The anal itch is the state which is characterized by a persistent itch in the field of back pass and being a clinical symptom of many proktologichesky diseases. It can be observed in the absence of pathology of a large intestine. For the purpose of identification of the reasons of an anal itch also tool diagnostics (an anoskopiya, a rektoromanoskopiya) is carried out laboratory (a research of perianalny scrape, a calla on eggs of helminths, blood glucose). The algorithm of elimination of an anal itch assumes conservative or surgical treatment of the main pathology, application of local means, holding physiotherapeutic procedures.
Anal itch – pathological feeling of a persistent itch in the field of back pass. Can be an independent disease or to serve as a symptom of other diseases: hemorrhoids, helminthic invasions, anal cracks, diabetes, dysbacteriosis, etc. Brings physical and psychological discomfort, causes a sleep disorder and a habitual way of life. Leads to combing, emergence of anal cracks and accession of an infection. In the started cases formation of ulcers, bleedings, transition of a disease to a chronic form is observed. The anal itch can have quite resistant character and cure it happens not easy.
Reasons and risk factors
The increased dryness of skin can be the reason of irritation of field of back pass and emergence of an anal itch (a frequent state at elderly people, and also - it is characteristic at dehydration). Tendency to the increased humidity (and respectively, to irritation and an anal itch) happens at the persons suffering from excessive perspiration and also at frequent ponosa and in case of an incontience a calla.
The persistent anal itch can cause regular application of a rigid bast, caustic means for washing, rough toilet paper, badly washed away soap. Around an anus some antigemorroidalny means, contraceptive candles and gels of local application can cause irritation of skin. The itch can arise at fans of spicy spicy food as a result of irritation its components of a mucous membrane. Insufficient personal hygiene, in particular in the field of an anus, also leads to irritation of skin. Sometimes the anal itch is a consequence of removal of hair in this zone.
Many diseases are followed by this clinical symptom: proktologichesky (hemorrhoids, an anal crack, sfinkterit, proktit), gynecologic (an inflammation of genitalia), infections virus (peaked condylomas), fungal (actinomycosis, the milkwoman) and bacterial, helminthic invasions, pubic louses, itch; dermatological (psoriasis, seborrhea, an inflammation of sweat glands, atopic eczema, flat deprive), the diseases connected with exchange violation (diabetes, a liver failure, pancreatitis, etc.).
Besides, the anal itch can be a consequence of neurosis (neurogenetic) and result from the use of some medicines (yatrogenny). When it is not possible to establish the obvious reason of pathology, speak about an idiopathic itch and assume that it is connected with decrease in sokratitelny function of a sphincter and irritation of skin the slime which is emitted from a rectum.
It is worth paying attention that chronic proktosigmoidit can proceed it is reserved, the anal itch resulting from sharp change of acid-base balance of a direct and sigmovidny gut, presence in Calais of proteolytic enzymes that promotes growth in an okoloanalny zone of amount of the residual nitrogen which is directly irritating nervous receptors will be the only clinical symptom at the same time.
In a proktologiya distinguish primary and secondary anal itch. Primary (true, idiopathic, cryptogene, suigenny, essentsialny, neurogenetic) represents the itch which does not have the visible reason (this or that pathology of intestines which can be followed by an anal itch).
The secondary anal itch arises at hemorrhoids, a chronic anal crack, helminthic invasions, inflammations of terminal departments of intestines (proktit, proktosigmoidit), inflammatory diseases of genitals, fungal defeat of anal area and a crotch, burns, mechanical injuries of a zone of back pass. At early stages of diabetes one of its clinical signs – the skin itch – can be limited to an anus zone. Besides, the anal itch is subdivided on sharp and chronic.
Symptoms of an anal itch
Itch in an anus – as a rule, the only complaint of the patient. Can arise at night and promote sleeplessness. At a long current skin around back pass becomes covered by grazes, reddens, over time grows coarse or becomes thinner and becomes easily damaged. The deep expressed raschesa can be infected.
The sharp anal itch begins suddenly and intensively, has constant character, in the field of an anus maceration (moistening) of skin, her irritation, changes as moist skin is found. Traces can be noted having combed. The chronic itch develops slowly, gradually amplifies. Skin around back pass is usually inclined to dryness (the thinned dry skin on type of parchment paper is sometimes noted). There can be no pigmentation, characteristic of this area. Raschesov, as a rule, is not marked out.
