Dermatology-Online

Anus itch

introduction

As anus itch, in medical terminology Pruritus ani, This is the term used to describe regular or permanent itching in the anal area. It is a phenomenon that affects many people with a percentage of up to five percent of the population, but is still a taboo subject in society, which is often avoided even in a conversation with a trusted doctor. Anal itching occurs most frequently between the ages of 30 and 50, and affects men much more often than women.

The unpleasant sensations can be triggered by numerous diseases. Although most of the causes are harmless, prolonged anal itching can be a sign of a chronic condition that requires medical evaluation and treatment. Last but not least, itching of the anus can have a significant effect on everyday life and thus the quality of life of those affected and should be addressed when visiting a doctor due to the often easily treatable causes.

Symptoms

As Pruritus ani (Anus itch) one designates a permanent or regularly recurring itchy discomfort in the anal area. The itching can occur spontaneously and disappear again after a while without treatment. In some cases, however, the problem occurs more frequently or even persists. The anus itch can be of a Burn or slight pain be accompanied. If there are also visible redness and skin changes, one speaks of a in medical terminology eczema, or one dermatitis (Skin inflammation). Occurs related to itchy anus tumor-like growths the skin in the anal area is contracting an infection human papillomarives (HPV) to think. A warning sign is related to anal itching Loss of blood when defecating or one Contact bleeding when cleaning. In this case, a thorough examination for possible cancer should be carried out.

Causes of itching on the anus

As already mentioned in the introduction, the causes of anus itch are often harmless in nature. In most cases, the reason for anal itching is unbalanced, i.e. poor or excessive anal hygiene. The sensitive skin of the anal area maintains a protective layer of secretions from the skin glands in order to ward off mechanical and chemical stimuli. In particular, frequent washing with harsh soaps and washing lotions can remove this protective coating, making the skin drier and prone to infections and mechanical irritation. Doctors therefore often advise against using damp toilet paper. Often the cause of anal itching is also a contact allergy to soaps or detergents.

If, on the other hand, anal hygiene is neglected, stool residues can collect in the folds of the anal area and, in combination with sweat and body heat, form irritant substances that attack the skin and cause itching. If the Pruritus ani in connection with psoriasis (Psoriasis vulgaris) on, is due to the occurrence of a special form, the Inverse psoriasisto think in the gluteal fold. The most common disease in connection with anus itch is the so-called hemorrhoidal disease, a pathological enlargement of the hemorrhoids (Latin plexus hemorrhoidalis), a vascular network at the end of the intestinal canal. How it comes to an expansion of the hemorrhoids, which incidentally occur in every human being as an anatomical structure, has not yet been conclusively clarified. It is believed, however, that frequent constipation with a hard stool consistency leads to disproportionately long, heavy pressing during bowel movements. This increases the pressure in the abdominal cavity, causing blood to back up into the hemorrhoids, which then expand. Signs of a haemorrhoidal disease are irritation and itching of the bulging, sensitive skin at the anus, blood drainage and a disturbance of the fine continence with occasional unwanted mucus drainage. If itching of the anus occurs in connection with frequent diarrhea, a chronic inflammatory bowel disease should be considered. In this case, a doctor should be examined for the presence of Crohn's disease or ulcerative colitis.

Another chronic condition that too Pruritus ani the metabolic disease diabetes mellitus. Due to a disturbance of the immune system, frequent infections of the anal region occur here. In the case of immunodeficiency due to an infection with HIV or as part of chemotherapy, frequent infections with bacteria or yeasts can occur. If the itching occurs in connection with small bumps in the anal or genital region, an infection with human papillomavirus (Low risk types) to think. One speaks of genital warts (Condylomata acuminata), which are sexually transmitted diseases. Also worm diseases like the infection with Enterobius vermicularis, the Pinworm, can cause anus itch. Rare but serious causes of anal itching are anal carcinoma and anal margin carcinoma. The anal carcinoma occurs in the anal canal, the anal margin carcinoma at the transition from the anal canal to the outer skin. Both forms are associated with the human papillomavirus (high risk types), which is also responsible for the development of cervical cancer in women.

Treatment of anus itch

In the treatment of anus itch, the main focus is on treating the underlying condition. If anal hygiene is exaggerated or neglected, it is usually enough to change your cleaning habits to bring about a rapid improvement in the symptoms.When it comes to hygiene measures, the motto is “thorough but gentle”. Cleaning should ensure adequate removal of stool residue and dirt, but must be done without the use of harsh soaps or lotions. In many countries, the anal area is cleaned exclusively with water after using the toilet. Compared to using toilet paper, this is particularly gentle. If a hemorrhoidal disease is diagnosed, treatment is based on the severity of the disease. In mild cases, it is sufficient to remedy the chronic constipation by changing eating habits or administering swelling agents to soften the stool. In advanced cases, an operative correction must be sought.

