Materiały źródłowe

• #1 Pruritus Ani

  https://pmc.ncbi.nlm.nih.gov/articles/PMC2647235/

  Pruritus ani is a common condition with many causes, predominately anorectal pathology. There are some new insights and therapies, but the most recommendations are based on low-level evidence. […] A review of the evidence is presented and a management plan based on the elimination of irritants and scratching, general control measures and active treatment measures is offered. […] Treatment of primary and secondary pruritus ani has a good prospect of regression of symptoms and skin changes. […] Pruritus ani is defined as intense chronic itching affecting peri-anal skin. It affects 15% of the population, is four times more common in men and is most frequent between the fourth and sixth decades of life. […] The goal of treatment is asymptomatic, intact, dry, clean peri-anal skin with reversal of morphological changes. The aim of this review is to provide a systematic method of diagnosis and management of pruritus ani.

• #2

  https://link.springer.com/article/10.1007/s43472-024-00130-z

  Anal pruritus is a frequent disorder accounting for many proctological consultations, affecting mainly middle-aged males. […] It is believed that it implies a vicious circle of itching and scratching, increasing irritation and inflammation, and thus symptoms. […] The most frequent causes are irritant factors such as anal over-hygiene and some foods, faecal soiling due to incontinence, and proctological diseases such as haemorrhoids. […] Treatment depends principally on the underlying aetiology. […] Anal pruritus is itching of the perianal region. […] It represents the second most common proctological complaint after haemorrhoids. […] Physiopathology of anal pruritus is not fully understood. […] It is supposed to be initiated by Cfibres in the skin, with the implication of itching mediators such as bradykinin, histamine and kallikrein.

• #3 Anal Itch (Pruritus Ani) – Harvard Health

  https://www.health.harvard.edu/a_to_z/anal-itch-pruritus-ani-a-to-z

  Anal itch, also known as pruritus ani, is an irritating, itchy sensation around the anus (the opening through which stool passes out of the body). Anal itch is a symptom, not an illness, and it can have many different causes. […] To help identify the cause of your anal itch, the doctor may ask you to describe your current diet and medications, your bowel habits, and the way you routinely clean your anal area after a bowel movement. The doctor will review your medical history, including any history of rectal problems (hemorrhoids, fissures, or fistulas) or skin problems (psoriasis, eczema, or seborrhea). Your doctor’s questions will be followed by a physical examination of your anal area and, sometimes, by a digital rectal examination. […] If your anal itch is due to a local irritation in the anal area, the doctor usually can diagnose the problem based on your history, diet, and personal hygiene routine, and the results of your physical examination. Sometimes, the doctor will request a stool sample if he or she suspects a worm or parasite infection. Rarely, your doctor may need to examine the area by inserting a special viewing instrument called an anoscope into your anus. This can help your doctor determine whether the itch is being caused by a problem inside your rectum.

• #4 Anal itching – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/anal-itching/diagnosis-treatment/drc-20369350

  Your health care provider may be able to diagnose the cause of your itching by asking about your symptoms, medical history and personal habits. You may need a physical exam, including a rectal exam. You might have a test for pinworms if a pinworm infection is suspected. […] If the cause of your itching isn’t obvious or your itching doesn’t respond to treatment, your health care provider may refer you to a specialist in skin conditions. This type of doctor is called a dermatologist. In many cases, the cause of the itching isn’t known, but the symptoms can be treated. […] Most people won’t need to see a health care provider about anal itching. But if the itching doesn’t stop even after taking self-care measures, seek help. Your care provider may refer you to a skin doctor called a dermatologist, or to a doctor who specializes in treating rectal and anal problems. This type of doctor is called a proctologist.

• #5 Anal Itch (Pruritus Ani) – Harvard Health

  https://www.health.harvard.edu/a_to_z/anal-itch-pruritus-ani-a-to-z

  Anal itch, also known as pruritus ani, is an irritating, itchy sensation around the anus (the opening through which stool passes out of the body). Anal itch is a symptom, not an illness, and it can have many different causes. […] To help identify the cause of your anal itch, the doctor may ask you to describe your current diet and medications, your bowel habits, and the way you routinely clean your anal area after a bowel movement. The doctor will review your medical history, including any history of rectal problems (hemorrhoids, fissures, or fistulas) or skin problems (psoriasis, eczema, or seborrhea). Your doctor’s questions will be followed by a physical examination of your anal area and, sometimes, by a digital rectal examination. […] If your anal itch is due to a local irritation in the anal area, the doctor usually can diagnose the problem based on your history, diet, and personal hygiene routine, and the results of your physical examination. Sometimes, the doctor will request a stool sample if he or she suspects a worm or parasite infection. Rarely, your doctor may need to examine the area by inserting a special viewing instrument called an anoscope into your anus. This can help your doctor determine whether the itch is being caused by a problem inside your rectum.

• #6 Evaluation, management and future perspectives of anal pruritus: a narrative review | European Journal of Medical Research | Full Text

  https://eurjmedres.biomedcentral.com/articles/10.1186/s40001-023-01018-5

  Thorough history and physical examination are very important in view of multiple possible causes of anal pruritus. Most of the focus during examination is drawn on to the perianal region. A digital rectal examination and an anoscopy are essential. It is necessary aim of this narrative review is to overview the classification, diagnostics, possible treatment options and future perspective of anal pruritus. […] In this narrative review we overview the classification, diagnostics and possible treatment options of anal pruritus. […] One of the crucial diagnostic goals is to differentiate between primary and secondary pruritus. […] In view of that, a thorough history and digital examination is of great importance. […] A thorough general physical examination may expose other sites of dermatological conditions, allergies and infections. Most of the focus during examination is drawn on the perianal region, however, the perineal and genital regions should not be forgotten as their inspection may indicate other, with pruritus-associated pathologies.

• #7

  https://link.springer.com/article/10.1007/s43472-024-00130-z

  About 100 possible causes have been identified. […] It can be classified into primary (idiopathic) or secondary. […] Main secondary causes can be classified into local irritation, infections, proctological diseases, neoplastic lesions, dermatological and systemic diseases, and other aetiologies. […] Rigorous history taking is mandatory to identify a potential secondary cause, and thus to be able to propose an adapted treatment. […] Identification of frequency, consistency of stools and history of incontinence is a mandatory point. […] Perianal faecal soiling is one of the main causes of anal itching. […] A systemic evaluation should search for other dermatological lesions that could be associated with systemic diseases potentially responsible for anal pruritus. […] If an infection is suspected, microbiological swabs can be performed to confirm diagnosis.

• #8 Pruritus Ani

  https://pmc.ncbi.nlm.nih.gov/articles/PMC2647235/

  Patients may not relate peri-anal itch to skin symptoms elsewhere. Co-existing skin disease, atopy, urticaria and other allergies should be questioned for. […] A full examination may reveal other sites of skin disease or infection. […] The concurrent rate of infection is significant; however, as microbiological investigations are frequently incorrectly performed, false negatives occur resulting in treatment failure. […] Biopsies should include neighbouring normal skin as well as affected skin. In persistent cases, skin-patch testing should be carried out. […] Management has three components which function in parallel elimination of irritants and scratching, general control measures and active treatment measures. […] If not constipated, seepage may be reduced by adding fibre to the diet and loperamide.

