Rectal itching

Rectal itching can be one of the most unpleasant conditions causing prolonged complaints.
There are many triggers to consider, but unfortunately in a quarter of cases the cause is not found.
The condition affects 5% of the population and is twice as common in men.
The itching itself is “only” a symptom, which may have a rectal, colonic or dermatological origin.
But which?
And which specialist clinic should the patient go to first?
And if neither the dermatologist nor the proctologist can find the cause, what should be done?
I would like to give you some information about these problems and the way to a cure.
So, if the patient has an itchy anus, what is the first thing you do?
You go to a dermatologist, which is the right thing to do, because if you clearly have a dermatological problem, you can get help quickly.
However, this is very rare, because in the vast majority of cases the itching is caused by some rectal disease, lesion or even a trivial reason.
Let’s not forget the internal medical problems that can also cause skin itching.
These include cirrhosis of the liver, kidney disease, haematological causes, diabetes and tumours.

Very often the only cause of itching is poor hygiene.
If the patient does not wash the anus with a shower gel after defecation, but only wipes it with toilet paper, faecal crumbs may remain in the anus.
These can cause permanent skin irritation due to the breakdown enzymes they contain, and bacteria and fungi can multiply more easily.
This is particularly true for people with skin caruncula, as these anus openings really cannot be kept clean without washing them after defecation.
In the case of larger “skin tags”, “marks” left on the linen often indicate that the cleaning has not been adequate.
Cigarette smoking can also lead to rectal itching, as it promotes leakage from the mucous membrane by reducing the tone of the internal sphincter.
This in turn maintains a constant supply of moisture, also known as a moist anus.
In a damp environment, the skin becomes soggy and fungi and bacteria can more easily multiply.
Intimate gymnastics can increase muscle tone, and low cleansing enemas can ‘clear’ stools from the area for several hours, even a day.
Fungal infections around the anus are a common cause, especially among people who use communal baths and swimming pools.
In hot, humid weather, fungus can easily attack the folded areas, folds and buttocks, and often proliferate even when taking antibiotics or steroids.
Diabetes, immunodeficiency and obesity are also predisposing factors.
People who eat a lot of sweets can also expect a “fungal attack”.
A popular representative is Candida albicans.
Of course, you are not alone in this problem, fungal skin can predispose you to eczema and, secondarily, other pathogens can also colonise it.

Rectal itching is not just a separate lesion, but can also be a symptom of other diseases:

• In the third and fourth stages of haemorrhoids, rectal itching can be one of the leading symptoms.
  Stage three haemorrhoids appear in the anus every time you defecate, or even when standing up or squatting, regardless of defecation, so the secretion of the protruding mucous membrane maintains the itching.
  THE IV.
  Stage IV haemorrhoids are constantly outside the anus, producing secretions and contaminating the lining.
• The fissure of the rectum (fissura ani) often acts like a gutter, draining mucous secretions to the outside, thus maintaining the itching.
• Caruncula can cause hygiene problems, the natural consequence of which is skin irritation and rectal itching.
• Itching of the rectum can often be the only symptom of colon cancer.
  If no specific cause of the itching is found during the colonoscopy, it is always worthwhile to examine the whole colon (colonoscopy).
• Condyloma (viral genital warts) cause constant wetting, irritation and itching of the rectum.
  Until the warts are removed, you cannot expect the symptoms to go away.

A proctological examination is essential to solve the problem, but the patient can also help to alleviate the symptoms.
Following the advice listed below together can bring positive results:

1. Avoiding soap (soap dries, degreases and irritates already irritated skin).
2. Washing with a jet of water after sterilisation.
3. Rectal drying with a hair dryer.
   Avoid rubbing with a towel, as this can increase itching by irritating nerve endings.
4. Wearing loose cotton clothing.
   Avoid wearing clothing that tightly covers the buttocks, e.g. tight jeans, as this may cause irritation.
5. It is a good idea to place a sheet of gauze between the buttocks and change it every hour or two.
   This helps to absorb sweat.
6. Refrain from using scented powders.
   However, the use of drying, disinfecting powders can be beneficial.
7. Refrain from using creams unless prescribed by a specialist.
8. Ensure normal bowel function.
9. Avoidance of anus scratching.
   In severe cases, the patient wakes up itching at night, or does not wake up at all, but “scratches” the skin in half-sleep, so that it will never heal.
   It is therefore advisable to wear cotton gloves at night except in mild cases.
10. Avoid spicy foods, coffee, citrate foods.

Certain foods and drinks cause rectal itching by changing the pH of the stool, and leaving them out may help to relieve symptoms.
Such foods include:

• cola;
• milk and milk products;
• alcohol, especially beer and wine;
• tomatoes and tomato-based products, e.g. ketchup;
• chocolate;
• nuts.

Patience, perseverance and keeping a diet diary may also be needed to resolve the symptoms of rectal itching through diet.