PRURITIS ANI
Funny name, right? It’s a Latin term meaning ‘itchy anus’. Chronic burning and itching is a very common problem. It is often mistaken for a hemorrhoid problem; think about many of the adds and TV commercials which refer to the burning and itching of hemorrhoids! Though itching is not uncommon during the healing process after other anal conditions or surgery, chronic burn and itch is not a symptom of hemorrhoids. There are a number of factors which can cause burning and itching. Anything causing loose, frequent stools can result in pruritis secondary to repeated wiping and the fact that stool is alkaline and an irritant. Various foods have also been found to cause irritation…caffeine, beer and wine, dairy products, chocolate and tomato based products are common offenders. Many times excessive cleaning and wiping can prolong or cause the problem. Soap and many topical ointments can in fact cause irritation. Skin infections such as Herpes, HPV, and Shingles can cause severe symptoms. Often there is no clear cut cause identified.
Treatment consists of treating any underlying cause that can be identified. Except in those cases related to infection, we take a very practical approach to eliminate possible sources of the irritation. This consists of treating loose stool, avoidance of soap and the overuse of topical creams. I like to think of the way we treat burns; remove the burning irritant! Avoid soap and those things in the diet which can cause irritation. Cleansing with plain warm water or a vinegar and water solution on a kleenex or cotton ball: this neutralizes the alkaline effect of the stool. Milk of Magnesia can also be applied to soothe the skin after bowel movements. Something I learned from patients is the application of Vitanin A & D ointment as a skin barrier. Often seepage is noted between bowel movements and wisps of cotton can be used to absorb the drainage. Most patients will find that as symptoms improve, the seepage ceases. I personally recommend the use of psyllium daily. This helps thicken the stool and makes it easier to clean after bowel movements. I also learned this from a patient who told me that he was virtually cured after starting psyllium. As he described…I now have a “white wipe”! Often treatment can be a process of trial and error. It tends to be a chronic or recurring problem in most patients. That said, by adhering to the basic principals most patients can bring their symptoms under control.
If you are experiencing any anorectal symptoms, contact a Board Certified Colorectal Surgeon. We have the training and expertise to treat all of your Colorectal problems. From colon cancer screening and treatment to anorectal disease. Outcomes are better when treated by a Colorectal Surgeon.