• #9

  https://link.springer.com/article/10.1007/s43472-024-00130-z

  About 100 possible causes have been identified. […] It can be classified into primary (idiopathic) or secondary. […] Main secondary causes can be classified into local irritation, infections, proctological diseases, neoplastic lesions, dermatological and systemic diseases, and other aetiologies. […] Rigorous history taking is mandatory to identify a potential secondary cause, and thus to be able to propose an adapted treatment. […] Identification of frequency, consistency of stools and history of incontinence is a mandatory point. […] Perianal faecal soiling is one of the main causes of anal itching. […] A systemic evaluation should search for other dermatological lesions that could be associated with systemic diseases potentially responsible for anal pruritus. […] If an infection is suspected, microbiological swabs can be performed to confirm diagnosis.

• #10 Anal Itching (Pruritus Ani): Causes, Treatment, Home Remedies

  https://my.clevelandclinic.org/health/diseases/15574-anal-itching-pruritus-ani

  Anal itching (pruritus ani) is a skin condition that affects your perianal area, which may become worse at night or after a bowel movement. […] Anal itching usually causes an uncontrollable urge to scratch your anus. However, scratching doesn’t provide long-lasting relief. […] Your healthcare provider will perform a physical examination to identify possible causes of your itchy anus, such as dermatological conditions or illnesses. They’ll visually inspect your perianal area and note any changes in skin color, skin texture, rashes or lesions. […] If your healthcare provider can’t determine the cause of your itchy anus, or if you don’t respond to treatment, they may refer you to a dermatologist. […] Treatment for an itchy anus usually first focuses on establishing good anal hygiene. Thoroughly clean your anus after pooping, dry the area and apply nonmedicated talcum powder. […] If you have secondary pruritis ani, your treatment depends on the specific cause. […] Call your healthcare provider if your itchy anus doesn’t improve with treatment, your itching gets worse after treatment or the area looks infected (discolored skin, irritation or swelling).

• #11 Perianal Disease | Symptoms, Causes & Treatment| Guts UK

  https://gutscharity.org.uk/advice-and-information/conditions/perianal-disease/

  Most conditions can be easily diagnosed by a GP after asking about the problem and carrying out an examination or other tests. […] Examination: this usually involves lying on the left hand side of the examining couch to expose the anal area. This can be embarrassing for some patients, but doctors are used to dealing with such problems and it is essential for ensuring the correct diagnosis and treatment. […] A visual examination and a digital rectal examination (a gloved finger inserted into the rectum) will be carried out and the entire rectal wall will be examined to feel for lumps and check for blood. […] Proctoscopy or rigid sigmoidoscopy: this can be carried out by the GP and involves inserting an illuminated hollow plastic tube into the rectum through which air can be blown to distend the bowel and increase the amount of bowel lining which is visible. […] Flexible sigmoidoscopy and colonoscopy: if an explanation for the symptoms is not found by your GP or nurse practitioner, they may refer you to hospital or a specialist centre for these investigations which can examine a much larger area of the bowel.

• #12 Anal Itching: Treatment, Causes, Symptoms & Home Remedies

  https://www.medicinenet.com/anal_itching/article.htm

  Anal itching is first evaluated with a careful examination of the anus for such abnormalities as hemorrhoids, anal fissures, skin tags, moisture, and excoriations (breaks in the skin from scratching). […] A rectal examination with a finger inserted into the anal canal can identify rectal tumors. For a closer look at the anal canal, a proctoscope can be used. A proctoscope is a short tube that is inserted through the anus and into the rectum so that the anal canal can be examined visually. […] If pinworms are suspected, they and their eggs can be identified using the pinworm test, a test in which the worms and eggs are recovered from the anus using transparent adhesive tape.

• #13 Perianal Disease | Symptoms, Causes & Treatment| Guts UK

  https://gutscharity.org.uk/advice-and-information/conditions/perianal-disease/

  Most conditions can be easily diagnosed by a GP after asking about the problem and carrying out an examination or other tests. […] Examination: this usually involves lying on the left hand side of the examining couch to expose the anal area. This can be embarrassing for some patients, but doctors are used to dealing with such problems and it is essential for ensuring the correct diagnosis and treatment. […] A visual examination and a digital rectal examination (a gloved finger inserted into the rectum) will be carried out and the entire rectal wall will be examined to feel for lumps and check for blood. […] Proctoscopy or rigid sigmoidoscopy: this can be carried out by the GP and involves inserting an illuminated hollow plastic tube into the rectum through which air can be blown to distend the bowel and increase the amount of bowel lining which is visible. […] Flexible sigmoidoscopy and colonoscopy: if an explanation for the symptoms is not found by your GP or nurse practitioner, they may refer you to hospital or a specialist centre for these investigations which can examine a much larger area of the bowel.

• #14 Perianal Disease | Symptoms, Causes & Treatment| Guts UK

  https://gutscharity.org.uk/advice-and-information/conditions/perianal-disease/

  Most conditions can be easily diagnosed by a GP after asking about the problem and carrying out an examination or other tests. […] Examination: this usually involves lying on the left hand side of the examining couch to expose the anal area. This can be embarrassing for some patients, but doctors are used to dealing with such problems and it is essential for ensuring the correct diagnosis and treatment. […] A visual examination and a digital rectal examination (a gloved finger inserted into the rectum) will be carried out and the entire rectal wall will be examined to feel for lumps and check for blood. […] Proctoscopy or rigid sigmoidoscopy: this can be carried out by the GP and involves inserting an illuminated hollow plastic tube into the rectum through which air can be blown to distend the bowel and increase the amount of bowel lining which is visible. […] Flexible sigmoidoscopy and colonoscopy: if an explanation for the symptoms is not found by your GP or nurse practitioner, they may refer you to hospital or a specialist centre for these investigations which can examine a much larger area of the bowel.

• #15 Pruritus Ani

  https://pmc.ncbi.nlm.nih.gov/articles/PMC2647235/

  Patients may not relate peri-anal itch to skin symptoms elsewhere. Co-existing skin disease, atopy, urticaria and other allergies should be questioned for. […] A full examination may reveal other sites of skin disease or infection. […] The concurrent rate of infection is significant; however, as microbiological investigations are frequently incorrectly performed, false negatives occur resulting in treatment failure. […] Biopsies should include neighbouring normal skin as well as affected skin. In persistent cases, skin-patch testing should be carried out. […] Management has three components which function in parallel elimination of irritants and scratching, general control measures and active treatment measures. […] If not constipated, seepage may be reduced by adding fibre to the diet and loperamide.

• #16 Perianal Disease | Symptoms, Causes & Treatment| Guts UK

  https://gutscharity.org.uk/advice-and-information/conditions/perianal-disease/

  Most conditions can be easily diagnosed by a GP after asking about the problem and carrying out an examination or other tests. […] Examination: this usually involves lying on the left hand side of the examining couch to expose the anal area. This can be embarrassing for some patients, but doctors are used to dealing with such problems and it is essential for ensuring the correct diagnosis and treatment. […] A visual examination and a digital rectal examination (a gloved finger inserted into the rectum) will be carried out and the entire rectal wall will be examined to feel for lumps and check for blood. […] Proctoscopy or rigid sigmoidoscopy: this can be carried out by the GP and involves inserting an illuminated hollow plastic tube into the rectum through which air can be blown to distend the bowel and increase the amount of bowel lining which is visible. […] Flexible sigmoidoscopy and colonoscopy: if an explanation for the symptoms is not found by your GP or nurse practitioner, they may refer you to hospital or a specialist centre for these investigations which can examine a much larger area of the bowel.

