why does my anus itch after a bowel movement
What is pruritis ani? Pruritus ani is a bothersome and sometimes intense itching or burning sensation of the skin around the anus (rectal opening). It is most noticeable at night or after a bowel movement. The most common complaint is an irresistible urge to scratch. Some people will note occasional bleeding when wiping after a bowel movement. This is a common problem that affects up to 5% of the population. It affects men and women equally and may occur at any age. How is pruritis ani diagnosed? It is diagnosed by an examination of the skin around the anal area. The appearance of the skin will vary, depending on the severity and the length of time the condition has been present. It may start with redness of the skin and can progress to thickening of the skin. It may also lead to cracks and open sores which may result in small amounts of blood on the toilet tissue. Sometimes a biopsy (a small piece of skin removed for microscopic examination) is necessary. What causes pruritis ani? Excessive Cleanliness: Excessive washing, rubbing, cleansing with soap, face cloths, and brushes which lead to chronic skin irritation.
Moisture: Prolonged exposure to moisture from vaginal discharge, perspiration, loose stools or mucus discharge from other rectal problems may lead to pruritus ani. For example, people who perspire when they exercise may find the moisture irritating to the skin around the rectum. Tight clothing, nylon underwear, and skin folds resulting from obesity may trap moisture in the area. Diet: Certain foods can produce irritation to the skin when stool is passed. The most common ones are products containing caffeine (coffee, tea, colas, and chocolate), spicy foods, dairy products, beer, acidic foods like citrus fruits, tomatoes, and nuts. Skin Irritants: Dyed or scented toilet paper, soaps, and laundry detergent may cause the irritation. Stool left on the skin from leakage or incomplete hygiene may be another cause. Occasionally, once the itching starts, some people may respond with excessive wiping of the area which can increase symptoms. Other Causes Other rare causes are pinworms and various skin conditions such as fungal infections or skin burns from radiation.
There is no specific test to determine the cause of pruritus ani. It is often a trial and error process to discover what may be causing your skin irritation and how to resolve it. How is it treated? Treatment of pruritus ani is directed at the care of the skin and determination of the underlying cause. After gently cleansing the skin and patting it, it is important to make sure the skin is dry. Some people use a hair dryer. Apply the ointment recommended by your doctor. Place a wisp of rolled cotton between the cheeks to absorb moisture. What can I do to speed healing and help prevent pruritis ani? DO NOT: Scratch or rub the anal area. Wipe gently. Use scented, colored or patterned toilet paper. Use cleansing pads moistened with alcohol. Consume spicy foods, tomatoes, nuts, dairy products, or beer. Consume caffeine (cola drinks, coffee, tea, chocolate). DO: Use plain white toilet paper or moist wipes to cleanse after bowel movements. Wipe gently - never rub harshly. Use mild soap or don t use soap at all. Gently dry skin thoroughly (you can use a hairdryer).
Wear loose clothing and underclothing. Wear cotton rather than nylon underwear. Take prescribed medications. Watch your diet and eliminate foods that seem to make your condition worse. When your symptoms (itching) disappear, you may be able to resume these foods in moderation. Increase your and water or juice intake if you tend to be constipated. Loose stool may require evaluation. Increase your
intake to absorb the extra moisture in the stool. Return to your doctor s office for follow-up visits as recommended. Your physician may have additional suggestions for you. Initial treatment of simple itching is directed toward relieving the burning and soreness. It is important to clean and dry the anus thoroughly and avoid leaving soap in the anal area. Cleaning efforts should include gentle showering without direct rubbing or irritation of the skin with either the washcloth or towel. After bowel movements, moist pads (such as baby wipes, flushable moist wipes, and flushable anal cleansing wipes) should be used for cleaning the anus instead of toilet paper.
If there is constant moisture present in the anus or stool incontinence, it may be necessary to clean the anus with moist pads between bowel movements. Many over-the-counter (OTC) products are sold for the treatment of anal itching and are available as ointments, creams, gels, suppositories, foams and pads. These products often contain the same used to treat hemorrhoids. When used around the anus, ointments, creams, and gels should be applied as a thin covering. When applied to the anal canal, these products should be inserted with a finger using finger cots (latex covers for the fingertips) or a pile pipe. Pile pipes are most efficient when they have holes on the sides as well as at the end. Pile pipes should be lubricated with ointment prior to insertion. Suppositories or foams do not have advantages over ointments, creams, and gels. Most products contain more than one type of active ingredient. Almost all contain a protectant in addition to another ingredient. Only examples of brand-name products containing one ingredient in addition to the protectant are discussed in this article.
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