Anal Itching: Causes, Symptoms, and Treatment Options

Anal itching

I experienced some hard stools and noticed slight bleeding afterward.
I initially thought it would resolve after a while, but I have since experienced pain during bowel movements, even though the stools are not very hard.
There have been a few instances of bleeding, and there is also a small lump near the anus that is very itchy.
What could be the issue?

Liu, 10~19 year old female. Ask Date: 2016/09/23

Dr. Ke Fangxu reply Surgery

Based on your description, it seems to be a typical symptom of anal fissure, which is characterized by pain during bowel movements accompanied by slight bleeding.
If there is concurrent bleeding from hemorrhoids, the amount of blood may be greater.
The primary cause of anal fissures is usually hard stools, but diarrhea, frequent bowel movements, or prolonged straining can also lead to fissures.
It is recommended to improve bowel habits and to take warm sitz baths to alleviate symptoms.
The small lump next to the anus is likely a polyp caused by the fissure, but it could also be a small external hemorrhoid.
Topical ointments and suppositories can be used for treatment.
If conservative treatment does not yield satisfactory results, surgical intervention may be considered.
If symptoms persist for more than a week without improvement, it is important to consult a physician for further evaluation.

Reply Date: 2016/09/23

More Info

Anal itching, or pruritus ani, is a common condition that can be caused by a variety of factors. Based on your description, it seems you are experiencing symptoms that may be related to a few potential issues, including hemorrhoids, anal fissures, or possibly an infection or skin condition.

Causes
1. Hemorrhoids: These are swollen veins in the lower rectum and anus that can cause pain, itching, and bleeding during bowel movements. They can be internal or external, and symptoms often worsen with straining during bowel movements or sitting for prolonged periods.

2. Anal Fissures: These are small tears in the lining of the anus, often caused by passing hard stools. They can lead to sharp pain during and after bowel movements, and may also cause bleeding. The pain can be quite severe, and the area may become itchy as it heals.

3. Skin Conditions: Conditions such as eczema, psoriasis, or fungal infections can also lead to itching and irritation around the anal area. These conditions may require specific treatments to manage the symptoms.

4. Infections: Bacterial or yeast infections can cause itching and irritation. Pinworms, particularly in children, can also lead to intense anal itching, especially at night.

5. Dietary Factors: Certain foods, such as spicy foods, caffeine, and alcohol, can irritate the anal area and exacerbate itching.

Symptoms
The symptoms you describe—pain during bowel movements, bleeding, and itching—are indicative of a possible anal fissure or hemorrhoids. The presence of a small lump near the anus could suggest an external hemorrhoid or a skin tag, which can occur after an anal fissure heals.

Treatment Options
1. Dietary Changes: Increasing fiber intake can help soften stools and reduce straining during bowel movements. Drinking plenty of water is also essential.

2. Over-the-Counter Treatments: Creams or ointments containing hydrocortisone can help reduce inflammation and itching. Witch hazel pads can provide soothing relief for hemorrhoids.

3. Warm Sitz Baths: Soaking in warm water for 10-15 minutes several times a day can help relieve pain and itching.

4. Avoiding Irritants: Keeping the anal area clean and dry is crucial. Avoid using scented soaps or wipes, which can irritate the skin.

5. Medical Treatment: If symptoms persist, it is essential to consult a healthcare provider. They may recommend prescription medications or procedures to treat hemorrhoids or fissures. In some cases, surgical intervention may be necessary.

6. Follow-Up: Since you mentioned bleeding, it is crucial to seek medical attention if the bleeding continues or worsens, as this could indicate a more serious condition.

Conclusion
Given your symptoms, it is advisable to consult a healthcare professional for a thorough examination and appropriate diagnosis. They can provide tailored treatment options based on the underlying cause of your symptoms. Early intervention can help prevent complications and improve your quality of life. Remember, while anal itching and discomfort can be embarrassing, they are common issues, and seeking help is a positive step towards recovery.

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