Causative and risk factors
Itching at the anus can be due to hemorrhoids, warts or worm infestations. It can also result due to irritant dermatitis as a result of perfumes or chemicals coming in contact with the anal region. Recurrent diarrhea or excessive sweating in the anal region can also give rise to anal itching. Certain food products can cause anal itching esp. peppers, coffee etc or skin diseases such as psoriasis or eczema affecting the anal region can lead to itching. Rarely, cancer of the anus can cause itching
Clinical presentation
Itching in or around the anal region is the primary symptom. Occasionally the patient may experience other symptoms depending upon the cause of anal itching. These include pain, soreness or burning at the anus, constipation or bleeding per rectum. Occasionally a lump or tumor may be present in the anal region.
Diagnosis & Investigations
The diagnosis of the cause of anal itching is made by means of physical examination as well as investigations. On physical examination, your doctor will look for fissure around the anus, prolapsed hemorrhoids, lump or tumor at the anal region and skin changes suggestive of psoriasis or eczema. A per rectal exam will be carried out if deemed necessary. Your doctor may occasionally carry out a proctoscopy i.e. an endoscopic examination of the rectum.
Treatment
The choice of treatment will be determined on the basis of cause of the anal itching. Certain lifestyle changes help to reduce anal itching. Wear loose fitting underwear made of natural fabrics. Do not eat any foods that you have found to exacerbate your anal itching. Resist the urge to scratch. Always keep your anal region dry.
Medications: Topical creams containing hydrocortisone or zinc oxide are recommended. Anti histaminic drugs are prescribed to relieve the excessive itching. Anti helminthic drugs are given in cases of worms.
Minor surgical procedures may be necessary in patients with anal warts or grade 3 hemorrhoids.
