Pruritis Ani
If you continue to have discomfort, then it is absolutely important to see your physician! There are a number of other disease processes that can manifest as an itchy butt. Although rare, it is still important to have a professional (like myself!) check it out. I hope you learned something today! Have a fantastic week and make sure to follow my instagram: @ocbuttsngutsThere is a condition in the colorectal world that is often embarrassing for patients to talk about and that people often confuse with hemorrhoids. I guarantee at some point in your life, you have had it... PRURITIS ANI , which in Latin, means "itchy anus." Pruritis ani is a very very common condition with multiple causes. That itch can come at any time of the day or night, after a bowel movement, and even after a shower (where you SWORE you washed your butt clean)! It can be distressing.
Let's start with an example: You have lovely taco dinner and indulge in some spicy salsa. The next day you are paying for it on the toilet. You are burning and your stool is softer than usual. You then wipe with some toilet paper and feel like you have to keep wiping. You get up and proceed with your day. Then you feel an itch.. You go back and clean again, maybe you add water this time, maybe even a shower. But... it keeps itching. You think it must be hemorrhoids! You put some prep H on it but no help! The cycle continues- itch, wipe, clean, repeat. Maybe you think you have an infection? You add some neosporin or wash with a harsher soap. But it keeps going! Itch, wipe, clean, repeat! By the time you know it your butt is irritated and angry and no hemorrhoid cream or wipe will help!
In this scenario, the simple action of over-cleaning has created a monster. The initial injury of spicy soft stool led to forceful wiping which creates tiny tears. Those tears create intense itching and burning not because you are dirty, but more just irritated from constant wiping and washing. This is just one of a number of different scenarios that can lead to Pruritis Ani.
Redundant external hemorrhoidal tissue (extra skin) is a common nidus for pruritus due to having to clean a bit more if stool isn't perfect in size and consistency. Making a simple hygiene modification is all you may need to fix it, unless you want to get rid of the excess hemorrhoidal tissue that impedes with hygiene.
Every patient needs to be evaluated and individually treated. Examination by a trained physician is very important! Most of the time if I get a patient with pruritus, I first take a thorough history. I ask about bowel habits, how one cleans after a bowel movement, what one uses in the shower to clean, even laundry detergent. I will also ask about medical conditions like diabetes or recent antibiotic use. If you have any concerns, speak up! See a board-certified colorectal surgeon (like myself) to nip your symptoms in the bud!
In the meantime, here are a few helpful products in your tush itch battle:
After you poop: 1. A BIDET is the absolute best thing you could invest in. Bidets don't have to be fancy. Amazon carries a variety at all price ranges that are easy to install. Bidets offer a nice way to clean your tush without having to wipe too much. Also better for the environment. 2. Balneol cleansing solution or bidet balm. Two good products that essentially turn your regular toilet paper into gentle cleansing wipes. A little goes a long way, plus these products are easy to take with you in your purse or leave some at work.
In the shower: First, stop all body washes that have scents or any antibacterial properties. I recommend using Dove (unscented) beauty bar or cerave bar. Luvena cleanser is available on Amazon and it is a fantastic all around cleanser. Avoid scrubbing.
After you cleanse: Make sure your tush is dry! If it is particularly irritated, then I suggest using a hair dryer on cool setting or a hand-held fan to get yourself dry. Otherwise, gently pat dry with a soft cloth or soft TP. Walk around naked if you can, air it all out! Get it dry! Then apply a balm to soothe your tush. My all-time favorite product is called Calmoseptine. This is a zinc-oxide based multi-purpose cream that is applied to the perianal skin to cool and soothe. There is a bit of menthol on it to relieve itching. Some people don't like this sensation, so if that is you, then just use diaper rash cream (the key is zinc-oxide base) like Balmex or Desitin.