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What is Pruritus Ani?
Pruritus ani is a common condition causing itching or irritation around the anus (back passage). It has many possible causes, including piles and certain skin conditions. However, the most common cause is a minor leakage from the anus. If small amounts of stool (bowel motion) or liquid mucus (slime) leak from the anus, this can irritate the delicate skin around the anus.
What you can do to help yourself
Pruritus is often difficult to treat and it may take many months of gentle care to improve things. There are some things that you can do to help.
• Pay special attention to hygiene. Be very careful to keep the area as clean as possible, ideally by careful washing and gentle drying at least once a day and after each bowel motion.
• If you do not have access to a bidet, you may find that sitting on the edge of the bath and using a shower head (if available) makes washing easier. If you are out or at work, take a small plastic bottle of water into the toilet with you to wash with after a bowel motion.
• Some people find that cold water is more soothing than warm.
• Wash without soap as soap can sting. It is best to use water on your hand rather than on a flannel. Never use soaps with a strong perfume or any antiseptics on your bottom.
• Use very soft white toilet tissue or you may find damp cotton wool the most comfortable for wiping. Never rub.
• If you have a problem with leakage from the anus, a small amount of damp cotton wool on your finger tip may be used to gently clean into the anus to make sure there is no residue left behind.
• If your leakage continues after wiping, a small plug of cotton wool in the anus may stop the stool from coming out to irritate the skin.
• Dry the area by gentle patting with a soft towel or tissue. Avoid rubbing. If you are very sore you may find that a hairdryer on a low setting is the most comfortable way of drying the area.
• Try to avoid scratching the area, however tempting this may be. If you find that you are scratching in your sleep at night, get some cotton mittens (available from your chemist).
• Never use anything on your bottom except the treatment suggested by your specialist. This includes all cream, deodorants, talcum powder and antiseptics.
• Never put anything in your bath water. In particular, avoid all antiseptics, bath salts, bath oil and bubble bath.
• Wear loose cotton underwear and change daily. Avoid all man-made fabrics coming into contact with your bottom. Women should wear stockings or open-crotch tights rather than regular tights, which can cause sweating. You should also avoid tight trousers or jeans and sitting on plastic chairs for long periods.
• Wash your underwear in nonbiological washing powder and make sure that all traces of detergent are rinsed out.
• Try to establish a regular bowel habit.
• A diet high in fibre makes the stools softer and more likely to cause leakage. You can try to make your stools firmer and therefore less likely to leak, by cutting down the amount of fibre in your diet. This means avoiding foods like bran cereals, muesli, beans, peas, pulses and nuts. Moderate your intake of fruit and vegetables, particularly those with skins.
• Avoid lagers and flat beers (i.e. those with high yeast content) as these can make the problem worse.
• Avoid coffee, chocolate and fruit juices high in citric acid for the same reason.
This leaflet is based on one designed by the Association of Coloproctology of Great Britain and Ireland, but has been modified (with permission) by us to reflect local policies. The Association of
Coloproctology web site (www.acpgbi.org.uk) has further information on all aspects of colon and rectal disease.
People are unique and the alternatives, risks and benefits will of course vary from person t o person. We hope this leaflet will support the information you have already received from your doctor in enabling you to make an informed decision.