Merck Manual

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Causes and Features of Anal Itching

Causes and Features of Anal Itching

Cause

Common Features*

Tests

Anal or rectal disorders

Discharge of pus

Pain in the rectum (sometimes) and/or abdomen (often)

Sometimes diarrhea

Examination of the lower portion of the large intestine, the rectum, and the anus with an endoscope (sigmoidoscopy) or of the entire large intestine (colonoscopy)

Hemorrhoids (internal or external)

With internal hemorrhoids, bleeding (a small amount of blood on toilet paper or in the toilet bowl)

With external hemorrhoids, a painful, swollen lump on the anus

A doctor's examination

Usually examination of the rectum with an endoscope (anoscopy) or sigmoidoscopy

Infections

Bacterial infection (caused by scratching)

Inflamed, red area, sometimes visible scratching

A doctor's examination

Yeast infection (Candida)

A rash around the anus

A doctor's examination

Sometimes examination of a sample of skin scrapings under a microscope (to identify the fungus)

Usually in children

Sometimes present in several family members

Microscopic examination of transparent tape that was applied to the anal area to check for pinworm eggs

Intense itching, usually worse at night

Possibly itching of other body areas

Possibly pink, thin, slightly raised lines or bumps (burrows) on the affected areas

A doctor’s examination

Examination of skin scrapings

Cancer of the skin around the anus (perianal skin)

Scaly or crusty area

Examination of a tissue sample (biopsy)

Skin disorders

An itchy, red, oozing, and crusty rash

A doctor’s examination

Sometimes itchy or painful patches on the skin

A doctor's examination

Drugs

Antibiotics

Current or recent use of an antibiotic

Elimination of the drug to see whether symptoms are relieved

Foods and dietary supplements

Beer, caffeine, chocolate, hot peppers, milk products, nuts, tomato products, citrus fruits, spices, or vitamin C tablets

Symptoms that occur after a substance is ingested

Elimination of the substance from the diet to see whether symptoms are relieved

Hygiene-related problems

Excessive sweating described by the person, particularly with wearing of tight and/or synthetic clothing

Measures to limit sweating (such as wearing loose cotton underwear and changing underwear frequently) to see whether symptoms are relieved

Overly meticulous or aggressive cleansing of the anal area

Poor cleansing

Inappropriate cleansing practices described by the person

A change in cleansing practices to see whether symptoms are relieved

Skin irritants

Anesthetic preparations, ointments, soaps, and sanitary wipes

Use of a possibly irritating substance described by the person

Avoidance of the substance to see whether symptoms are relieved

* Features include symptoms and the results of the doctor's examination. Features mentioned are typical but not always present.