Pruritis ani (itchy bottom)

What causes pruritis ani?
Pruritis ani is a common condition, which causes itching or irritation of the skin around the anus (back passage). It has many possible causes, including haemorrhoids (piles) and certain skin conditions. However, the most common cause is a minor discharge from the anus. If small amounts of faeces (bowel movement) or liquid mucus (slime) leak from the anus, this can irritate the surrounding skin which is delicate and sensitive.

Can I reduce the irritation?
Yes, though this takes time and patience. It may take many months of gentle care to improve itching symptoms.

What can I do to help myself?

• Pay special attention to hygiene. Be careful to keep the area as clean as possible, ideally by carefully washing and gently drying the area at least once a day and after each bowel movement. If you do not have access to a bidet, you may find that using a showerhead makes washing easier. Some people find cold water more soothing than warm water.
• Avoid using soap or rough material to cleanse as it can sting or cause further irritation.
• If you have a problem with faeces or mucus leaking from the anus, laying a piece of cotton wool/tissue over the anus to prevent the faeces or mucus from coming out and irritating the skin can help.
• Avoid using wipes, creams, deodorants, talcum powder, antiseptics or anything else on your anus, apart from the treatment suggested by your specialist. Do not add anything to bath water such as antiseptics, bath salts, bath oils and bubble bath.
• Wear loose cotton underwear and change this every day. Women can wear stockings rather than tights to reduce sweating. You should also avoid tight trousers or jeans and sitting on plastic chairs for long periods of time. Wash your underwear in non-biological washing powder and make sure that all traces of detergent are rinsed out.

Should I change my diet?
Although there is no specific diet to follow, it is important to try and establish a regular bowel habit. A diet that is high in fibre makes the faeces softer and more likely to cause leakage. You can try to make your faeces firmer and so less likely to leak by reducing the amount of fibre in your diet. This means avoiding large quantities of bran cereals, muesli, beans, peas, pulses and nuts. Limit the amount of fruit and vegetables, particularly those with skins, you eat.

Avoid:

• lagers and flat beers as these can make the problem worse
• coffee, chocolate and fruit juices high in citric acid as these too make the itching worse