• #17 Perianal Disease | Symptoms, Causes & Treatment| Guts UK

  https://gutscharity.org.uk/advice-and-information/conditions/perianal-disease/

  Most conditions can be easily diagnosed by a GP after asking about the problem and carrying out an examination or other tests. […] Examination: this usually involves lying on the left hand side of the examining couch to expose the anal area. This can be embarrassing for some patients, but doctors are used to dealing with such problems and it is essential for ensuring the correct diagnosis and treatment. […] A visual examination and a digital rectal examination (a gloved finger inserted into the rectum) will be carried out and the entire rectal wall will be examined to feel for lumps and check for blood. […] Proctoscopy or rigid sigmoidoscopy: this can be carried out by the GP and involves inserting an illuminated hollow plastic tube into the rectum through which air can be blown to distend the bowel and increase the amount of bowel lining which is visible. […] Flexible sigmoidoscopy and colonoscopy: if an explanation for the symptoms is not found by your GP or nurse practitioner, they may refer you to hospital or a specialist centre for these investigations which can examine a much larger area of the bowel.

• #18 Evaluation, management and future perspectives of anal pruritus: a narrative review | European Journal of Medical Research | Full Text

  https://eurjmedres.biomedcentral.com/articles/10.1186/s40001-023-01018-5

  Anoscopy should be performed for all the patients with anal pruritus to identify commonly associated proctological diseases such as hemorrhoids, anal fistula or fissures as this would change the therapeutic approach later on. […] Unusual findings during digital rectal examination, sudden changes in bowel habits, long-standing inflammatory bowel disease and family history of adenomas or colorectal cancer should prompt the clinician to consider a colonoscopy. […] Although not widely used in clinical practice, several additional classification systems have been proposed by various authors. It can be acute or chronic (lasting over 6 weeks). […] Management of patients with anal pruritus may be challenging and long lasting. In cases when an exact etiology causing pruritus has been diagnosed, an intervention eliminating this factor usually is enough to resolve the symptoms.

• #19 Anal pruritus: Don’t look away

  https://pmc.ncbi.nlm.nih.gov/articles/PMC10989252/

  Anal pruritus is a common anorectal symptom that can significantly impair a patients quality of life, including their mental health. […] Patients often delay seeking medical attention, since it is an embarrassing but non-life-threatening situation. […] Pruritus ani can be associated with idiopathic and secondary causes, such as anorectal diseases, cancer (anal or colorectal), dermatological and sexually transmitted diseases, fungal infections and systemic diseases. […] A proper digital anorectal examination is important, as well as an anoscopy to help to exclude anorectal diseases or suspicious masses. […] Endoscopists should be aware of the common etiologies, and classification of the perianal area abnormalities should be provided in the colonoscopy report. […] It is important to carry out a proper digital anorectal examination and an anoscopy in these patients.

• #20 Perianal Disease | Symptoms, Causes & Treatment| Guts UK

  https://gutscharity.org.uk/advice-and-information/conditions/perianal-disease/

  Most conditions can be easily diagnosed by a GP after asking about the problem and carrying out an examination or other tests. […] Examination: this usually involves lying on the left hand side of the examining couch to expose the anal area. This can be embarrassing for some patients, but doctors are used to dealing with such problems and it is essential for ensuring the correct diagnosis and treatment. […] A visual examination and a digital rectal examination (a gloved finger inserted into the rectum) will be carried out and the entire rectal wall will be examined to feel for lumps and check for blood. […] Proctoscopy or rigid sigmoidoscopy: this can be carried out by the GP and involves inserting an illuminated hollow plastic tube into the rectum through which air can be blown to distend the bowel and increase the amount of bowel lining which is visible. […] Flexible sigmoidoscopy and colonoscopy: if an explanation for the symptoms is not found by your GP or nurse practitioner, they may refer you to hospital or a specialist centre for these investigations which can examine a much larger area of the bowel.

• #21 Evaluation, management and future perspectives of anal pruritus: a narrative review | European Journal of Medical Research | Full Text

  https://eurjmedres.biomedcentral.com/articles/10.1186/s40001-023-01018-5

  Anoscopy should be performed for all the patients with anal pruritus to identify commonly associated proctological diseases such as hemorrhoids, anal fistula or fissures as this would change the therapeutic approach later on. […] Unusual findings during digital rectal examination, sudden changes in bowel habits, long-standing inflammatory bowel disease and family history of adenomas or colorectal cancer should prompt the clinician to consider a colonoscopy. […] Although not widely used in clinical practice, several additional classification systems have been proposed by various authors. It can be acute or chronic (lasting over 6 weeks). […] Management of patients with anal pruritus may be challenging and long lasting. In cases when an exact etiology causing pruritus has been diagnosed, an intervention eliminating this factor usually is enough to resolve the symptoms.

• #22 Anal Pruritus | Colorectal Surgeons Sydney

  http://colorectalsurgeonssydney.com.au/conditions/anal-conditions/anal-pruritus

  Anal pruritus (also known as pruritus ani) is persistent itching of the skin around the anus. It affects 1- 5% of the population with men more often affected than women. Many present late due to severe embarrassment. It is important not to trivialise the symptoms of this debilitating condition. […] Regardless of cause, the problem is exacerbated by a self-escalating itch-scratch-itch cycle. […] Skin conditions such as dermatitis, psoriasis and lichen sclerosis have typical plaque appearance and also can irritate the anus and result in anal pruritus. These need to be considered in the differential diagnosis and usually respond to corticosteroid creams. Sometimes punch biopsy is required to get a definitive diagnosis. […] Anal cancer is uncommon, as are precancerous lesions (Bowens and Pagets disease). However, when present, they may first present as a perianal itch. It is therefore important for your colorectal surgeon to examine the area, and on occasions a biopsy of any suspicious area may be needed to exclude anal cancer.

• #23 Anal pruritus: Don’t look away

  https://pmc.ncbi.nlm.nih.gov/articles/PMC10989252/

  A prospective two-year study, including 109 patients with anal pruritus as the only presenting complaint, showed that 35% of the patients had an abnormal proctosigmoidoscopy or colonoscopy. […] The duration of the pruritic symptoms and an age greater than 50 years were risk factors for a diagnosis of a neoplasm. […] This detailed examination of the perianal area, combined with digital anorectal examination and an anoscopy, will allow a correct evaluation and classification of the situation, and should exclude anorectal diseases that might be associated with anal pruritis. […] For treatment it is important to promote correct hygiene, the elimination of irritants and skin care. […] Several topical therapies have been described, including steroids, capsaicin, tacrolimus and methylene blue intradermal injections.

• #24 Anal itching: Causes, treatments, and home remedies

  https://www.medicalnewstoday.com/articles/168728

  In some cases, the doctor may also recommend laboratory tests, such as: swabs to check for an infection, a biopsy, if skin-related or other changes are present, a stool culture if diarrhea is a symptom, blood tests to rule out systemic conditions, such as liver disease. […] If treatment does not resolve the itching within a few weeks, a doctor may refer the person to a specialist. […] If the itching is persistent or severe, or it happens alongside other symptoms, a person should consult a doctor. In rare cases, there may be an underlying condition that needs medical attention.

