Itching of the anus: what are the causes in children, adults or in pregnancy?

Rectal itching (anal pruritus or pruritus ani) is an unpleasant irritating sensation around the mouth of the anus and in the rectum.

The most frequently asked questions are:
What causes this unpleasant condition in children, adults or pregnancy?
Can mycosis, eczema be the cause of the itch, or is it triggered by antibiotics?
How to relieve it?
The answers to these questions are provided in the article.

Itching, pinching and other unpleasant sensations in the anal area are a common problem. It is not always possible to clarify the cause. Then it is referred to as idiopathic pruritus ani or also primary pruritus.

The cause is unknown...

The other side is the secondary form, which has a basis in a particular disease.

In this case, itching is a symptom...

Pruritus in the rectum is a symptom of hemorrhoids, parasites and yeast infections. It is triggered by antibiotics, occurs after stools or at night.

Like any itch, it makes you scratch. It can make the problem worse.

Localised damage to the integrity of the skin and mucous membranes is added. Small wounds can become infected with bacteria from the gut, complicating the condition with inflammation.

This completes the vicious circle.
The problems are intense and persistent.
They bother and restrict the person in any daily situation.
They disturb the person and do not allow him to concentrate on his school or work duties.

Pruritus can be temporary or long term.

In case of persistence, there is no room for hesitation and a professional examination is necessary.

Why, you ask?
It may be due to a more serious inflammation of the intestine, a systemic and metabolic disease or an oncological process.

What are the common and frequent causes of rectal itching?

Quite often diet is behind the itching. Some foods contain irritating chemicals that irritate the area when stool is passed.

Of course, this is a temporary problem. The trouble sets in a few hours after eating the risky food. With regard to the speed of digestion.

Examples are spicy and pungent foods with chilli or other spices.

Other foods that can trigger itching:

• Chilli
• pepper
• caffeinated drinks and coffee
• alcohol, beer
• Dairy products
• peanuts and nuts
• citrus fruits
• grapes
• tomato
• chocolate
• acidic foods

The level of hygiene is one of the other triggers. This can be inadequate, with faecal residues irritating the surrounding skin or the lining of the anus.

This is fecal contamination.

Alternatively, perfumed and otherwise 'enriched' soaps and shower gels are used during cleansing. These can even cause local inflammation, contact dermatitis.

Therefore, it is recommended to use soaps without various additives or natural-based products for intimate hygiene and cleaning of the anal area. Products designed for these areas are available.

Contact dermatitis also occurs after a change of detergent or fabric softener.

The wearing of tight clothing and unbreathable underwear, which is usually made of artificial fibres, is risky. It is therefore advisable, especially on hot days, to choose cotton, airy and natural clothing.

Why?

The rectal area overheats excessively, which also increases the humidity.

Heat + humidity = favourable environment for the growth of microorganisms.

Under normal conditions, there is a natural bacterial microflora in the area. The induced atmosphere increases the risk of an outbreak.

This again leads to local inflammation.

A related name is allergic contact dermatitis. This is a local irritation with substances to which the body overreacts.

Aggravation occurs after the use of cleaning, but also therapeutic (medical) products, chemicals, soaps, creams, wet wipes, toilet paper (especially with the addition of dyes and aromas).

Other skin problems include:

• herpes - cold sores
• psoriasis
• eczema, atopy, urticaria
• abscess - ulcer
• lichen ruber planus

Inflammation and infection in the rectal area

Perianal infections can be caused by an overgrowth of local bacteria or by contamination with microorganisms from scratching.

Perianal means around the anal opening.

In women, transmission of infection from the genital area is possible.

It is reported that approximately 15% of cases are caused by fungi.

Candida albicans is a yeast that causes various mycoses. Basically, the current state of health and the immune system contribute to its overgrowth.

Yeast infections are common in people who suffer from diabetes (diabetes mellitus), blood diseases, immune and oncological diseases as well as HIV.

Treatment with drugs that deliberately reduce immune responses in the body is also an example.

Antibiotic treatment and steroid treatment (corticosteroids) are often cited as triggers. The latter causes a change in bacterial colonisation throughout the body. Women, but also men, can have yeast infections of the genitals(vagina, penis) and so on with antibiotic treatment.

Read also: fungus on the feet and nails.

In addition, infection and inflammation can be triggered by trauma and damage to the skin in the area, in addition to fecal contamination, as well as sexual intercourse.

In this context, it is necessary to mention sexually transmitted diseases.

HPV infection is also a representative. HPV is divided into two groups, of which the high-risk strains cause cervical cancer. The low-risk strains most often cause warty growths (warts), papillomas or condylomas.

Herpes virus can also cause skin problems.

Alternatively, a number of other dermatophytes (mycoses), staphylococci, streptococci and others are responsible for the infection.

Could it be hemorrhoids, another intestinal or anal problem?

The answer is:
They can and often are mainly hemorrhoids or small fissures.

Not only hemorrhoids, but also other local colorectal (bowel), anal, perianal diseases. These can be benign, but also serious.

An example is:

• haemorrhoids are a common and frequent disease characterised by the enlargement of blood vessels in the anal area
• fissure of the anus - fissure ani
• intestinal functional disorders, irritable bowel syndrome
• rectal sphincter dysfunction, incontinence, partial or complete
• diarrhoea or constipation
• Crohn's disease
• fistula - a diseased connection of the bowel, for example with the intestine, skin and other surrounding areas, which causes the passage of faeces
• cancer, colorectal cancer, rectal cancer

Also the consistency and number of stools affects the development of itching around the anus and rectum.

Hard stools cause damage, tears. Conversely, frequent loose stools (diarrhea) increase local moisture and irritate the anal opening and nearby skin.

This is when itching sets in, especially after stool.

