Pruritis ani

Pruritus ani
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Synonyms	Itchy anus
Pronounce	N/A
Specialty	N/A
Symptoms	Itching around the anus
Complications	Infection, skin damage
Onset
Duration
Types	N/A
Causes	Dermatitis, hemorrhoids, infections, dietary factors
Risks	Poor hygiene, excessive cleaning
Diagnosis	Physical examination, medical history
Differential diagnosis	N/A
Prevention	N/A
Treatment	Topical treatments, hygiene measures, dietary changes
Medication	N/A
Prognosis	N/A
Frequency
Deaths	N/A

Pruritus ani is a common condition characterized by itching around the anus. It can be a symptom of various underlying conditions or occur as a primary condition without an identifiable cause.

Etiology

Pruritus ani can be classified into two categories: primary and secondary.

• Primary pruritus ani is idiopathic, meaning no specific cause can be identified. It is often related to lifestyle factors such as diet and hygiene.
• Secondary pruritus ani is associated with identifiable causes, including:

 * Dermatitis: Contact dermatitis from soaps, creams, or other irritants.
 * Infections: Fungal infections like candidiasis, bacterial infections, or parasitic infections such as pinworms.
 * Anorectal disorders: Conditions like hemorrhoids, anal fissures, or fistulas.
 * Systemic diseases: Conditions such as diabetes mellitus, liver disease, or thyroid disorders.

Pathophysiology

The itching sensation in pruritus ani is thought to be due to irritation of the sensitive skin around the anus. This can be exacerbated by moisture, friction, and the presence of irritants. Inflammatory mediators released in response to irritation or infection can further contribute to the sensation of itching.

Clinical Presentation

Patients with pruritus ani typically present with:

• Intense itching around the anus, often worse at night.
• Redness and irritation of the perianal skin.
• Possible excoriations or skin changes due to scratching.

Diagnosis

Diagnosis of pruritus ani involves:

• A thorough medical history to identify potential causes or contributing factors.
• A physical examination of the perianal area to assess for signs of dermatitis, infection, or other anorectal conditions.
• Additional tests may be conducted if a secondary cause is suspected, such as stool tests for parasites or blood tests for systemic diseases.

Management

Treatment of pruritus ani focuses on addressing the underlying cause if identified and relieving symptoms. Management strategies include:

• Hygiene measures:

 * Gentle cleaning of the anal area with water and mild soap.
 * Avoidance of irritants such as scented wipes or harsh soaps.
 * Keeping the area dry and well-ventilated.

• Topical treatments:

 * Application of barrier creams or ointments to protect the skin.
 * Use of topical corticosteroids to reduce inflammation and itching.
 * Antifungal or antibacterial creams if an infection is present.

• Dietary modifications:

 * Avoidance of foods that may exacerbate symptoms, such as caffeine, alcohol, and spicy foods.

• Behavioral changes:

 * Avoidance of excessive scratching to prevent further irritation and potential infection.

Prognosis

The prognosis for pruritus ani is generally good with appropriate management. However, recurrence is common, especially if underlying causes are not addressed or lifestyle factors are not modified.

Also see

• Dermatitis
• Hemorrhoids
• Anal fissure
• Candidiasis
• Pinworm infection