe and cannot be expected to be cured in the near future. Medicinal sitz baths and anti-inflammatory, sometimes anesthetic ointments are usually prescribed, the use of which should be monitored by a doctor.
Self-medication is not appropriate for pruritus ani, as certain ointments or applications can make the itching even worse. The very sensitive skin around the anal area is significantly weakened by pruritus ani. Irritations of any kind are to be avoided by the patient. Toilet paper is not to be used. Rather, going to the toilet should be ended by thoroughly rinsing off with clear water.
Sufferers are also advised to stay away from spicy foods (high in capsaicin) and perfumed soaps. Heat and sweat also promote irritation of the skin. Consequently, air-permeable clothing made from a soft, undyed cotton fabric is optimal. If possible, the area should be exposed even for short periods or overnight.
Prevention
In principle, preventing pruritus ani is only possible if there is no underlying disease. Otherwise, its occurrence can only be delayed or its intensity reduced by certain measures. It is particularly advisable to carefully and at the same time carefully clean the area.
pH-neutral washing lotions and unscented, soft toilet paper should be used. On the other hand, skin-irritating wet wipes and vigorous rubbing should be avoided entirely. In order to reduce the risk of contact allergies, the cleaned underwear must not contain any detergent residues and attention should also be paid to allergy-causing substances in body lotions and creams.
Aftercare
Pruritus Ani, severe itching that occurs in the anal area, can be triggered by various underlying diseases. After a detailed examination and a medical diagnosis, the causative disease must first be treated consistently. In addition, the affected person can use self-care creams with which he creams the anal region several times a day.
Wound and healing ointments with added marigold or witch hazel are particularly suitable for this. If the symptoms are not sufficiently reduced despite this treatment, the doctor can prescribe creams that contain lidocaine or procaine and have an anesthetic effect. Pain-relieving gels containing ibuprofen or diclofenac should not be used, however, as they irritate the sensitive anal region and can aggravate the itching.
Sitz baths with the addition of sulfonated shale oils, which are available in pharmacies, also bring relief to the patient. pH-neutral care products are recommended for regular anal hygiene. Too many washes should be avoided in order not to irritate the sensitive anal region even more.
Often there is no medical cause for the pruritus ani. The idiopathic disease can also have psychological causes. With psychotherapeutic treatment, the patient can be helped to distract himself from his problem region and lead a symptom-free life again.
You can do that yourself
Since the itching can have various causes, the underlying disease should be treated by a doctor. Adherence to therapy and consistent implementation of the prescribed measures ensure success here.
In addition, nourishing creams that are applied to the anus once or twice a day will help. Baby creams, wound and healing ointments with marigold or witch hazel can be used for this. Also recommended are gels that contain light-colored sulfonated shale oil and have both an antimicrobial and wound-healing effect. If a care cream is not enough and cannot relieve the itching permanently, the doctor prescribes an anesthetic cream containing lidocaine or procaine. Pain-relieving gels containing ibuprofen or diclofenac are not indicated because they unnecessarily irritate the inflamed anal region.
Regular sitz baths in sulfonated shale oils also help. They can relieve inflammation and thus the itching even in moist wound conditions. These sitz baths are available in pharmacies. Furthermore, regular anal hygiene should be ensured. The care products used are ideally pH-neutral. But hygiene shouldn’t be exaggerated either, because too much washing unnecessarily irritates the sensitive anal region.
If no cause was found for the pruritus ani, it is an idiopathic disease that mostly has psychological causes. In addition to psychotherapy or psychotherapeutic crisis intervention, a changed lifestyle that distracts from the problem region also helps here.
