Pruritus Ani

If you've got an itch... don't scratch it!

Hiding your hemorrhoids is possible, but enduring pruritus ani (an itchy anus) while presenting a report or singing a solo in front of everyone is another challenge – a greater challenge.

How many times have you gone to the bathroom just to scratch that itch away? Was scratching your anus your only source of oasis and comfort for the past few weeks?

Apparently, an itchy ring or anus in Latin, is one of the most irritating and unnerving symptoms of hemorrhoids. It usually manifests with persistent perianal itching or a burning sensation, most especially after moving a bowel. It occurs during periods of stress or at night.

Acute pruritus ani is observed with skin reddening and weeping excoriations, which probably resulted from repeated scratching of the anal area.

In chronic pruritus ani, the skin surrounding the anus has thickened and feels leathery with excessive darkening of the area. This is probably due to the repeated anal trauma, again caused by scratching. Itching around the anus is not considered a medical emergency but it might indicate an existing disease.

Hemorrhoids, otherwise known as piles, are another cause. The itchiness is concentrated on the area around the anal ring. Hemorrhoids result from impaired venous return from the anus, which causes the buildup of pressure against the walls of the rectal veins. The walls weaken, distend and bulge out, forming the anorectal lesions called hemorrhoids.

But the signs and symptoms of hemorrhoids is not limited to the formation of rectal varices and pruritus ani. Hemorrhoids usually cause discomfort, pain, rectal bleeding, anal leakage and prolapse of the rectum.

The condition usually occurs in prolapsed internal hemorrhoids or thrombosed external hemorrhoids. Internal hemorrhoids allow the feces to leak out of the anus, making a contact to the skin, and irritating skin area. Bear in mind that the fecal matter contains skin-irritating components, and when incompletely washed or removed, these materials can cause itching of the anus.

Individuals with external hemorrhoids develop small skin growths, called the skin tags. This extra skin needs meticulous skin care, which might be difficult for some to perform. However, anything that’s excessively done can also cause some anal itching. Obsessive cleaning of the anal area can strip the protective layer and natural oils away from the skin, subsequently resulting in pruritus ani. The first and most important way to manage pruritus ani is to stop yourself from scratching the area. Scratching might give you an immediate relief from the itch but it could also result in more complications, such as bleeding and infections, which can cause more severe itching. For an immediate relief, apply a warm and moist washcloth to the affected area.

• Gently wipe the anal area after a bowel movement, using non-fragrant and soft tissues. If you need to wash it, do not use soap. Thoroughly wash the anal area using cold water as it can be more soothing to the itching area. Avoid scrubbing.
• Keep the area around the anus clean and dry. Corn starch powder can do the trick.
• Sitz baths can relieve the anal irritation. Immerse your buttocks in warm water free from any bath soaps, essential oils or antiseptics for 20 minutes.
• Avoid any product with irritating components to have a contact with the anus. Non-fragrant white tissues are recommended over the colored ones. Thoroughly wash your underwear to ensure that it is free from any traces of detergent.
• Eat a high-fiber diet to have softer and bulkier stools. This can lessen the perianal irritation and itching.

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