• #25

  https://link.springer.com/article/10.1007/s43472-024-00130-z

  About 100 possible causes have been identified. […] It can be classified into primary (idiopathic) or secondary. […] Main secondary causes can be classified into local irritation, infections, proctological diseases, neoplastic lesions, dermatological and systemic diseases, and other aetiologies. […] Rigorous history taking is mandatory to identify a potential secondary cause, and thus to be able to propose an adapted treatment. […] Identification of frequency, consistency of stools and history of incontinence is a mandatory point. […] Perianal faecal soiling is one of the main causes of anal itching. […] A systemic evaluation should search for other dermatological lesions that could be associated with systemic diseases potentially responsible for anal pruritus. […] If an infection is suspected, microbiological swabs can be performed to confirm diagnosis.

• #26 Pruritus ani

  https://www.pcds.org.uk/clinical-guidance/pruritus-ani

  Pruritus ani is a common condition characterised by the sensation of perianal itching or burning. Most cases are idiopathic or hygiene-related, but it can be secondary to an underlying skin condition, or occasionally a bowel disorder. […] In order to ascertain the diagnosis patients require: An accurate history including bowel habit and hygiene regime, Examination of the perianal skin (and the genitalia if lichen sclerosus is suspected), A digital rectal examination in appropriate cases, Skin swabs, Additionally, some patients require a more thorough skin examination if the likely cause is an inflammatory skin condition. […] All patients require a swab for microscopy, culture and sensitivity (MCS). […] If bowel cancer is suspected refer urgently (two-week wait).

• #27 Anal Itching: Treatment, Causes, Symptoms & Home Remedies

  https://www.medicinenet.com/anal_itching/article.htm

  Anal itching is first evaluated with a careful examination of the anus for such abnormalities as hemorrhoids, anal fissures, skin tags, moisture, and excoriations (breaks in the skin from scratching). […] A rectal examination with a finger inserted into the anal canal can identify rectal tumors. For a closer look at the anal canal, a proctoscope can be used. A proctoscope is a short tube that is inserted through the anus and into the rectum so that the anal canal can be examined visually. […] If pinworms are suspected, they and their eggs can be identified using the pinworm test, a test in which the worms and eggs are recovered from the anus using transparent adhesive tape.

• #28

  https://www.healthychildren.org/English/health-issues/conditions/skin/Pages/Anal-Itching-in-Young-Children.aspx

  Have you noticed your little one scratching their bottom? Anal itching (pruritus ani) is common among children. This uncomfortable condition can have a variety of causes. Thankfully, most of these causes are easily treatable. […] How are pinworms diagnosed in children? The information you share about how your child is feeling and behaving can help the doctor diagnose pinworms. Sometimes, pinworms can be seen on the perianal skin around 2-3 hours after the child falls asleep. The pinworms look like a moving white thread that is around inch long. Stool tests are not useful as worms and eggs are not typically passed in stool. […] Perianal strep is diagnosed with a skin swab that is sent to the lab, similar to how strep throat is diagnosed. This test can be done by any medical provider. […] The best way to help skin irritation around the anus is to prevent it from happening in the first place. Avoid children’s products that contain fragrance, like bubble bath and scented soaps. Small children should also get help to wipe the area clean after toileting.

• #29 Anal itching: Causes, treatments, and home remedies

  https://www.medicalnewstoday.com/articles/168728

  In some cases, the doctor may also recommend laboratory tests, such as: swabs to check for an infection, a biopsy, if skin-related or other changes are present, a stool culture if diarrhea is a symptom, blood tests to rule out systemic conditions, such as liver disease. […] If treatment does not resolve the itching within a few weeks, a doctor may refer the person to a specialist. […] If the itching is persistent or severe, or it happens alongside other symptoms, a person should consult a doctor. In rare cases, there may be an underlying condition that needs medical attention.

• #30 Itchy anus (pruritus ani) | healthdirect

  https://www.healthdirect.gov.au/itchy-anus

  Sometimes your doctor may choose to do the following tests: skin biopsy: to rule out any specific causes, blood tests: to check for diabetes, allergy testing: to check if your itch is due to an allergic reaction, proctoscopy: a colorectal surgeon will put a small camera in your anus to look for haemorrhoids, anal fissures or warts.

• #31 Pruritus Ani

  https://pmc.ncbi.nlm.nih.gov/articles/PMC2647235/

  Patients may not relate peri-anal itch to skin symptoms elsewhere. Co-existing skin disease, atopy, urticaria and other allergies should be questioned for. […] A full examination may reveal other sites of skin disease or infection. […] The concurrent rate of infection is significant; however, as microbiological investigations are frequently incorrectly performed, false negatives occur resulting in treatment failure. […] Biopsies should include neighbouring normal skin as well as affected skin. In persistent cases, skin-patch testing should be carried out. […] Management has three components which function in parallel elimination of irritants and scratching, general control measures and active treatment measures. […] If not constipated, seepage may be reduced by adding fibre to the diet and loperamide.

• #32 Anal itching – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/anal-itching/diagnosis-treatment/drc-20369350

  Your health care provider may be able to diagnose the cause of your itching by asking about your symptoms, medical history and personal habits. You may need a physical exam, including a rectal exam. You might have a test for pinworms if a pinworm infection is suspected. […] If the cause of your itching isn’t obvious or your itching doesn’t respond to treatment, your health care provider may refer you to a specialist in skin conditions. This type of doctor is called a dermatologist. In many cases, the cause of the itching isn’t known, but the symptoms can be treated. […] Most people won’t need to see a health care provider about anal itching. But if the itching doesn’t stop even after taking self-care measures, seek help. Your care provider may refer you to a skin doctor called a dermatologist, or to a doctor who specializes in treating rectal and anal problems. This type of doctor is called a proctologist.

• #33 Pruritus Ani

  https://pmc.ncbi.nlm.nih.gov/articles/PMC2647235/

  Patients may not relate peri-anal itch to skin symptoms elsewhere. Co-existing skin disease, atopy, urticaria and other allergies should be questioned for. […] A full examination may reveal other sites of skin disease or infection. […] The concurrent rate of infection is significant; however, as microbiological investigations are frequently incorrectly performed, false negatives occur resulting in treatment failure. […] Biopsies should include neighbouring normal skin as well as affected skin. In persistent cases, skin-patch testing should be carried out. […] Management has three components which function in parallel elimination of irritants and scratching, general control measures and active treatment measures. […] If not constipated, seepage may be reduced by adding fibre to the diet and loperamide.

• #34 Pruritus Ani

  https://pmc.ncbi.nlm.nih.gov/articles/PMC2647235/

  Patients may not relate peri-anal itch to skin symptoms elsewhere. Co-existing skin disease, atopy, urticaria and other allergies should be questioned for. […] A full examination may reveal other sites of skin disease or infection. […] The concurrent rate of infection is significant; however, as microbiological investigations are frequently incorrectly performed, false negatives occur resulting in treatment failure. […] Biopsies should include neighbouring normal skin as well as affected skin. In persistent cases, skin-patch testing should be carried out. […] Management has three components which function in parallel elimination of irritants and scratching, general control measures and active treatment measures. […] If not constipated, seepage may be reduced by adding fibre to the diet and loperamide.

