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Q: Anal Itch ( Answered 5 out of 5 stars,   3 Comments )
Subject: Anal Itch
Category: Health > Conditions and Diseases
Asked by: palmquasi-ga
List Price: $15.00
Posted: 28 Jun 2006 12:44 PDT
Expires: 28 Jul 2006 12:44 PDT
Question ID: 741811
I've been having these symptoms for several years now:
* Anal itching -- less than daily sometimes.  It is most severe at
night and in the afternoon.  The itchiness is around the anus (at max
an inch or two away) and just inside the anus, but is very very
* Painful bowel movements.  Sometimes my bowel movements are fine,
other times they are very painful.  I haven't really noticed a
correlation with the itching, but I wouldn't rule it out either.  If
this makes any sense, the pain doesn't come until the bowel starts to
move out of my body; in other words, the pain isn't up inside me, it's
on the exterior, or right near it.  Sometimes wiping is painful too --
but at times of great itchiness it actually feels like a relief.
* Bleeding.  Bright red blood in my bowels sometimes.  (It's not dark
so I hear that means it's not coming from my intestines.)  Not a lot,
just a bit.  Not consistently, but enough to be noticed.  Maybe
happens once a month (much less frequent than the other issues).

So I have had this problem off and on for about 5 years now.  I've
talked to two doctors about it.  I've had a colonoscopy to see if the
issues I have were caused by problems higher up (cancer or polyps). 
They were not, things in my intestine looked fine.  No polyps, no
cancer, no issues at all "upstairs."  They also looked around the anus
and while they see redness and irritation, they didn't see
hemorrhoids.  Furthermore, I've tried hemorrhoid medication and it
didn't help.

So, things that this probably isn't:
* Cancer
* Polyps
* Anything above the anus
* Hemorrhoids (although this still may be the issue, i dunno)

Things that I've tried that haven't helped:
* Fungicide
* Moisturiser
* Not itching (although it's very hard to control while sleeping)
* Vaseline
* Anti-Itch (Hydrocodizone or whatever it's called)
* Doing nothing (I've tried this most of the time -- the things listed
above were tried for a week or two each for this problem that has
lasted for years so this isn't a case of skin irritation caused by
doing the things above.)

Background Info:
I'm 27, in good health, not overweight (over 6 feet and 180 lbs) get
daily exercise (walk 5+ miles a week), and take no special meds.  I
work at a computer, so i do spend a fair amount of time sitting --
probably 10 hours a day.  I'm gay, but I haven't had anal sex since
long before this showed up, and I've been with a single partner all
the while (he has no such issues).

Specific questions:
* What might this be?
* How can it be fixed?
* What type of doctor can fix this?

I moved last year and I'm dreading having another doctor look at my
bum and getting nowhere yet again...  I need some fresh ideas about
how i can fix this.
Subject: Re: Anal Itch
Answered By: crabcakes-ga on 28 Jun 2006 18:09 PDT
Rated:5 out of 5 stars
Hello Palmuasi,

   First, let me say that we at Google Answers are unable to diagnose
your problem, and that the information contained in this answer is for
informational purposes only, and not to be considered a diagnosis.

Because there are numerous causes of pruritus ani (anal itching), I
will start with some you have not mentioned. My first thought was a
food allergy or reaction. As you will see further down, some foods,
particularly fruits, beer, citrus fruit, caffeinated drinks, nuts and
popcorn, can cause this condition in some people.

Have you changed detergents to see if that may be irritating the skin
around the anus? Try washing your clothes and linens in Ivory Snow or
a mild detergent free of coloring and scenting agents. If you use
fabric softener, try discontinuing it?s use for a few weeks and see if
it makes a difference.

Even though you are an adult, have you been in close contact with
children, as in working in a school or day care? Pinworms are
notorious for causing anal itching. Your doctor can provide you with a
plastic paddle for collecting a specimen at night (when they come
?out?!!). A common blood test, a CBC and diff, would likely show an
elevated eosinophil count if you happened to have pinworms.

?Numerous factors may cause anal itching to be more intense ?
including moisture, the abrasion caused by your clothing, and the
pressure of sitting. Symptoms may be worse at night or right after a
bowel movement.
Anal itching is a common problem that many people have experienced.
Don't be afraid to talk with your doctor about this condition. With
proper treatment and self-care measures, most people can achieve
complete relief from anal itching.

