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What to Do About Itchy Anus

Many different problems could cause an itchy anus, and the treatment should be matched to the cause. Could the problem be too much coffee?

Q. I have suffered from pruritus ani (itchy anus) for years. I saw different specialists who were good at diagnosing the problem but incapable of telling me what caused it or how to cure it.

Many of the treatments they prescribed (pills or creams) worked temporarily, but they didn’t really eliminate the embarrassing itch. Can you offer any remedies that might work?

How Can You Relieve Itchy Anus?

A. Itchy bottom can be caused by several factors. In fact, scientists have found nearly a hundred different causes for this condition (Annals of the Royal College of Surgeons of England, Sep. 2008). A treatment will work only if it is appropriate for the specific problem that has triggered the itch. That is why it is important to get a medical examination if the problem persists for long. Sometimes the primary problem is psoriasis. Hemorrhoids and fissures are common causes.

Some people report that diet has an impact. Coffee apparently relaxes the sphincter that keeps fecal matter where it belongs. The result may be soiling that is not visible but results in irritation. We have also heard from people who react badly to wheat, citrus fruit or chocolate. Others fault peanuts, spices, grapes or tomatoes. Although scientists haven’t studies the role of diet for controlling itchy anus, most doctors recommend paying attention.

Occasionally, fungal infections are behind pruritus ani. People with diabetes may develop yeast infections that cause itchy anus. A doctor could prescribe an antifungal medication in such cases.

Medicines That Cause Pruritus Ani:

Sometimes, the medication itself is the problem. Readers report that the heartburn drugs esomeprazole and lansoprazole can cause trouble. Peppermint oil (used for irritable bowel syndrome) or colchicine (for gout) may also be irritating.

Contact Dermatitis:

Moist toilet wipes that contain preservatives can cause an itchy contact dermatitis. Creams, soaps and toilet paper dye are other common culprits. Plain water or witch hazel may be better choices for hygiene.

We have heard from readers who find using a bidet can be helpful:

“I have found long-term relief from itching by installing a bidet toilet seat. I never need to use toilet paper and there is no residue that can cause itch. The air dryer that comes with the seat is quite nice.”

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About the Author
Terry Graedon, PhD, is a medical anthropologist and co-host of The People’s Pharmacy radio show, co-author of The People’s Pharmacy syndicated newspaper columns and numerous books, and co-founder of The People’s Pharmacy website. Terry taught in the Duke University School of Nursing and was an adjunct assistant professor in the Department of Anthropology. She is a Fellow of the Society of Applied Anthropology. Terry is one of the country's leading authorities on the science behind folk remedies..
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