Anal Irritation / Anal Itching
Irritation (itching) in the anal region can be a most distressing
symptom. Usually it is mild and soon forgotten, but at times
patients are driven to distraction by a severe problem which
becomes chronic and a threat to normal living.The causes, unfortunately
are not simple and may take time to unravel. Many of these conditions
can be simply and painlessly treated in the Centre. Naturally
if a more serious condition is suspected, further investigation
will be necessary.The Wales Day Centre (Sydney) specialises in
Proctology and if your doctor considers it necessary, we will
identify and
treat your problem. Contact your GP about the Centre. We are
open Monday to Friday.
THE CAUSES OF ANAL IRRITATION
Increased Moisture
This can be due to sweating but is more commonly due to leakage.
Leakage can be due to weak sphincters and/or the presence of
internal haemorrhoids which produce an excess of liquid. Problems
which cause increasing fluid also include diarrhoea due to
colitis, tumours inside the bowel, fissures, fistulae and other
diseases.
Mild Pain
Mild pain is sometimes interpreted by the patient as being
an itch. Fissures-in-ano are sometimes the cause of this.
The multitude
of causes react upon one another and numerous vicious circles
are produced.
Psychological factors
With any symptoms psychological factors can cause and worsen
irritation. The fear of having cancer is often at the root
of the trouble. Scratching results and this can worsen the
symptoms.
Infestations
When there is an excess of moisture the most likely infestation
is that due to a yeast called monilia or Candida usually called
'thrush'.This can increase itching to intolerable levels. Other
organisms, for instance herpes, can also be involved. Thread
worms are a common cause in children. Adults are occasionally
troubled by this condition. Monilial infestation is increased
by excessive use of steroid applications which in the first
instance appear to be helpful.
Anal Lichen
A number of skin conditions of unknown cause affect the skin in
the anal area. Lichen simplex chronicus is the commonest. It
associated with undue scratching and can be alleviated by removing
other factors which cause increased moisture such as haemorrhoids.
It is diagnosed by biopsy. Lichen sclerosus is a more serious disease
which causes intractable irritation and narrowing of the anus and
the vulva. Fortunately it is rare. It is also diagnosed by biopsy.
TREATMENT
The doctor must first eliminate the
most common causes of irritation.This involves examining the
bowel with a proctoscope which merely
examines the lowest part of the bowel. The higher level
examination must be either a sigmoidoscopy or if necessary a
full colonoscopy.
All abnormalities must be eliminated before treatment is
begun. Thus haemorrhoids have to be ligated and injected, fissures
require
treatment. Colitis, and of course, cancer must be eliminated.
If all these major causes have been adequately treated
the thrush infestation, if present, can be tackled with anti-monilial
(anti thrush) creams. Very often the itching stops and
all
the problems cease. However, the itching may continue and
under these circumstances, it is sometimes justifiable
to treat the
area with a short course of steroid and anti-irritant applications.
Local anaesthetic creams are usually harmful in these cases.
Warning:
Itching may not be a minor symptom. If it persists you should
go and see your doctor for further advice.
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