• #35 Pruritus Ani

  https://pmc.ncbi.nlm.nih.gov/articles/PMC2647235/

  Patients may not relate peri-anal itch to skin symptoms elsewhere. Co-existing skin disease, atopy, urticaria and other allergies should be questioned for. […] A full examination may reveal other sites of skin disease or infection. […] The concurrent rate of infection is significant; however, as microbiological investigations are frequently incorrectly performed, false negatives occur resulting in treatment failure. […] Biopsies should include neighbouring normal skin as well as affected skin. In persistent cases, skin-patch testing should be carried out. […] Management has three components which function in parallel elimination of irritants and scratching, general control measures and active treatment measures. […] If not constipated, seepage may be reduced by adding fibre to the diet and loperamide.

• #36 Anal Pruritus | Colorectal Surgeons Sydney

  http://colorectalsurgeonssydney.com.au/conditions/anal-conditions/anal-pruritus

  Anal pruritus (also known as pruritus ani) is persistent itching of the skin around the anus. It affects 1- 5% of the population with men more often affected than women. Many present late due to severe embarrassment. It is important not to trivialise the symptoms of this debilitating condition. […] Regardless of cause, the problem is exacerbated by a self-escalating itch-scratch-itch cycle. […] Skin conditions such as dermatitis, psoriasis and lichen sclerosis have typical plaque appearance and also can irritate the anus and result in anal pruritus. These need to be considered in the differential diagnosis and usually respond to corticosteroid creams. Sometimes punch biopsy is required to get a definitive diagnosis. […] Anal cancer is uncommon, as are precancerous lesions (Bowens and Pagets disease). However, when present, they may first present as a perianal itch. It is therefore important for your colorectal surgeon to examine the area, and on occasions a biopsy of any suspicious area may be needed to exclude anal cancer.

• #37 Anal Itching (Pruritus Ani): Causes, Treatment, Home Remedies

  https://my.clevelandclinic.org/health/diseases/15574-anal-itching-pruritus-ani

  Anal itching (pruritus ani) is a skin condition that affects your perianal area, which may become worse at night or after a bowel movement. […] Anal itching usually causes an uncontrollable urge to scratch your anus. However, scratching doesn’t provide long-lasting relief. […] Your healthcare provider will perform a physical examination to identify possible causes of your itchy anus, such as dermatological conditions or illnesses. They’ll visually inspect your perianal area and note any changes in skin color, skin texture, rashes or lesions. […] If your healthcare provider can’t determine the cause of your itchy anus, or if you don’t respond to treatment, they may refer you to a dermatologist. […] Treatment for an itchy anus usually first focuses on establishing good anal hygiene. Thoroughly clean your anus after pooping, dry the area and apply nonmedicated talcum powder. […] If you have secondary pruritis ani, your treatment depends on the specific cause. […] Call your healthcare provider if your itchy anus doesn’t improve with treatment, your itching gets worse after treatment or the area looks infected (discolored skin, irritation or swelling).

• #38 Itchy Bottom (Pruritus Ani): Causes and Treatment

  https://patient.info/skin-conditions/itchy-bottom-pruritus-ani

  An itchy bottom (pruritus ani) is a persistent itch around the anus. There are many different causes, like haemorrhoids, skin conditions, or infections. Treatments depend on the cause, but include hygiene measures and creams or ointments to treat the itching. […] Pruritus ani is the medical term for a persistent (chronic) itchy feeling around the anus, or an itch in the anus. The main symptom is an urge to scratch your anus, which is difficult to resist. […] Various conditions may cause an itchy bottom. When the cause is another condition which has been identified, this is known as secondary pruritus ani. However, in many cases the cause is not clear. This is called 'idiopathic pruritus ani’ which means 'itchy anus of unknown cause’. Up to 90% of cases of pruritus ani may be idiopathic.

• #39 Itchy Bottom (Pruritus Ani): Causes and Treatment

  https://patient.info/skin-conditions/itchy-bottom-pruritus-ani

  An itchy bottom (pruritus ani) is a persistent itch around the anus. There are many different causes, like haemorrhoids, skin conditions, or infections. Treatments depend on the cause, but include hygiene measures and creams or ointments to treat the itching. […] Pruritus ani is the medical term for a persistent (chronic) itchy feeling around the anus, or an itch in the anus. The main symptom is an urge to scratch your anus, which is difficult to resist. […] Various conditions may cause an itchy bottom. When the cause is another condition which has been identified, this is known as secondary pruritus ani. However, in many cases the cause is not clear. This is called 'idiopathic pruritus ani’ which means 'itchy anus of unknown cause’. Up to 90% of cases of pruritus ani may be idiopathic.

• #40

  https://fascrs.org/patients/diseases-and-conditions/a-z/pruritis-ani-expanded-version

  Pruritis ani is a common medical problem affecting both men and women. […] There are many causes of pruritis ani, and an accurate diagnosis is important in order to treat the specific cause. […] A careful medical history must be obtained from the patient focusing on the timing and duration of the pruritis ani as well as any accompanying symptoms. […] Your doctor will perform an office physical examination to provide information regarding a possible cause of the symptoms. […] Primary or idiopathic pruritis ani is classified by a staging system used at Washington Hospital Center, and is based on the physical features of the skin. […] The goal of therapy is to restore clean, dry, and intact skin. Treatment can be challenging, as many cases have no clear identifiable cause. […] In order to control symptoms, a short course of a steroid ointment may be tried.

• #41 Evaluation, management and future perspectives of anal pruritus: a narrative review | European Journal of Medical Research | Full Text

  https://eurjmedres.biomedcentral.com/articles/10.1186/s40001-023-01018-5

  Anoscopy should be performed for all the patients with anal pruritus to identify commonly associated proctological diseases such as hemorrhoids, anal fistula or fissures as this would change the therapeutic approach later on. […] Unusual findings during digital rectal examination, sudden changes in bowel habits, long-standing inflammatory bowel disease and family history of adenomas or colorectal cancer should prompt the clinician to consider a colonoscopy. […] Although not widely used in clinical practice, several additional classification systems have been proposed by various authors. It can be acute or chronic (lasting over 6 weeks). […] Management of patients with anal pruritus may be challenging and long lasting. In cases when an exact etiology causing pruritus has been diagnosed, an intervention eliminating this factor usually is enough to resolve the symptoms.

• #42 Anal itching – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/anal-itching/diagnosis-treatment/drc-20369350

  Your health care provider may be able to diagnose the cause of your itching by asking about your symptoms, medical history and personal habits. You may need a physical exam, including a rectal exam. You might have a test for pinworms if a pinworm infection is suspected. […] If the cause of your itching isn’t obvious or your itching doesn’t respond to treatment, your health care provider may refer you to a specialist in skin conditions. This type of doctor is called a dermatologist. In many cases, the cause of the itching isn’t known, but the symptoms can be treated. […] Most people won’t need to see a health care provider about anal itching. But if the itching doesn’t stop even after taking self-care measures, seek help. Your care provider may refer you to a skin doctor called a dermatologist, or to a doctor who specializes in treating rectal and anal problems. This type of doctor is called a proctologist.

• #43 Approach to the patient with anal pruritus – UpToDate

  https://www.uptodate.com/contents/approach-to-the-patient-with-anal-pruritus

  Approach to the patient with anal pruritus […] This topic will review the etiology, diagnostic approach, and management of patients with anal pruritus. […] Approximately 75 percent of cases of anal pruritus are secondary to inflammatory, infectious, systemic, neoplastic, and anorectal disorders that contribute to or underlie the development of pruritus. […] Anorectal diseases associated with anal pruritus include prolapsed internal hemorrhoids, abscesses, fissures, and fistulas. […] Anal pruritus can also result from a variety of inflammatory skin disorders.