?Dry skin. As you age, skin in and around your anus is more prone to
dryness. Dry skin can cause persistent, intense anal itching.
?Too much moisture. Moisture around your anus from excessive sweating
or from moist, sticky stools can be irritating. Anal itching can also
be caused by frequent diarrhea or the escape of small amounts of stool
(fecal incontinence).
?Excessive washing. Excessive wiping with dry, harsh toilet paper or
excessive scrubbing with harsh soaps can cause or aggravate anal
itching. Failure to rinse away the soap completely also may cause
?Chemical irritants. Certain laundry soaps, colognes, douches and
birth control products contain chemicals that can irritate skin in and
around your anus. Scented or colored toilet paper can be irritating to
people with sensitive skin.
?Food irritants. Anal itching may be the result of irritating
chemicals in some foods, such as those found in spices and hot sauces.
Similarly, some foods may directly or indirectly irritate your anus as
they exit your colon. Common culprits include chocolate, fruits,
tomatoes, nuts and popcorn. Consuming certain beverages, including
milk or caffeinated drinks, may cause some people to experience
diarrhea followed by anal itching.
?Medications. Anal itching may be a side effect of certain
medications, including some antibiotics, that can cause frequent
?Overuse of laxatives. Excessive or improper use of laxatives can lead
to chronic diarrhea and the risk of anal irritation and itching.
?Hemorrhoids. Hemorrhoids are engorged veins located just under the
membrane that lines the lowest part of your rectum and anus. They
often occur as a result of straining during a bowel movement. Anal
itching can be a symptom of hemorrhoids. However, most hemorrhoids
don't itch.

?Infections. Sexually transmitted diseases may also involve the anus
and can cause anal itching. In children, the parasite that causes
pinworms can cause persistent anal itching. Other parasites may cause
similar itching.
?Skin disorders. Common skin problems ? such as psoriasis, seborrhea
and eczema ? can involve and irritate the area in and around your
?Yeast infections. This common infection, which usually affects women,
can irritate your genital and anal areas.
?Anal abrasions and fissures. An anal abrasion is a small tear in your
anus, usually caused by forced bowel movements through a tight anus.
An anal fissure is a deeper tear. Both conditions can cause anal
itching, as well as painful bowel movements and bleeding.
?Anal tumors. Rarely, benign or cancerous tumors in or around the anus
may be a cause of anal itching.
?Other causes. Anal itching may be related to anxiety or stress.
Sometimes, the cause remains undetermined.

?Anal itching can be caused by irritating chemicals in the foods we
eat, such as are found in spices, hot sauces, and peppers. It also can
be caused by the irritation of frequent liquid stools, diarrhea, or
escape of small amounts of stool (incontinence). Diseases that
increase the possibility of yeast infections, such as diabetes
mellitus or HIV infection, as well as treatment with antibiotics can
lead to a yeast infection and irritation of the anus. Psoriasis also
can irritate the anus. Abnormal passageways (fistulas) from the small
intestine or colon to the skin surrounding the anus can form as a
result of disease (such as Crohn's disease), and these fistulas bring
irritating fluids to the anal area. Other problems that can cause anal
itching include pinworms, hemorrhoids, tears of the anal skin
(fissures), and skin tags (abnormal local growth of anal skin).?

Many over-the-counter products are sold for the treatment of anal
itching. These often contain the same drugs that are used for treating
hemorrhoids. Products used for the treatment of anal itching are
available as ointments, creams, gels, suppositories, foams, and pads.
Ointments, creams, and gels--when used around the anus--should be
applied as a thin covering. When applied to the anal canal, these
products should be inserted with a finger or a "pile pipe." Pile pipes
are most efficient when they have holes on the sides as well as at the
end. Pile pipes should be lubricated with ointment prior to insertion.
Suppositories or foams do not have advantages over ointments, creams,
and gels.?

This page has numerous suggestions for treating the itch. Whichever
?remedy?  you try, be sure to follow the directions, and don?t
discontinue treatment too early. Make sure the skin is clean and dry
before applying any cream or ointment.

This is intended for children, but includes some good ideas!
?Have your child change his underwear several times a day. ''For a
persistent itch, change your child's underpants frequently (three or
four times a day), and don't let your child wear them to bed,'' he

Take a powder. ''A cornstarch powder may be helpful for keeping the
anal area dry,'' says Dr. Fleiss. When you apply it to the child, be
sure to shake the powder into your hand and then spread it on his
bottom. Don't shake it all over, because it could be irritating if

Always come clean. ''Itching could be due to the child's not cleaning
himself well,'' says Dr. Fleiss. So teach your child to wipe himself
properly. ''Dry toilet paper cannot get the anal area completely
clean,'' he points out. But some children can easily learn to clean
themselves with moistened toilet paper.
''Show your child how to wet the toilet paper and use it after each
bowel movement,'' Dr. Fleiss suggests. ''It's a good idea to bathe
after a bowel movement. Or have a supply of moistened wipes near the
toilet for him to use,'' he says. Afterward, he should use dry toilet
paper to finish wiping.
Serve fiber-rich foods. Hemorrhoids are rarely the cause of anal
itching in children. But if your child has been diagnosed with a case
of these bulging veins, it's time for some diet changes.

''Be sure your child eats more high-fiber foods such as vegetables,
fruits and whole grains and cuts down on low-fiber items such as cake,
candy, cookies and potato chips,'' says Dr. Fleiss. ''A low-fiber diet
can cause constipation. When a constipated child strains to have a
bowel movement, that can result in hemorrhoids or aggravate those
already there.'' When increasing dietary fiber, it's also important to
see that your child drinks more water and eats more fruits and
vegetables, he says.