The anal itch existing a long time leads to the expressed raschesa, can promote bacterial damage of skin, eczema, an ulceration and bleeding. Complications of a secondary itch are connected with the main pathology which symptom it is. It is necessary to remember: after detection of a disease it is necessary to see a doctor, but not to ignore symptomatology and not to self-medicate. The anal itch can be a clinical symptom of serious pathologies.
Diagnostics and inspection
Direct diagnosis of an anal itch is performed by the doctor-proctologist on the basis of complaints and lack of other clinical signs. However, detection of a disease demands to establish its probable cause, in case of its secondary character to find the main pathology. Therefore at an anal itch apply a wide range of tool and laboratory researches. Establishment of a probable cause can be promoted by character and features of an itch: whether it is connected with defecation, the use of alcoholic drinks or spicy food, identification time, existence duration, intensity.
At survey note inflammation signs, take scrape. All patient makes the triple analysis a calla on eggs of worms. Consultation of the gynecologist with a fence of dabs is made for an exception of infections of genitals. In the presence of signs of violations of a chair make a bacteriological research a calla. Make a rektoromanoskopiya (survey a rectum) for detection of inflammatory diseases of intestines an irrigoskopiya, a kolonoskopiya. Kolonoskopiya allows to reveal inflammatory changes of a mucous wall of intestines throughout a large intestine.
Blood is investigated on the content of sugar and identification of the exchange violations which are followed by a skin itch. For definition of functional insufficiency of an anal sphincter use a sfinkteromanometriya. For the purpose of detection of pathology of the top departments of a digestive tract which are followed by regular ponosa or locks make gastroscopy and ultrasonography of abdominal organs. Ultrasonography of a prostate can be recommended to men.
Treatment of an anal itch
Treatment can present certain difficulties and to be quite long. The key moment in therapy of an anal itch is identification of the reason of its emergence and its eradication. Besides, apply local means to simplification of an itch. In case of the secondary nature of a disease therapy is directed to disposal of the main pathology. At infectious diseases antibiotic treatment or fungicide means (is appointed at a fungal infection). Antigelmintny medicines apply to treatment of a helminthic invasion.
At inflammatory diseases of a large intestine the full course of the corresponding treatment is shown. Some diseases demand as therapeutic remedies, and, according to indications, surgical intervention. At hemorrhoids the gemorroidektomiya is carried out, the alloying by latex rings and other operations is carried out. In the presence of the corresponding pathology excision of an anal crack is made. Sometimes the anal itch is a clinical symptom of serious diseases (diabetes, syphilis, hepatitises, cirrhosis), treatment of such diseases can be quite long and difficult.
For local application as the means reducing discomfort and reducing an itch ointments with Prednisolonum, dekspantenoly and lidocaine, and also microenemas are recommended (with a 3kh percent kollargol or protargoly, broths of herbs, oils). The elektrotrankvilization can be applied to knocking over of a resistant pain syndrome. It is the most difficult to treat an anal itch which reason is not established. In such cases there are only measures of symptomatic therapy, demulcents, careful (but not superfluous) hygiene and restriction in a diet of the products capable to irritate mucous and skin of an anal zone (pepper, a citrus, chocolate, tea, Coca, alcohol, hot spices).
Forecast and prevention
The forecast directly depends on an etiology and pathogenesis of an anal itch, early identification and the timely beginning of therapeutic actions. If the anal itch is not a consequence of an incurable disease, an outcome at strict observance of medical appointments favorable. Preventive measures of the prevention of a recurrence and deterioration in a course of a disease consist in following to recommendations about a diet and hygiene of an anal zone.
1. Out-patient coloproctology / Rivkin of V. L. - 2009
2. An anal itch in out-patient practice / Shakhrai S. V., Gain Yu. M.//Topical issues of the emergency surgery: the collection of scientific works of a republican scientific and practical conference, Minsk - 2009
3. Diagnostics and treatment of symptoms of inflammatory diseases of intestines: an anal itch / Parfyonov of A.I.//Medical council - 2011