Itching in the anus or anal itching can be a very embarassing experience. Talking of my own expereience here. And it can be a lot annoying too. Below is my answer to the lady that sent me an email through www.colonnews.com recently. This anwer is in no way to be taken as gospel or substitute for a professional medical subscription. Also, much of what I have written is taken from my readings and research on the subject matter. Please feel free to pass around the information as lavishly as you can to others whom you feel must be suffering from the same irritation.

“My anus itches constantly to varying degrees, but there is almost always a slight tingle. On wiping my bottom after going to the toilet, I find that there is a slight trace of blood on the paper. On inspection of the anus, it does not appear to be inflamed, nor is there any sign of tear. What treatment will help? Or does this relate to intestinal or colon problems?”

This is the question and a look of concern from a lady I have had the opprotunity to recieve an email from. At first thought, I dig deep into my own experience as I stare blankly into my monitor, preparing for an answer back. Here is what I got.

Dear Jane,

The condition that you describe is known as pruritis ani (also known as anusitis or “the swamps”). It is the irritation of the skin at the exit of the rectum, known as the anus, causing the desire to scratch. The intensity of anal itching increases from moisture, pressure, and rubbing caused by clothing and sitting. At worst, anal itching causes intolerable discomfort that often is accompanied by burning and soreness[1] and it can have a number of causes.

Amongst the most common causes are:
- intestinal worms,
- dermatitis due to overgrowth of fungal or bacterial components
- skin inflammation caused by a mixture of infection and simple irritation.

Consequently, skin problems tend to produce an obvious rash between the buttocks and around the anus, but it seems that in your case this is not present.

It is not common to see any traces of blood with intestinal worms except of course that intense itching can produce prodding or scratching which in turn can lead to a trace of blood seen on the toilet paper.

Looking at your question and concern, the likeliest cause in your case is an anal fissure. This is very common and is produced by an elongated ulcer, which extends upwards into the anal canal from the anus itself.

It often starts from a small tear in the lining of the anus caused by passing hard motions. Seeing a small amount of bright red blood mixed with the motions or on the toilet paper is often reported.

Usually an anal fissure will heal by itself within a week or two, but a high fibre diet, including whole grain products, fruit and vegetables with plenty of fluids to soften the motions certainly helps.

Should worms be responsible, then a simple preparation such as Pripsen two sachets taken 14 days apart will solve the problem.

A troublesome anal fissure may heal more quickly by using suppositories such as Anugesic hydrocortisone available on NHS prescription.

[1] From Wikipedia, the free encyclopedia
James, William; Berger, Timothy; Elston, Dirk (2005). Andrews’ Diseases of the Skin: Clinical Dermatology. (10th ed.). Saunders. ISBN 0-7216-2921-0.