The treatment of inflammatory bowel disease is lengthy and complicated. However, a good therapy can also help to reduce paresthesia in the anal area. If you have diabetes, adjusting your blood sugar level well can help improve your symptoms. In the case of genital warts, surgical removal using a laser or cauterization (burning with cautery) is often sought. The standard therapy for anal cancer nowadays is combined radiochemotherapy. If the cause of the anus itching cannot be remedied immediately, there are numerous methods to make the itching more bearable. Regular Sitz baths or the application of numbing or anti-inflammatory creams can provide rapid relief. Due to the sensitivity of the anal skin to any kind of mechanical and chemical stimuli, as described above, Sitz baths or creams should only be used in close consultation with the attending physician.

Treatment with ointment

If the anus is itchy, fatty ointments such as petroleum jelly should be avoided as they keep the affected areas extremely moist, which makes it difficult for the irritated skin to heal. In general, drugs should only be applied or taken after consultation with the attending physician. A common preparation is Tannolact, a cream that is used for skin conditions that cause itching and inflammation. It soothes irritated skin, relieves itching and has an anti-inflammatory effect. Mitosyl ointment is a preparation with a high zinc content, which is used for inflammatory diseases in the anal area and painful tears in the anal skin (Anal fissure) is used. Zinc oxide has antibacterial and anti-inflammatory properties and is also available in ointment form.

What should I do?

Who at Anus itch should primarily pay attention to not to scratch. The damaged skin is further irritated and the symptoms worsen. The itching should not be the reason for extensive hygiene measures, either frequent washing aggravate the problem can. If you are not sure what is causing the anal itching or if you notice accompanying symptoms such as bleeding or diarrhea, you should contact his family doctor in each case seek out. The same applies to people who have had the itching for a long time or who keep coming back.

diagnosis

Shed light on the nature of the underlying disease Anus itch the doctor tries primarily to be thorough History taking and the physical examination, which of course also a careful examination of the anal area and rectum involves attaining. When examining the rectum, in addition to the digital rectal examination with the finger, it may also be necessary to inspect the rectum with the aid of a speculum. If the doctor detects any suspicious changes in the skin, a biopsy can be taken to clarify any cancer that may be present. If no diagnosis is made even after a thorough examination of the anal area and rectum, additional measures such as the Reflection of the entire large intestine (Colonoscopy) become necessary. Blood tests can provide information about possibly existing metabolic diseases or diseases of the immune system.

Which doctor should I see?

The first port of call for itchy anus should be your family doctor. He can approach the problem by taking a thorough medical history and examination and, if necessary, refer it to a specialist. Skin diseases are the responsibility of the dermatologist or allergist, diseases of the gastrointestinal tract are the responsibility of the gastroenterologist and the proctologist is responsible for diseases of the rectum and the anal region.

Anal itching in children

The anal itching (Pruritus ani) is less common in children overall. The triggers are essentially the same as in adults, with the exception of the haemorrhoidal disease, which does not occur in children. The problem should be taken seriously in children too. A medical examination can show whether a serious disease such as diabetes or a chronic inflammatory disease is the cause, or whether an adaptation of the hygiene measures is sufficient to alleviate the symptoms.
By far the most common cause of anus itching in children is Enterobiasis, an infection with the pinworm Enterobius vermiculariswhich can cause severe itching at night (see below). This can be treated with special drugs against worms.

Also read: Worming

Itching at night

The most common cause of itching anus at night is an infection with the so-called pinworm, lat. Enterobius vermicularis.

Also read the article: Itching at night.

An infection with worms

Pinworms lay their eggs on the anus at night and cause itching

The pinworm is a parasitic type of roundworm that lives in the human intestine and is one of the most common parasites in humans. About half of all people get sick at least once in a lifetime. The infection occurs through the ingestion of dust contaminated with worm eggs through the mouth or faecal-oral. The worm eggs ingested enter the duodenum through the stomach, causing the egg shell to soften. After about six hours, the first larvae develop and migrate through the intestines and settle on the intestinal wall near the appendix. There they form a so-called commensal (feeding community) together with their host, the human being, by feeding on the leftover food in the large intestine. The vicinity of the large intestine is also the place of mating.
About two weeks after fertilization, the females migrate towards the anus to lay eggs. This, mostly nocturnal process, creates severe itching in the anal area, which can lead to sleep disorders, irritability, lack of concentration and severe scratching in the anal area. Eggs that collect under the fingernails when scratched can lead to reinfection through renewed ingestion through the mouth. The Enterobiasis, i.e. the infection with the pinworm, is harmless in the majority of cases, even if it is very annoying due to the sometimes strong itching. If a disease is suspected, it can be diagnosed using a simple procedure. In the morning, an adhesive strip is stuck on the anal region, immediately peeled off and examined under the microscope for the presence of worm eggs. The treatment is carried out with anti-wormer drugs such as mebendazole, which are administered orally and which are also well tolerated by children.

Read more on this topic at: Worms in the intestines