Itchy Rectum and Anus Causes and Treatment

The alimentary canal begins with the mouth and ends in the anal opening. In between, lies a long tube (approx. 30 feet in length) that is divided into different regions that work to digest the food, absorb its nutrients and then excrete the waste. The last part of the alimentary canal is comprised of the rectal canal (approx. 12 cm in length) and the anal canal (approx. 2-4 cm in length). The anal canal opens to the outside in the form of an anal opening (also called anus).

Other Symptoms with an Itchy Rectum

A persistent itching sensation is the primary symptom. The anus and the skin surrounding the anus is sensitive to itch. However, the rectum does not have any itch receptors. Therefore, any discomfort in the rectum is felt as pain rather than an itch. However, any changes in the rectal mucosa may also spread to the anus and the surrounding groin region, leading to itching sensations. Thus, anal itch may reflect problems in both the anal canal as well as in the deeper rectal region.

Causes of Itchy Rectum and Anal Itching

Itchy anus can occur due to a variety of different causes, ranging from poor hygiene to infections and diseases. Following are some of the common causes:

Lack of hygiene

Poor hygiene practices can result in accumulation of dried feces, sweat, dust and sloughed off skin cells in the anal region. These, either individually or in concert, can lead to itchy anus. Scratching the anal area should be avoided as it is one of the main factors that aggravates anal itch.

Skin dryness

Dry skin in the anal region can be caused by hot showers and dry weather conditions. It is especially a problem in older people.

Foods

The intake of spicy foods, aerated drinks, milk products, caffeine, wine, and citrus fruits can also lead to upset stomach and itchy anus. Food allergies can also be a cause.

Seborrheic dermatitis

Skin inflammation that is a result of excessive oil production from the glands in the skin and their subsequent fungal infection can result in an itchy anal region. Seborrheic dermatitis results in scaly, yellowish patches of itchy skin in sweaty areas such as the groin, scalp, nose, ears, and armpits.

Hemorrhoids

Hemorrhoids (or piles) are one of the most common reasons for anal itch. Hemorrhoids refer to bloated, varicose veins in the anal region, either inside the anal canal (known as internal hemorrhoids) or under the skin of the anal area (known as external hemorrhoids). These varicose veins may develop due to conditions such as obesity, pregnancy, prolonged sitting, and constipation.

Diarrhea

Diarrheal diseases (such as Crohn’s disease, ulcerative colitis) could also lead to an itchy anal region. The itching in these conditions can be due to frequent bowel movements, painful ulcers/fissures, or due to the frequent wiping of the anal area.

Fungal skin infections

Infections of the skin at the groin and anal regions (such as Candida albicans) also result in persistent itching. Candida grows in moist regions of the skin and its growth is promoted by long term antibiotic use, low immunity, steroid intake and chemotherapy. Tinea cruris or jock itch is also another frequent fungal infection (especially in athletes) that results in persistent itching in and around the groin region. Anti-fungal creams and oral medicines are used to combat these infections.

Bacterial skin infections

Certain skin infections caused by bacteria (e.g., group A beta-hemolytic streptococci, Corynebacteria minutissimum) can result in persistent itchy skin in regions of the groin and the surrounding areas. These infections are treatable by anti-bacterial medications, but have a high chance of reappearing.

Parasites

Pinworms (also known as thread worms) are small intestinal parasites that mostly affect children. They come out of the rectum at night to lay eggs on the skin of the anal region. This can cause persistent itching in the affected children. Anti-parasite medications are used for the treatment of this condition.

Sexually transmitted diseases

Several sexually transmitted diseases caused by various microorganisms can display symptoms of an itchy anus. Examples include chlamydia, gonorrhea, syphilis, genital herpes, and genital/anal warts. Pubic lice (crabs) also cause intense itching in the groin and the surrounding regions.

Eczema

Eczema in the groin appears as reddish, itchy, flaky patches of skin. In babies, it could be due to diaper irritation or soap allergies. In adults, friction due to unwashed new undergarments and irritation due to clothes might be the causative factors. It helps to keep the skin around the groin and anal regions dry. Ointments are usually prescribed for eczema treatment.

Inverse psoriasis

Inverse psoriasis is a genetic disease that results in reddish, itchy and smooth patches of skin in the groin, armpits and the skin under the breasts.

Anal skin tags

These are harmless, fleshy outgrowths of the skin in the anal region. They are quite common in the population. Itching is their main manifestation.

Anal fissures

Cracks in the skin of the anal region due to various causes can also result in an itchy anus.

Treatment for Itchy Rectum and Anus

There are certain measures that one can take to maintain proper hygiene in the anal region and prevent an itchy anus/rectum:

  • Cleaning the anal region properly after passing stools is essential. Moistened tissues can be used to prevent accumulation of dried up feces in the area.
  • Washing the anal region with lukewarm water also helps. However, soaps should not be used since they can dry out the skin and increase the itch.
  • Scratching the anal region should be avoided.
  • Cosmetics such as deodorants and powders should not be applied to the anal region.

In case of an anal itch, following treatment measures can be undertaken, in consultation with a doctor:

  1. Moisturizing creams can be used to prevent drying the skin surrounding the anus. Topical creams containing corticosteroids (e.g., 1% hydrocortisone) can be used for a short duration.
  2. Straining should be avoided while passing stools. Changes in diet should be incorporated in order to soften the stool and avoid constipation.

Anal itch that is due to infections and diseases should be investigated by a doctor. Suppositories and home remedies should not be used without a doctor’s approval. An appropriate line of treatment can be prescribed only after determining the underlying cause of the anal/rectal itch.

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