Why hemorrhoids itchy: relieving them is quite simple
Anal itching (“scratching ass” or “anal pruritus” for doctors) is very common but in every other case, no cause is identified. Simple measures of local hygiene, however, are enough to relieve them. The doctor must be consulted in case of recurrence.
What is anal pruritus?
Anal itching, or “anal pruritus”, is a sensation that causes the urgent need to scratch the anus and the surrounding area of the intergluteal fissure.
The problem is that if it is too insistent, scraping can cause skin lesions that will themselves sustain pruritus.
The explanation of pruritus is often complex but histamine is very often involved (release of histamine by some white blood cells – neutrophils or basophils – in the superficial layers of the skin). It should be remembered that scratching usually increases pruritus and this is explained by the fact that scratching causes pain that will stimulate the production of serotonin, a molecule that is supposed to control pain. In the present case, this serotonin activates serotoninergic receptors on “GRPR neurons”, nerve cells that are precisely those that express the sensation of pruritus in the brain.
“Scratch lesions” can, moreover, bleed and become infected.
Pruritus occurs at any time during the day. At night he is responsible for insomnia.
What are the causes of anal itching?
- Often, no definite cause is found and anal pruritus ceases after local treatment.
- The most common cause of nocturnal anal itching in children, and sometimes in adults, is an infestation with small parasitic intestinal worms, the “pinworms”, where the female lays her eggs at night.
- Different diseases of the anus can cause anal pruritus: Hemorrhoids can also be responsible for itching, especially at night, because of the dilation of hemorrhoids due to increased venous pressure. this level lying down. Some attacks of the anus such asAnal fissures or abscesses of the anal margin are also involved. The anal fistulas, which communicate the anal canal and around the anus with a permanent seepage of feces, cause local infection and pruritus.
- Some skin diseases such as psoriasis, eczema, and some fungal infections can be located in the anal area and cause itching.
- Finally, poor hygiene, persistent diarrhea, severe sweating, obesity and overeating spices, alcohol or coffee are sometimes itchy.
How to make the diagnosis of anal pruritus?
The diagnosis is made at the inspection of the anal area.
The skin is irritated, sometimes oozing with some blood or pus. When they exist, hemorrhoids, fissures or fistulas are visible around the anus.
Pinworm is the most common intestinal worm, especially in children. It is a round white worm that measures 5 mm to 1 cm and is visible on the surface of the stool. It causes anal pruritus mainly in the evening and at the beginning of the night.
The doctor can request a local sampling (“Scotch test”) and a parasitological examination of the stool to search for an infection or parasitosis. In some cases, consultation with the gastroenterologist specialist is necessary for performing an endoscopic examination (“colonoscopy”).
Should I consult urgently?
Anal pruritus is not an emergency.
In the majority of cases, simple local measures overcome them.
The doctor must be consulted when the disorder persists to search for a cause, or if it is accompanied by a flow of blood or pus, and if pains occur.
What is the treatment?
- In the absence of specific causes, simple local measures are usually sufficient to calm pruritus. The toilet should be made with neutral soap or soap-free products, if possible after each bowel movement. Maceration is to be avoided, the skin of the anal area must remain dry. It is advisable to put clean cotton underwear, changing them every day. Avoid using irritating or scented toilet paper and rubbing too hard. It is necessary to fight against the transit troubles, such as diarrhea or constipation, by adopting an adapted diet.
Sometimes the doctor is required to prescribe local disinfection with an antiseptic and ointment with a corticosteroid.
• When a specific cause has been diagnosed, the doctor prescribes a specific treatment.
For the oxyurose, flubendazole (Fluvermal®) and pyrantel (Combantrin®) in single-dose, to be renewed three weeks later, are effective. The whole family should take the treatment and observe hygiene measures: careful and regular hand washing, especially after the stool, cutting short nails and washing clothes and sheets at the time of treatment.
The hemorrhoids are treated with veinotonic drugs in short courses at high doses to relieve pain and itching. They may be accompanied by the use of paracetamol-type analgesics. Locally, ointments with or without cortisone provide some relief.
What to do to prevent anal pruritus?
It is advisable to use a neutral soap or soap-free product to wash and to make a local toilet if possible after each saddle.
It should be sweating and maceration avoids that follows, and keep the skin dry anal area.
We must avoid using irritating and perfumed toilet paper, and do not rub too hard but stamped.
It is advisable to put loose and clean cotton underwear every day. Diarrhea and constipation
must be controlled by adequate dietary habits, and limit coffee, spicy foods, and alcohol.
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