Troublesome itching at the back passage area (pruritus ani) can be a miserable condition, suffered in silence by many patients. An irresistible urge to scratch the anal area results and usually occurs in bed at night or after a bowel movement. However, sufferers are frequently evaluated and successfully treated in the Institute's out-patient clinics. After initial assessment and treatment of common underlying anorectal disorders such as haemorrhoids, patients are given advice on strategies to reduce and eliminate any triggering factors such as excessive cleaning of the anal area; avoiding moisture; cutting out drinks such as beer, caffeine-containing beverages, milk and citrus drinks; and avoiding certain foods such as chocolate, nuts, tomatoes and fruit. Rarer causes of pruritus ani can include worm infections; skin conditions such as dermatitis, eczema and psoriasis; and allergies.
An information leaflet of useful "do's and dont's" is given to patients advising them to avoid moisture in the anal area; to avoid excessive amounts of fluids and triggering foods; to avoid trauma to the anal area in terms of rubbing or scratching; and to use only those topical medications recommended after review at the Institute.
A subgroup of patients often require referral for specialist dermatological review. Where necessary subsequent patch testing is performed to determine if the patient is allergic to common chemicals found in various everyday items including such as soap powders, perfumes and some ointments used for treatment of piles.