• #44

  https://link.springer.com/article/10.1007/s43472-024-00130-z

  About 100 possible causes have been identified. […] It can be classified into primary (idiopathic) or secondary. […] Main secondary causes can be classified into local irritation, infections, proctological diseases, neoplastic lesions, dermatological and systemic diseases, and other aetiologies. […] Rigorous history taking is mandatory to identify a potential secondary cause, and thus to be able to propose an adapted treatment. […] Identification of frequency, consistency of stools and history of incontinence is a mandatory point. […] Perianal faecal soiling is one of the main causes of anal itching. […] A systemic evaluation should search for other dermatological lesions that could be associated with systemic diseases potentially responsible for anal pruritus. […] If an infection is suspected, microbiological swabs can be performed to confirm diagnosis.

• #45 Evaluation, management and future perspectives of anal pruritus: a narrative review | European Journal of Medical Research | Full Text

  https://eurjmedres.biomedcentral.com/articles/10.1186/s40001-023-01018-5

  Thorough history and physical examination are very important in view of multiple possible causes of anal pruritus. Most of the focus during examination is drawn on to the perianal region. A digital rectal examination and an anoscopy are essential. It is necessary aim of this narrative review is to overview the classification, diagnostics, possible treatment options and future perspective of anal pruritus. […] In this narrative review we overview the classification, diagnostics and possible treatment options of anal pruritus. […] One of the crucial diagnostic goals is to differentiate between primary and secondary pruritus. […] In view of that, a thorough history and digital examination is of great importance. […] A thorough general physical examination may expose other sites of dermatological conditions, allergies and infections. Most of the focus during examination is drawn on the perianal region, however, the perineal and genital regions should not be forgotten as their inspection may indicate other, with pruritus-associated pathologies.

• #46 Anal Itching – Digestive Disorders – Merck Manual Consumer Version

  https://www.merckmanuals.com/home/digestive-disorders/anal-and-rectal-disorders/anal-itching

  Itching of the anus (the opening at the end of the digestive tract where stool leaves the body) and the skin around the anus (perianal skin) is called anal itching or pruritus ani. […] Most often, doctors do not identify a specific disorder as the cause of anal itching, and the itching goes away without treatment after a period of time. […] Once anal itching starts, an itch-scratch-itch cycle can begin, in which scratching causes more itching. […] In people with anal itching, certain symptoms and characteristics are cause for concern. […] People who have anal itching plus bloody diarrhea or draining pus should see a doctor as soon as possible. […] Doctors first ask questions about the person’s symptoms and medical history. […] The physical examination is focused on the appearance of the anus and the perianal skin.

• #47 Itchy Anus: Causes, Symptoms, and Diagnosis

  https://www.healthline.com/health/itchy-anus

  Anal itching, or pruritus ani, is a common symptom of a variety of conditions. A person may experience burning, itching, redness, or soreness in the anal area. Depending on the underlying cause, a doctor can prescribe an appropriate medication. […] Symptoms of an itchy anus are rarely a medical emergency. An exception is when you experience bleeding from your rectum. Bleeding may signal recurrent gastrointestinal bleeding. […] Make an appointment to see your doctor if your itching disrupts your daily life and is getting worse even after self-care treatments. […] If the itching is due to an infection, a doctor can prescribe an antifungal, antibacterial, or antiparasitic treatment to get rid of the infectious organisms. […] Hemorrhoids that cause anal itching may require more invasive treatments, such as banding to shrink the hemorrhoid or surgical removal of the hemorrhoid.

• #48 Evaluation, management and future perspectives of anal pruritus: a narrative review | European Journal of Medical Research | Full Text

  https://eurjmedres.biomedcentral.com/articles/10.1186/s40001-023-01018-5

  Anoscopy should be performed for all the patients with anal pruritus to identify commonly associated proctological diseases such as hemorrhoids, anal fistula or fissures as this would change the therapeutic approach later on. […] Unusual findings during digital rectal examination, sudden changes in bowel habits, long-standing inflammatory bowel disease and family history of adenomas or colorectal cancer should prompt the clinician to consider a colonoscopy. […] Although not widely used in clinical practice, several additional classification systems have been proposed by various authors. It can be acute or chronic (lasting over 6 weeks). […] Management of patients with anal pruritus may be challenging and long lasting. In cases when an exact etiology causing pruritus has been diagnosed, an intervention eliminating this factor usually is enough to resolve the symptoms.

• #49 Pruritus ani – Wikipedia

  https://en.wikipedia.org/wiki/Pruritus_ani

  Pruritus ani is the irritation of the skin at the exit of the rectum, known as the anus, causing the desire to scratch. The intensity of anal itching increases from moisture, pressure, and rubbing caused by clothing and sitting. At worst, anal itching causes intolerable discomfort that often is accompanied by burning and soreness. It is estimated that up to 5% of the population of the United States experiences this type of discomfort daily. […] Diagnosis is usually done with a careful examination of the anus and the patient’s history. If the presentation or physical findings are atypical, ie change in bowel habits or personal/family history of colorectal cancer/adenomas, a colonoscopy should be proposed. […] In case of long-lasting symptoms, above all in patients over 50 years of age, a colonoscopy is useful to rule out a colonic polyp or tumor, that can show pruritus ani as first symptom.

• #50

  https://journals.lww.com/wjcs/fulltext/2023/12030/anal_pruritus__diagnosis_and_management.1.aspx

  The treatment of pruritus ani is guided by the underlying etiology and past medical history with the goal of restoring a normal anoderm. A thorough history and physical examination can help rule out secondary causes. The underlying etiology of pruritus drives management. Biopsy should be performed in patients with refractory pruritus and an abnormal physical exam to ensure no secondary causes are missed.

• #51 Anal Pruritus | Colorectal Surgeons Sydney

  http://colorectalsurgeonssydney.com.au/conditions/anal-conditions/anal-pruritus

  Anal pruritus (also known as pruritus ani) is persistent itching of the skin around the anus. It affects 1- 5% of the population with men more often affected than women. Many present late due to severe embarrassment. It is important not to trivialise the symptoms of this debilitating condition. […] Regardless of cause, the problem is exacerbated by a self-escalating itch-scratch-itch cycle. […] Skin conditions such as dermatitis, psoriasis and lichen sclerosis have typical plaque appearance and also can irritate the anus and result in anal pruritus. These need to be considered in the differential diagnosis and usually respond to corticosteroid creams. Sometimes punch biopsy is required to get a definitive diagnosis. […] Anal cancer is uncommon, as are precancerous lesions (Bowens and Pagets disease). However, when present, they may first present as a perianal itch. It is therefore important for your colorectal surgeon to examine the area, and on occasions a biopsy of any suspicious area may be needed to exclude anal cancer.

• #52 Pruritus Ani (Anal Itching) – Gastrointestinal Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/gastrointestinal-disorders/anorectal-disorders/pruritus-ani-anal-itching

  The perianal skin tends to itch, which can result from numerous causes. This condition is also known as pruritus ani. Occasionally, the irritation is misinterpreted by the patient as pain, so other causes of perianal pain (eg, abscess or cancer) should be ruled out. […] Most anal itching is idiopathic (the majority) or hygiene-related. […] Once itching occurs, resulting from any cause, an itch-scratch-itch cycle can begin, in which scratching begets more itching. […] Hygiene issues, use of topical agents, and local disorders (eg, candidal infection, hemorrhoids) are usually apparent by history and examination. […] In adults with acute itching without obvious cause, ingested substances should be considered; a trial of eliminating these substances from the diet may be useful. […] For many patients, a trial of empiric, nonspecific therapy is appropriate unless particular findings are noted.

