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Doctors’ Answers to “Frequently Asked Questions” – Pruritus Ani

These comments are made for the purpose of discussion and should NOT be used as recommendations for or against therapies or other treatments. An individual patient is always advised to consult their own physician.

Pruritus Ani [posted 7/23/98]

Question: I have been a patient of pruritus ani for the last year. I have consulted a

skin specialist. I have also visited a surgeon, but there was no relief.

My brief history as follows: Age: 24 years, sex: male, occupation: medical student.

It started as a mild itching, especially after defecation, but I

didn’t take it seriously until 4 months back when I consulted a skin

specialist and he game me some anti-fungal, but there was no relief. The

cream name was travogen containing ketoconazole. I have also tried a

triple regimen containing gemtamicin-nystatin and some other

antibiotic for one month. I have no history of alcohol, smoking or any other ill habit.

On examination by the surgeon there was no Hemorrhoids or any Polyp. There was no complaint of mucus. I

keep it dry all the day my sleep was not disturbed and my bowel habits

are normal, but I did not go for fungal scraping test. Please kindly

advise me some treatment

Answer: Pruritus Ani can be incredibly difficult to treat. You have had the usual starting treatments. You might try eliminating all tomato products, especially sauces from your diet. Eliminate any alcohol at all. Lastly, use a product like Tucks which is witch hazel to cleanse your anus post defecation. Diet is usually the culprit which can be changed.

Pruritus Ani

Question: What are the causes and treatments for Pruritus Ani?

Answer: There are several causes of pruritus ani. About 80% of the time the cause is not found.

Possible causes are: 1) Different foods implicated in pruritus ani including: alcohol (especially

beer), cola, coffee, spices (especially ketchup and pizza sauce), tea, and milk. 2) Drugs including

colchicine and laxatives. 3) Fungal infections. 4) Parasitic infections including pinworm and scabies. 5) Rectal prolapse and hemorrhoids.

Treatment centers on using Sitz baths several times a day with warm to luke-warm water.

Good anal hygiene with post BM cleansing with Tucks, baby wipes or glycerine coated

cotton swabs is recommended. Clean the anal area once a day, minimizing the rubbing and follow with bath or mineral oil to the anal area. Use cotton (not nylon) underwear and avoid

sitting for long periods of time.