Anal itching - a pathological condition,characterized by persistent itching in the anus. This disease is very common, and Coloproctology know how serious it is, and how difficult it is to achieve stable positive results of treatment.
Idiopathic pruritus. Most often no apparent specific reasons. Due to the decrease in the ability to retain fluid in the anus, a small amount of mucus from the rectum falls on the perianal skin and cause irritation.
Anorektovaginalnye disease : Hemorrhoids, fistulas, fissures, genital warts, purulent hydradenitis, tumors, sphincter dysfunction, vaginal secretions.
Circulatory system diseases: Psoriasis, seborrheic dermatitis, atopic eczema, lichen planus, etc.
Contact dermatitis by topical application of ointments, deodorants, powders, soaps, suppositories, etc.
infection: Fungi (Candida), bacteria (scratching).
vermin: Worms, trichomoniasis, scabies, pubic lice.
Oral antibiotics: Tetracyclines, erythromycin and others.
systemic diseasesDiabetes mellitus, liver disease.
Personal hygiene: Insufficient or excessive.
The heat and humidity: Tight clothes, a warm climate, obesity, intense physical activity.
Food: Beverages (coffee, tea, cola, milk, beer, wine), food (spices, hot peppers, tomatoes, citrus, chocolate).
Psychogenic causes: Anksioznost and others.
Often, itching in the anus is the main and only complaint of the patient.
The clinical course useful to distinguishacute and chronic anal itching true. For the first form (stage) is characterized by sudden onset, constant current, and the intensity of a significant change in the local type of skin moist eczema with maceration, traces of scratching, hypertrophy of perianal folds. In chronic itching, on the contrary, the beginning of a slow, the skin often dry, thinning (it is compared with parchment paper), sometimes depigmented, traces of scratching is not at all or they have the form of thin linear abrasions, skin folds radiarnye, expressed little ( "spokes").
Anal itching should be divided clearly in"Primary" (synonyms: true, suigenny, cryptogenic, idiopathic, neurogenic, essential) and a "secondary", often accompanied by as the main symptom of diseases such as hemorrhoids, anal fissure, worm infestation, proctosigmoiditis different etiology, lack of anal sphincter, constipation (diarrhea), genital inflammation, exposure to harmful endogenous and exogenous substances and factors, fungal skin lesions in the sacrococcygeal region. In addition, anal itching can be an early sign of latent diabetes.
If the causes of secondary anal itching listed above are more or less known, the etiology of the primary, true, itching in the area has not been studied until the end.
To diagnose the disease would just like: itching in the anus is the main and only complaint of these patients. However, the definition of the type of itching (true or secondary), its stage (acute or chronic), forms (dry or wet), as well as the elucidation of the causes of secondary itching is not so easy.
First of all, you must install:
- Do itching associated with defecation. This symptom may indicate a lack of function of the anal sphincter, which is often observed in chronic hemorrhoids, rectal prolapse, a variety of traumatic injuries sphincter (postpartum, postoperative, and others.), Nerve lesions (especially in children), sexual perversion. Determine the degree of failure is possible only with the help sphincterometry;
- enhanced if itching after taking alcoholic drinks, spicy or salty foods: the presence of this tag indicates the presence proctosigmoiditis;
- whether the patient at home or in the production of harmful effects - chemicals, radiation, work in dusty environments, under high temperature, etc .;.
- whether close contact with pets (worm infestation);
- the presence of the patient or his relatives diabetes, fungal infections, constipation, diarrhea.
From laboratory tests for anal itchingproduce a blood test for sugar content and a three-time analysis of a feces on eggs of worms. Upon detection of lesions by conventional (rigid) irrigoscopy sigmoidoscopy should be performed. Men need to eliminate the urethra and prostate, women - vaginal itching. In the presence of an unstable chair should make the bacteriological analysis of feces on a microflora: the expressed dysbacteriosis anal pruritus therapy should include special preparations.
Treatment of anal itching - a complicated matter that requires patience and perseverance of the doctor and the patient. In secondary itching doctor unequivocal actions - treatment of the underlying disease.
It is important to diagnose even the initial stages ofhemorrhoids, papillita, kriptita, not to mention the anal fissure, prolapse of the rectum or anus sphincter insufficiency of any etiology. In these cases, usually itching is a symptom of the underlying disease.
If sigmoidoscopy revealed Proctosigmoiditis, it is necessary to conduct a full course of appropriate treatment.
If revealed intestinal dysbiosis without proctosigmoiditis, the treatment of anal itching combined with the appointment of bacterial preparations.
However, the most stubbornly proceed exactly those formsanal itching, in which the most careful questioning of the patient, clinical and laboratory tests do not reveal any pathology. And in these cases it is necessary to start with treatment of latent proctosigmoiditis: diet microclysters with colloid silver, skin ointments. For removal of pathological reflex with perianal itching of the skin in these patients it is advisable to use different types of injectable treatments.