• #53 Pruritus Ani (Anal Itching) – Gastrointestinal Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/gastrointestinal-disorders/anorectal-disorders/pruritus-ani-anal-itching

  Although most cases are idiopathic, rule out infectious, neoplastic, and other treatable causes. […] Pinworms in children and hygiene-related issues in adults are common causes. […] Foods and detergents or soaps can cause anal itching. […] Practicing appropriate, nonirritating hygiene (ie, not too little but not too vigorous, avoiding strong soaps and chemicals) and decreasing local moisture can help alleviate symptoms.

• #54 Itchy Anus STD: Causes, Symptoms, Treatment

  https://www.verywellhealth.com/itchy-anus-std-5443108

  STIs can cause anal itching. It is a common symptom of several STIs like herpes, gonorrhea, warts, and crabs. […] Diagnosing STIs can be done in a few different ways. For some STIs, a healthcare provider can diagnose the infection based on its appearance and the patient’s health history. Other ways to diagnose an STI can include: blood test, swab, e.g., of the vagina or urethra, urine test. […] It’s so important to get an STI diagnosis as soon as possible to prevent complications from the condition. […] Yes, anal itching is a common symptom of STIs. It is a symptom of gonorrhea, anal herpes, anal warts, and crabs. However, anal itching is also a symptom of several other conditions not related to STIs. Always talk to a healthcare provider to get the correct diagnosis.

• #55

  https://www.healthychildren.org/English/health-issues/conditions/skin/Pages/Anal-Itching-in-Young-Children.aspx

  Have you noticed your little one scratching their bottom? Anal itching (pruritus ani) is common among children. This uncomfortable condition can have a variety of causes. Thankfully, most of these causes are easily treatable. […] How are pinworms diagnosed in children? The information you share about how your child is feeling and behaving can help the doctor diagnose pinworms. Sometimes, pinworms can be seen on the perianal skin around 2-3 hours after the child falls asleep. The pinworms look like a moving white thread that is around inch long. Stool tests are not useful as worms and eggs are not typically passed in stool. […] Perianal strep is diagnosed with a skin swab that is sent to the lab, similar to how strep throat is diagnosed. This test can be done by any medical provider. […] The best way to help skin irritation around the anus is to prevent it from happening in the first place. Avoid children’s products that contain fragrance, like bubble bath and scented soaps. Small children should also get help to wipe the area clean after toileting.

• #56

  https://www.healthychildren.org/English/health-issues/conditions/skin/Pages/Anal-Itching-in-Young-Children.aspx

  Have you noticed your little one scratching their bottom? Anal itching (pruritus ani) is common among children. This uncomfortable condition can have a variety of causes. Thankfully, most of these causes are easily treatable. […] How are pinworms diagnosed in children? The information you share about how your child is feeling and behaving can help the doctor diagnose pinworms. Sometimes, pinworms can be seen on the perianal skin around 2-3 hours after the child falls asleep. The pinworms look like a moving white thread that is around inch long. Stool tests are not useful as worms and eggs are not typically passed in stool. […] Perianal strep is diagnosed with a skin swab that is sent to the lab, similar to how strep throat is diagnosed. This test can be done by any medical provider. […] The best way to help skin irritation around the anus is to prevent it from happening in the first place. Avoid children’s products that contain fragrance, like bubble bath and scented soaps. Small children should also get help to wipe the area clean after toileting.

• #57 Symptom Management

  https://crohnsandcolitis.ca/About-Crohn-s-Colitis/IBD-Journey/Symptom-Management/Anal-Itching-and-Irritation

  Diarrhea is a common symptom of IBD and it may lead to irritated or itchy skin around the anus. […] Keeping the skin clean and dry is the best way to minimize sore skin: […] If you are still experiencing discomfort, talk to your IBD team to see what other products can help heal your sore skin. Treatment options may include: […] Topical medications for anal irritation and itching include topical steroid creams or ointments, applied two or three times a day to the affected area for short periods of time. An alternative is topical capsaicin cream. […] Sometimes people with IBD can develop anal fissures, which are small painful tears or sores in the lining of the anus.

• #58 Symptom Management

  https://crohnsandcolitis.ca/About-Crohn-s-Colitis/IBD-Journey/Symptom-Management/Anal-Itching-and-Irritation

  Diarrhea is a common symptom of IBD and it may lead to irritated or itchy skin around the anus. […] Keeping the skin clean and dry is the best way to minimize sore skin: […] If you are still experiencing discomfort, talk to your IBD team to see what other products can help heal your sore skin. Treatment options may include: […] Topical medications for anal irritation and itching include topical steroid creams or ointments, applied two or three times a day to the affected area for short periods of time. An alternative is topical capsaicin cream. […] Sometimes people with IBD can develop anal fissures, which are small painful tears or sores in the lining of the anus.

• #59 Anal Itching: Causes and Treatments – Hemorrhoid Centers of America

  https://hemorrhoidcentersamerica.com/anal-rectal-problems/anal-itching/

  The most common cause of occasional anal itching (pruritus ani) is a fungus/yeast infection. Enlarged hemorrhoids cause the leakage of moisture, stool, and fungus. Repeated wiping, cleaning, scratching, and the use of harsh cleaners make the itching worse. It is frequently worse at night. […] There are many other possible causes of rectal itching. It may be due to poor hygiene, leakage of stool and mucous, diarrhea, over cleaning, prolapsed hemorrhoids, inflamed internal hemorrhoids, skin tags, anal fissure, anal fistula, age related dry skin, Crohns disease, rectal warts, pinworms, rectal fistula, psoriasis, eczema, seborrhea, lichen planus, scabies, STDs, anal cancer, viral warts (HPV), sweating, erythrasma, contact dermatitis, neurodermatitis, amebiasis, or proctitis. Diabetes mellitus increases infections and itching and liver failure can cause itching. Anxiety or stress may cause itching.

• #60 Anal itching – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/anal-itching/diagnosis-treatment/drc-20369350

  Your health care provider may be able to diagnose the cause of your itching by asking about your symptoms, medical history and personal habits. You may need a physical exam, including a rectal exam. You might have a test for pinworms if a pinworm infection is suspected. […] If the cause of your itching isn’t obvious or your itching doesn’t respond to treatment, your health care provider may refer you to a specialist in skin conditions. This type of doctor is called a dermatologist. In many cases, the cause of the itching isn’t known, but the symptoms can be treated. […] Most people won’t need to see a health care provider about anal itching. But if the itching doesn’t stop even after taking self-care measures, seek help. Your care provider may refer you to a skin doctor called a dermatologist, or to a doctor who specializes in treating rectal and anal problems. This type of doctor is called a proctologist.

