Pruritus ani is quite common in men between 40-60 years old. There are various causes and most can be associated to a certain health issue such as anal fissure or hemorrhoids. The other common causes include infection, irritation from fecal material, contact dermatitis, medication side effects, food and clothing reactions, skin conditions, anal or colorectal cancer and other medical and psychological conditions. The treatment usually depends on the cause of the symptoms.
Itchiness or pruritus is a prevalent condition experienced by many individuals. The itching may or may not occur with a rash that can be limited to small areas of skin or occur all over the body. Once a rash manifest, it can be an indication to the cause of the itchiness. In most cases, itching is a minor nuisance or a significant disruption that can drastically affect the quality of life.
Infections
When the peri-anal skin is infected, it can cause pruritus ani. These include fungal and yeast infections, pinworm infection and bacterial infections. The scotch tape test is used in identifying a pinworm infection and cultures are used in diagnosing bacterial and fungal infections.
Fecal contamination
The skin that comes in contact with the fecal matter either in minimal or large amounts is a common cause for pruritus ani. This might be due to direct irritation of the skin or a possible allergic reaction.
Individuals who have frequent bowel movements, consuming large quantities of coffee and have loose stools might be at danger for fecal contamination as the reason of pruritus ani. An increase in the consistency of the stool such as reducing the intake of coffee, increasing intake of bulk-forming agents and medications such as loperamide can help improve the symptoms.
Contact dermatitis
Contact dermatitis that develops in the anal region can also lead to pruritus ani. This can be triggered by cleansing wipes, toilet paper fragrances and dye, laundry detergents, soaps and topical medications used at the area.
In most cases, a patch test is used in diagnosing contact dermatitis and the treatment usually includes topical steroids particularly in ointment form.
Foods and medications that can trigger pruritus ani
There are various foods that can trigger or aggravate the symptoms of pruritus ani, particularly with foods that increases the amount of stool frequency or result to loose stools. These include caffeinated beverages, chocolate, alcohol and tomato products. A trial of eliminating foods from the diet must be done for 2 weeks to help minimize the symptoms.
Some medications can trigger the rash such as colchicine, laxatives, certain antibiotics and even peppermint. These can trigger pruritus ani as direct soreness or due to loose stool texture and high frequency of bowel movement.