Pruritus Ani information including symptoms, diagnosis, misdiagnosis, treatment, causes
Pruritus ani is a chronic itching of the skin around the anus. The skin of the perirectal area 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. The itch may be made worse by heat, wool, moisture, leaking, soiling, stress, and anxiety.The cause of pruritus ani may be difficult to determine, thus making pruritus ani a potentially difficult conditions to treat. Another main cause is yeast infection or Candidiasis. Some diseases increase the possibility of yeast infections, such as diabetes mellitus or HIV infection. Signs and symptoms of prurius ani is changes the skin excoriations, abrasions, thickening, and lichenification. Treatment with antibiotics can lead to a yeast infection and irritation of the anus. Antihistamines may help neutralize the effect of some allergens. Various different soothing preparations are suitable, including mild topical steroids and zinc paste. Strong steroid creams should not be applied for more than a few days. Wash the anus in a bidet or a bucket of lukewarm water. Moistened tissues or soft toilet paper are next best. Use aqueous cream, mineral oil or other soap-free cleanser. Avoid soap and rough toilet paper.Sign and symptoms * Anal itching. * Redness of skin around the anus. * The itching is often intense and worse at night. * Chronic inflammation can occur.Diagnosis Diagnosis is made from the appearance of the anal skin and relevant information from the history. The skin typically shows dullness and thickening, although the underlying pathology is often obscured by excoriation caused by scratching and secondary infection. A scraping of local skin may help disclose fungal infection, and a stool sample may help find parasites. Visible lesions may be biopsied.Pruritus Ani Treatment # Irritation of the anal skin needs to be reduced. It is impossible to eliminate it altogether because the stool continues to be in contact with the inflamed skin.# Cleanse carefully, thoroughly and gently after bowel movements.# Wash the anus in a bidet or a bucket of lukewarm water. Moistened tissues or soft toilet paper are next best. Use aqueous cream, mineral oil or other soap-free cleanser. Avoid soap and rough toilet paper. Dietary indiscretion, the use of antibiotics, or an infection, may alter the pH (measure of the acidity or alkalinity of a solution) of the intestinal tract. A simple stool acidity test can be helpful to diagnose the problem, but lacks specificity and should not be relied upon. An increase in pH (alkalinity) allows the intestinal tract’s normal protective mechanism to depart, and permits the proliferation of minority fungi and bacteria.