• #61 Anal Itching (Pruritus Ani): Causes, Treatment, Home Remedies

  https://my.clevelandclinic.org/health/diseases/15574-anal-itching-pruritus-ani

  Anal itching (pruritus ani) is a skin condition that affects your perianal area, which may become worse at night or after a bowel movement. […] Anal itching usually causes an uncontrollable urge to scratch your anus. However, scratching doesn’t provide long-lasting relief. […] Your healthcare provider will perform a physical examination to identify possible causes of your itchy anus, such as dermatological conditions or illnesses. They’ll visually inspect your perianal area and note any changes in skin color, skin texture, rashes or lesions. […] If your healthcare provider can’t determine the cause of your itchy anus, or if you don’t respond to treatment, they may refer you to a dermatologist. […] Treatment for an itchy anus usually first focuses on establishing good anal hygiene. Thoroughly clean your anus after pooping, dry the area and apply nonmedicated talcum powder. […] If you have secondary pruritis ani, your treatment depends on the specific cause. […] Call your healthcare provider if your itchy anus doesn’t improve with treatment, your itching gets worse after treatment or the area looks infected (discolored skin, irritation or swelling).

• #62 Anal Itching – Digestive Disorders – Merck Manual Consumer Version

  https://www.merckmanuals.com/home/digestive-disorders/anal-and-rectal-disorders/anal-itching

  Itching of the anus (the opening at the end of the digestive tract where stool leaves the body) and the skin around the anus (perianal skin) is called anal itching or pruritus ani. […] Most often, doctors do not identify a specific disorder as the cause of anal itching, and the itching goes away without treatment after a period of time. […] Once anal itching starts, an itch-scratch-itch cycle can begin, in which scratching causes more itching. […] In people with anal itching, certain symptoms and characteristics are cause for concern. […] People who have anal itching plus bloody diarrhea or draining pus should see a doctor as soon as possible. […] Doctors first ask questions about the person’s symptoms and medical history. […] The physical examination is focused on the appearance of the anus and the perianal skin.

• #63 Itchy anus (pruritus ani) | healthdirect

  https://www.healthdirect.gov.au/itchy-anus

  An itchy anus, also known as pruritus ani is characterised by a constant urge to scratch the anus causing distress. […] A doctor can diagnose you with pruritus ani by doing a physical examination. […] Despite taking these measures, its important to see your doctor if: you have any anal bleeding, the area seems to be infected, you dont know whats causing the itch, the itch is intense, the itch lasts longer than 2 months. […] Your doctor can check that rare and specific causes of itchy anus (such as worms and anal cancer) arent overlooked. They can prescribe treatments for the cause of the itch, and can also give you advice to manage your symptoms, so you are less likely to scratch. […] As with all general health issues, the best place to start is by seeing your GP. Depending on your symptoms and any other co-existing health conditions, your doctor may refer you to a dermatologist (skin specialist) who will examine your body. They will check if your itchy anus is caused by a skin condition.

• #64 Anal itching – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/anal-itching/diagnosis-treatment/drc-20369350

  Your health care provider may be able to diagnose the cause of your itching by asking about your symptoms, medical history and personal habits. You may need a physical exam, including a rectal exam. You might have a test for pinworms if a pinworm infection is suspected. […] If the cause of your itching isn’t obvious or your itching doesn’t respond to treatment, your health care provider may refer you to a specialist in skin conditions. This type of doctor is called a dermatologist. In many cases, the cause of the itching isn’t known, but the symptoms can be treated. […] Most people won’t need to see a health care provider about anal itching. But if the itching doesn’t stop even after taking self-care measures, seek help. Your care provider may refer you to a skin doctor called a dermatologist, or to a doctor who specializes in treating rectal and anal problems. This type of doctor is called a proctologist.

• #65 Anal Itching: Causes, Symptoms, Diagnosis and Treatment

  https://www.prepladder.com/neet-pg-study-material/surgery/anal-itching-causes-symptoms-diagnosis-and-treatment

  Anal itching is also referred to as pruritus, and it can have several reasons. […] If the cause of your itching is unknown or if treatment doesn’t seem to be helping, your doctor might advise you to consult a specialist in skin conditions. […] By asking about your lifestyle, medical history, and symptoms, your doctor may be able to identify the cause of your itching. A medical examination might be required, which could involve a rectal examination. […] The specific cause of your secondary pruritis ani will dictate the course of treatment for you. […] Your physician may suggest antibiotics or antifungal medications if they believe that an infection is the source of your itchy anus. […] If your body doesn’t respond to other treatments, your doctor may administer an injection of methylene blue to relieve your itchy anus.

• #66 Pruritus Ani

  https://pmc.ncbi.nlm.nih.gov/articles/PMC2647235/

  Pruritus ani is a common condition with many causes, predominately anorectal pathology. There are some new insights and therapies, but the most recommendations are based on low-level evidence. […] A review of the evidence is presented and a management plan based on the elimination of irritants and scratching, general control measures and active treatment measures is offered. […] Treatment of primary and secondary pruritus ani has a good prospect of regression of symptoms and skin changes. […] Pruritus ani is defined as intense chronic itching affecting peri-anal skin. It affects 15% of the population, is four times more common in men and is most frequent between the fourth and sixth decades of life. […] The goal of treatment is asymptomatic, intact, dry, clean peri-anal skin with reversal of morphological changes. The aim of this review is to provide a systematic method of diagnosis and management of pruritus ani.

• #67 Itchy Bottom (Pruritus Ani): Causes and Treatment

  https://patient.info/skin-conditions/itchy-bottom-pruritus-ani

  If the itch is persistent and you are not sure of the cause, it is best to see a doctor. As there are a number of possible causes (listed above), it is best to be examined and checked out by a doctor to diagnose or rule out known causes. Treatment depends on the cause. […] If a cause for the itchy bottom (pruritus ani) can be identified, it is easier to treat and relieve your symptoms. Most people respond well to treatment for an itchy bottom. However, in some people it can become a persistent (chronic) problem. Also, if you have had an itchy bottom in the past, you are more likely to develop it again at some point in the future.

• #68 Pruritus Ani

  https://pmc.ncbi.nlm.nih.gov/articles/PMC2647235/

  Systemic antihistamines may reduce nocturnal scratching; however, as this is probably a marker of anal seepage, the patient should be advised to wash the area immediately and apply a barrier cream. […] Pruritus ani has many causes mostly dermatological or anorectal, treatment of which results in regression of symptoms and skin changes. If after a rigorous history, examination and investigations a cause cannot be found, pruritus ani is described as idiopathic. These patients can still be managed with great success with the elimination of irritants and scratching, general control measures and active treatment measures.

• #69 Evaluation, management and future perspectives of anal pruritus: a narrative review | European Journal of Medical Research | Full Text

  https://eurjmedres.biomedcentral.com/articles/10.1186/s40001-023-01018-5

  For idiopathic pruritus and some of the inflammatory dermatoses escalating treatment tactic is recommended. […] This generic management for idiopathic pruritus ani is effective in more than 90% of patients. […] Emollients and barrier creams are key to pruritus treatment and should be used after cleansing. […] Although initial results of these novel treatment agents are promising, further research is warranted to determine their safety and effectiveness for treating idiopathic anal pruritus.

• #70

  https://link.springer.com/article/10.1007/s43472-024-00130-z

  Treatment should be directed through whatever causing factor that has been identified. […] Treatment strategies must often be escalated until a good regimen is found, which can be a long road for the patient and the clinician. […] Anal pruritus is a common source of proctological consultations, and the appropriate management depends on the identification of a potential secondary cause through rigorous history taking, physical examination and directed complementary investigations.

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