[49F] Experiencing anal itching

Patient Description

A 49-year-old female reports experiencing anal itching for approximately 3 months. The itching typically occurs after using the bathroom or changing clothes. She has attempted to alleviate the symptoms with lotions, Epsom salt baths, and medicated pads without significant relief. The patient has allergies to Bactrim and Vancomycin but is not currently on any medications. No other symptoms were reported, and the patient does not have a history of chronic illnesses or conditions.

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Arora's Assessment

What might be happening

Based on the information you've provided, possible causes of your anal itching include:

  • Hemorrhoids: These are swollen blood vessels in the rectum or anus that can be itchy, uncomfortable and difficult to treat. They're often caused by straining during bowel movements, obesity or pregnancy.

    • Treatment typically involves over-the-counter creams or ointments, warm baths, and increasing fiber in your diet.
  • Pinworms: These are tiny, thin, white worms that can live in the colon and rectum of humans. They're most common in children, but adults can get them too. The main symptom is itching in the anal area, particularly at night.

    • Treatment usually involves medication to kill the worms.
  • Anal Fissures: These are small tears in the lining of the anus, often caused by constipation. They can cause itching, pain and bleeding after a bowel movement.

    • Treatment usually involves increasing fiber in your diet to reduce constipation, using a topical anesthetic to relieve pain, and in some cases, surgery.
  • Allergic reactions or skin irritations: These could be caused by the toilet paper, soap, or laundry detergent you're using.

    • Treatment involves identifying and avoiding the irritant.

What you can do

Here are some things you can do to help alleviate your symptoms:

  1. Keep the anal area clean and dry. Avoid using soaps that contain harsh chemicals. After bathing, dry the area gently with a hair dryer set on a low setting.
  2. Avoid scratching the area, as this can make the itching worse.
  3. Try not to strain during bowel movements. This can cause hemorrhoids or worsen them if you already have them.
  4. Increase your fiber intake to help prevent constipation and make bowel movements easier.
  5. Try over-the-counter creams or ointments that contain hydrocortisone. But don't use them for longer than a week unless your doctor says it's OK.

What you should look out for

You should see a doctor if:

  • The itching doesn't go away or gets worse.
  • You notice blood in your stool or on the toilet paper after wiping.
  • You have pain in the anal area.
  • You notice a lump or swelling in the anal area.

Please remember that this advice is intended to be general in nature, and specific causes may not apply to your situation. Always consult with a healthcare provider for an accurate diagnosis.

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11 mo ago

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People Also Ask


What are common causes of anal itching?

Common causes of anal itching include hemorrhoids, pinworms, anal fissures, and allergic reactions or skin irritations from products like toilet paper or soap.


How can I differentiate between hemorrhoids and anal fissures?

Hemorrhoids often cause itching, discomfort, and sometimes bleeding, while anal fissures typically cause sharp pain and bleeding during bowel movements. A healthcare provider can help differentiate between the two.


What lifestyle changes can help alleviate anal itching?

To alleviate anal itching, keep the area clean and dry, avoid harsh soaps, increase fiber intake to prevent constipation, and avoid scratching. Over-the-counter creams may also help.


When should I see a doctor for anal itching?

You should see a doctor if the itching persists or worsens, if you notice blood in your stool, if you experience pain, or if you detect a lump or swelling in the anal area.


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