Pruritus ani is a Latin phrase meaning "itchy anus." It is an unpleasant sensation resulting in a strong urge to scratch the anal area.
While there are several potential causes of pruritus ani, one of the more common causes is excessive moisture in the anal area. Moisture can come from perspiration or a small amount of residual stool or mucus. Pruritus ani may be a symptom of other common anal conditions such as hemorrhoids, anal fissures (painful clefts or grooves), or anal fistulas (abnormal passageways between the bowel and an organ or skin surface). The initial condition may be made worse by repeated scratching.
In some individuals, pruritus ani may be caused by eating certain food products, smoking, and drinking alcoholic beverages, especially beer and wine. Food and beverage items that have been associated with pruritus ani include:
While stool on the perianal skin has been shown to cause itching, inadequate hygiene is seldom the cause of pruritus ani. More often, the natural tendency of a patient with significant itching is to wash the area vigorously and frequently with soap and a washcloth. Soaps and lotions and scents can be irritating, and the trauma to the anal skin from aggressive cleaning can destroy natural barriers and make the problem worse.
A careful examination by a colon and rectal surgeon may identify a cause for your itching. The physician can recommend treatment to eliminate the specific problem if one is found. Many times, however, no specific problem is found to be causing the symptoms of itching and burning. In this case, the problem is referred to as “idiopathic" (from unknown cause).
Treatment of pruritus ani involves the following principles:
Most people experience some relief from itching within a week. If symptoms do not resolve after 6 weeks, a follow-up appointment with your colon and rectal surgeon may be needed. Recurrent symptoms are not uncommon and patients may need to make long-term lifestyle changes to remain symptom-free.