An increased risk of inflammation with diarrhea should be assumed especially in young children who use a diaper and in the elderly who are immobile or incontinent and have a diaper.

Other diseases

In addition to the above, any disease that causes pruritus can lead to itching in the rectal area.

Examples are diseases such as:

• Diabetes and other metabolic diseases.
• systemic diseases
• blood diseases, anaemia
• kidney failure and inflammation of the bladder and urinary tract (urinary tract infection)
• liver disease
• allergies
• iron deficiency
• food intolerances, as well as celiac disease
• histamine intolerance
• thyroid disease
• oncological diseases, leukemia, lymphoma
• medications - after antibiotics, corticosteroids and others
• and other diseases that cause itching in general

Attention, stress, excessive mental stress also contribute to the development of itching. In addition, long-term difficulties lead to depression or worsen it. Alternatively, it is necessary to look for another psychological problem.

Read also.

Symptoms that may accompany itching of the anus

In addition to the itching itself, it is likely that other health problems are also associated, such as:

• pain in the rectum - burning, pinching, etc.
• redness of the skin, abrasions, wounds, skin breaks, scarring or thickening of the skin
• persistent and increasing itching
• bleeding, bleeding when wiping on toilet paper
• leakage of faeces
• bloating
• constipation
• diarrhoea
• itching in the genital area
• increase in body temperature to fever
• sleep and concentration disorders (especially in children)
• depression, anxiety, stress

Caution: If blood appears

Bleeding from the rectum can indicate several conditions. A minor example is a little blood on toilet paper during hygiene after a bowel movement. The cause may be haemorrhoids, anal fissure (tear) or abscess of the anal canal or nearby area.

However, if there is more blood, a specialist examination is recommended. It may be Crohn's disease, ulcerative colitis, but also other more serious diseases.

As for the anal canal:

• abscess, acute disease, there is also an increase in body temperature, and painful swelling around the anus
• a fissure is usually a chronic problem with bleeding and oozing of pus and pain
• both conditions are often associated with excessively hard or loose stools, the risk is overuse of laxatives

What is the main cause in children?

As in adults, children have problems caused by improper stool consistency or improper hygiene (either excessive or insufficient) and irritation from food and hygiene products.

However, parasitic diseases are quite common during this period.

The most common parasites in young children, preschoolers and school-age children are roundworms and hookworms.

In kindergartens and places with a higher prevalence of children, the transmission of parasites is greatly facilitated.

Sandpits that are not maintained and where parasites can be found at higher levels are at risk.

The worms cause enterobiosis. The worms cause what is known as ascariasis.

Read also:

• How do lice manifest themselves in children? What they look like and how to eradicate them
• Lice and other parasites or diseases in our schools and nurseries
• Children's sandboxes as a possible health risk?

You ask:
Why do children complain of itchy anus especially in the evening and at night?

The parasites enter the body through the mouth. They then travel through the intestines. At night, the female worm crawls out through the anus. She lays her eggs around the anus.

The typical symptoms of these parasitic infections are:

• abdominal pain
• itching in the rectal area
• insomnia
• fatigue
• bloating
• inability to concentrate and restlessness

Another of the parasites is the human hookworm or childhood roundworm. However, this is often an asymptomatic course where no external problems are present.

With roundworm, there is abdominal pain, bloating, diarrhea, but also allergic symptoms such as itching of other parts of the body and the nose.

Itching of the anus in pregnancy?

Yes, it is often a problem that is responsible for the increase in pressure in the abdominal cavity and impaired drainage of blood from this area. As a result, hemorrhoids arise.

Impaired defecation, but also childbirth itself contributes to them. And this is due to increased intra-abdominal pressure.

Increased pressure = impaired dilation of the veins in the rectal area.

Women are more likely to suffer from genital and bladder infections. Excessive wetness, intense vaginal discharge and risk of transmission to the rectal area.

The pathway is of course bidirectional and with infection in the rectal area, transmission to the genital and urinary tract can occur.

There is a higher risk of infection during pregnancy due to certain physical and immune changes.

Read also:

• Vaginal discharge and a change in its colour, smell or consistency = a problem?
• Itchy skin in pregnancy? An inconvenience and a possible risk to the baby
• What can cause uterine inflammation?
• Urinary tract inflammation is particularly troublesome in summer for the fairer sex
• Beware of ovarian inflammation in pregnancy. What are its causes and symptoms?
• Constipation in pregnancy?
• Are you pregnant and are you suffering from lower abdominal pain?

How to soothe the itching and prevent the problem?

Treatment depends on the underlying cause. For some conditions, drugs against parasites, yeast or bacteria and combinations of these are used. These can also be in topical form, such as ointments, gel, sitz baths with oak bark and others.

Subsequently, in the case of a secondary form of itching, it is important that the underlying disease is also treated appropriately.

Prevention is important.

Preventive measures:

• personal hygiene with products that are not irritating or unnecessarily perfumed (wet wipes).
• preferably with clean water and intimate hygiene products
• use lukewarm and cold water
• do not wash the anal area with hot water
• dry the skin, for example with a hairdryer
• avoid using coloured and perfumed toilet paper
• wipe gently and not roughly with paper after stool
• not scratching
• appropriate and loose-fitting clothing (cotton) that is airy and not made of man-made fibres
• women, do not wear tango panties
• increase intake of fruits, vegetables, fiber, garlic as a beneficial agent against inflammation and parasites (be careful with consumption)
• adequate exercise and physical activity
• limit sedentary lifestyle
• take enough breaks and change position when working sedentarily
• sufficient drinking
• reduce intake of foods such as: chilli, pepper, dairy products, citrus fruits, peanuts chocolate, tomatoes, ketchup, coffee, tea, alcohol (beer, wine)