An ESCP Guide for Patients
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What is pruritus ani?
Pruritus ani is the medical term for itching around the anus. This can be mild or very intense and may affect your comfort during daily activities or sleep.
Symptoms of pruritus ani
- Itching: a strong urge to scratch, which may be worse at night
- Irritation: scratching can cause redness, swelling, or soreness
- Discomfort: you might feel burning, pain, or rawness, especially if the skin becomes damaged.
Common causes of pruritus ani
Pruritus ani has many possible causes. Common ones include:
- Hygiene
- Too little cleaning can leave behind stool or sweat, which irritates the skin.
- Too much cleaning (especially with soap or wipes) can dry or damage the skin.
- Food and drink: Certain foods may trigger itching, such as:
- Coffee, tea, spicy foods
- Chocolate, dairy, tomatoes
- Fizzy drinks and alcohol
- Anal conditions
- Haemorrhoids (piles): swollen veins in or around the anus that can itch or bleed
- Anal fissures: small tears in the skin
- Skin tags: harmless growths that can trap moisture and irritate
- Infections
- Fungal or bacterial infections
- Sexually transmitted infections (STIs)
- Skin sensitivities
- Allergies or reactions to soaps, creams, toilet paper, or laundry detergent
Lifestyle tips for prevention
Treatment options for pruritus ani
Treatment depends on the cause, and any underlying conditions should be properly treated. Generally, treatment includes a combination of lifestyle changes and medications.
Diet and lifestyle modifications
Making adjustments to daily habits can significantly improve symptoms and prevent further irritation. Here are some tips:
- Clean gently
- Wash with water or a mild, unscented cleanser after bowel movements
- Avoid scrubbing - pat the area dry gently
- Avoid irritants
- Use fragrance-free soap, toilet paper, and laundry detergent
- Wear loose-fitting, cotton underwear to reduce moisture and friction
- Keep the area dry
- Use a soft cloth or a hairdryer on a cool setting
- Consider talc-free powders or zinc oxide cream to protect the skin
- Change out of damp or sweaty clothing as soon as possible
- Don’t scratch
- Scratching makes it worse and can cause infection
- Wearing cotton gloves at night may help prevent scratching while you sleep
- Manage bowel habits
- Eat high-fibre foods (fruits, vegetables, whole grains) and drink enough water to avoid constipation and straining
- Use soft toilet paper or rinse instead of wiping harshly
Medication
When lifestyle changes alone are not enough, medications may be recommended by your doctor to help relieve symptoms.
- Topical creams
- Hydrocortisone (1%) for short-term itch relief
- Antifungal cream if a yeast infection is suspected
- Barrier creams like zinc oxide or petroleum jelly to protect the skin
- Oral medications
- Antihistamines (like cetirizine or loratadine) for night-time itching
- Stool softeners if constipation is making things worse
When to see a doctor
See your doctor if:
- Symptoms don’t improve after 2-3 weeks of self-care
- Symptoms get worse over time
A specialist, such as a colorectal surgeon, can check for underlying causes and offer specific treatment.
If you have any questions, speak with your doctor or colorectal surgeon for personalised advice.
Disclaimer
The information provided here is general and with hopes to correctly inform the patient to the extent possible. However, this document cannot discuss all aspects of a specific surgical procedure or of the individual patient.
The decision on which procedure will give you the best result is made by your doctor or colorectal surgeon during consultation and based on shared and informed decision-making with the patient.