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Prurits ani (itchy bottom)

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02/05/2006

What is Pruritus Ani?

Pruritus ani or itchy bottom is very common and is commonly caused by piles (allowing leakage of mucus and stool) and skin problems (contact dermatitis or eczema).  It can be difficult to treat and sometimes requires the help of a dermatologist. 

What you can do to help yourself

  • Carefuly keep the area clean, washing and gentle drying at least twice a day.  Clean the area after each bowel action.
  • If you have a bidet, fine.  If not, have a shower or perhaps sit on the edge of the bath and using a shower head
  • Use aqueous cream (can be purchased from your pharmacist in large 500ml pots).  Never use soap as this can make things worse. Dont use a flannel, use cream and water on your hand. Never use antiseptics on your bottom.
  • Damp cotton wool and cream is an alternative.
  • If your leakage continues after wiping, a small plug of cotton wool in the anus may stop the stool from coming out to irritate the skin.
  • Dry the area by gentle patting with a soft towel. Avoid rubbing. If you are very sore you may find a hairdryer useful.
  • Protect the skin with a small amount of metanium barrier cream.  It can be purchased from your local chemist.  It is a little messy.
  • If things are bad, you may be prescribed a low dose of a topical hydrocortisone eg., Betnovate RD.  Use this sparingly as it can thin the skin.
  • Never scratch, however tempting this may be.
  • Never use anything on your bottom except the treatment suggested by your specialist. This includes all cream, deodorants, talcum powder and antiseptics.  They tend to cause a contact dermatitis!
  • Never put anything in your bath water.
  •  
  • Wear loose cotton underwear and change daily. Avoid man-made fabrics and tights.
  • Wash underwear in non-biological washing powder.
  • A diet high in fibre makes the stools softer and more likely to cause leakage. You can try to make your stools firmer and therefore less likely to leak, by cutting down the amount of fibre in your diet (includes fruit and vegetables).
  • Avoid lager and beer (i.e. those with high yeast content) as these can make the problem worse.
  • Avoid coffee, chocolate and fruit juices high in citric acid for the same reason.

In summary, look after your bottom as if you were looking after a baby with nappy rash!


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