Sitz 'em down. In a bathtub, dissolve three to four tablespoons of
baking soda in a couple of inches of warm water and have your child
sit in it for 15 minutes or so, suggests Howard Jeffrey Reinstein,
M.D., a pediatrician in Encino, California, and clinical assistant
professor of pediatrics at the University of Southern California
School of Medicine, Children's Hospital of Los Angeles. ''Sitz baths
are very soothing to itchy bottoms, regardless of the cause,'' he

Add oatmeal where he sitz. For some extra relief, try putting one
packet of Aveeno Bath Treatment containing colloidal oatmeal, a finely
powdered form of oatmeal, into your child's bathwater. ''It's
especially soothing,'' says Dr. Reinstein.

Smooth on something soothing. Though it's mainly intended for insect
bites, Itch-X Gel is an over-the-counter anti-itching medication that
can be useful for anal itching, too, says Dr. Reinstein. It's for
external use only. He also suggests trying petroleum jelly ( Vaseline)
or a soothing over-the-counter ointment such as Desitin to coat and
protect the itchy area.?

?	Do take daily baths or showers;
?	Do wear cotton underwear;
?	Do wipe gently with toilet paper;
?	Don't scratch or rub the area.

?	Do wash the skin around the anus after passing faeces;
?	Do use damp toilet paper or baby wipes and pat dry with dry tissue
afterwards (or you can use a hairdryer) to clean thoroughly but
?	Do wear loose clothing and underwear;
?	Do try placing a small piece of cotton wool at the opening of your
anus to prevent minor soiling;
?	Don't use scented toilet paper, in case you are allergic to it.
?	Don't use scented soap, medicated, perfumed or deodorant talcum
powders, or cleansing pads that contain alcohol or lanolin, which can
increase irritation.

Hemorrhoids can also cause itching.

?In the anal canal, the hemorrhoid is exposed to the trauma of passing
stool, particularly hard stools associated with constipation. The
trauma can cause bleeding and sometimes pain when stool passes. The
rectal lining that has been pulled down secretes mucus and moistens
the anus and the surrounding skin. Stool also can leak onto the anal
skin. The presence of stool and constant moisture can lead to anal
itchiness (pruritus ani), though itchiness is not a common symptom of

You say you tried a fungicide, but before you try anything, I?d
recommend asking the doctor to do a simple skin scraping to see if you
have some form of yeast. If so, then s/he can prescribe an appropriate
treatment. Yeasts can be tenacious, and you must finish any prescribed
treatment to eradicate any fungus among us!

Consider getting up and walking around for a few minutes for each hour
you sit at the PC. You need a good blood supply, even to the nether
regions! Try sitting on a doughnut cushion to relieve pressure. Here
is one type:

I hope this helps you some! There is more information on each link
provided, so be sure to check each one. If any part of my answer is
unclear, please request an Answer Clarification, and allow me to
respond, before you rate.

Good luck!
Sincerely, Crabcakes

Search Terms
pruritus ani + causes
anal itching
doughnut cushion
pruritus ani + foods
palmquasi-ga rated this answer:5 out of 5 stars
Great answer.  You touched on a few things I had heard of before, but
have quite a few new ideas for me to try and/or talk to my dr. about. 

Subject: Re: Anal Itch
From: apoptosiss-ga on 28 Jun 2006 18:21 PDT
Wow, very thorough answer!

But I think the bright red blood in stool may be a sign of upper GI
problem, please consult a physician for LFTs and Hemoglobin levels!!
Subject: Re: Anal Itch
From: crabcakes-ga on 13 Jul 2006 08:55 PDT
Actually, the comment left by apoptosis-ga is in error. Bright red
blood in the stool does not indicate upper GI problems. Bright red
blood indicates a bleed from the lower GI, and liver function tests
(LFTs) would be worthless. By the way, a hemoglobin would be useful,
and it is included in the CBC that I mentioned in the fourth paragraph
of my answer.

Regards, Crabcakes
Subject: Re: Anal Itch
From: summer1885-ga on 19 Jul 2006 23:22 PDT
Hi There,
Sorry you have been experiencing this discomfort for so long.  By
reading your description of your symptoms, I strongly believe that you
have a chronic anal fissure.  A gastroenterologist should be able to
properly diagnose this by a quick simple exam.  Nothing invasive, just
a quick peek at the bum area and he should be able to see it right
away.  Anal fissures are frustrating!  There is no specific cure and
recovery may take quite awhile because the tear that you have is
constantly being aggravated by involuntary spasming muscles in that
area that you can't control.  Your doctor may prescribe a calcium
channel blocker that will help that muscle stay at ease, which you
would apply (cream consistency) probably 3 times a day, especially
after rough times in the bathroom.  This solution isn't 100% recovery
guaranteed, but probably the first thing your doctor will recommend,
anal fissures are very annoying but more common than you think, just
many people don't like to talk about them.. Let me know if you need
anymore help!! Try googling: anal fissure

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