Pruritus Ani
Definition: Pruritus ani is a chronic scratching sensation in the anal region.
Types:
- Neurogenic pruritus: Caused by nerve damage or irritation.
- Inflammatory pruritus: Caused by inflammation in the anal region.
- Eczematous pruritus: Caused by eczema in the anal region.
Causes:
- Infection:
- Fungal infections (e.g., candidiasis)
- Bacterial infections (e.g., pseudomembranous colitis)
- Viral infections (e.g., herpes simplex)
- Irritation:
- Soaps or detergents
- Friction or rubbing
- Tight clothing
- Systemic diseases:
- Diabetes
- Hypothyroidism
- Liver disease
- Kidney disease
- Cancer (e.g., anal cancer)
Clinical Features:
- Intense itching sensation in the anal region
- Redness and inflammation of the skin
- Small bumps or nodules on the skin
- Skin thickening and hardening
Investigations:
- History and physical examination: To determine the cause of pruritus ani
- Anoscopy: To examine the anal canal and rectum
- Biopsy: To confirm the diagnosis of eczema or cancer
- Blood tests: To check for systemic diseases (e.g., diabetes, hypothyroidism)
Complications:
- Skin thickening and hardening: Can lead to anal stenosis
- Anal fissures: Can cause bleeding and pain
- Infection: Can spread to other parts of the body
Management:
- Topical treatments:
- Corticosteroids (e.g., hydrocortisone)
- Antibiotics (e.g., metronidazole)
- Antifungal agents (e.g., clotrimazole)
- Oral treatments:
- Antihistamines (e.g., diphenhydramine)
- Antibiotics (e.g., fluconazole)
- Lifestyle modifications:
- Avoiding tight clothing
- Keeping the anal region clean and dry
- Avoiding soap or detergent in the anal region
Treatment:
- Topical treatments: To reduce itching and inflammation
- Oral treatments: To treat underlying systemic diseases
- Surgical treatment: To remove skin thickening or nodules
Homeopathic Therapeutic Medicines:
- Graphites: For anal itching and discomfort
- Sulphur: For eczema and itching
- Pulsatilla: For anal itching and discomfort
- Urtica urens: For itching and burning sensations