I have pruritus ani with allergy and severe itching. Please help.

Question

Hi doctor,

I have had pruritus ani for about three years now. Recently, it has been worse. I am allergic to trees and cold urticaria. I am also prone to sinusitis. Other than allergies, I am in very good health.

My GP ruled out hemorrhoids, parasites (was not tested but no symptoms), and I got tested for celiac. It was negative. The allergist ruled out anal eczema. I have eczema patches on my arms. I am waiting to see a proctologist in a few months. My stool seems to be always soft. I cannot get my stool hard. No diarrhea, just soft stool. I have been prescribed 3.5% steroid cream, which I have had to use as I am in complete discomfort.

I do not want to use the steroid cream anymore, but the itch is really bad. I have to watch what fruit and vegetables I am eating as I also have the birch allergy oral syndrome. Another suggestion was an allergy to the toilet paper, which I have not eliminated yet.

I have my theories due to hours of research. I read an article about ph balance in the stool. Could it be my soft stool irritates the area? Is this connected?

I have started to cook all my vegetables. I have not stopped drinking coffee or chocolate, which is my next test. I also should say that the itch sometimes traces into my genital area, not as bad though and not always. Is there anything I should eat to harden my stool? I do not have any pain or anything else abnormal?

Answer 1

Hi,

Welcome to icliniq.com.

I can understand your concern. According to your statement, you have been suffering from pruritus ani for three years. You are an allergic person.

Pruritus ani may result from contact dermatitis, atopic dermatitis, seborrheic dermatitis, psoriasis, lichen planus, lichen sclerosis, scabies, bacterial or fungal infections, herpes infection, Bowen's disease, Paget's disease, sexually transmitted diseases, anal malignancy, etc.

Foods or drinks can aggravate pruritus ani such as milk, dairy foods, chocolate, tea, coffee, cheese, nuts, spicy foods, and carbonated beverages. If the anal area is not cleared correctly and regularly, some stool may present there, causing itching. Loose stools or mucus may lead to developing pruritus ani. Dyed or scented toilet paper, soaps, and laundry detergent may irritate, developing pruritus ani. Changing eating habits can change your stool consistency.

Is there any lesion or skin changes? You can use Hydrocortisone 1% cream on your affected area twice daily.

Answer 2

Hi,

Welcome back to icliniq.com.

Psyllium husks can modify stools' consistency as they can absorb water and can cause constipation if you do not drink enough water when you take them.

You can take green bananas and vegetables, which may make stool hard. You can cut your water consumption to half, but it is not recommended.

Taking red meat regularly may help to make stool hard.

I hope this helps.