How Your Doctor Evaluates Your Anal Itch
For most of us an itching anus is something that happens every so often and can easily be treated by administering a soothing anal cream or just making sure that the area is kept clean. For many thousands of people, however, anal itching, or pruritus ani, becomes a chronic problem that can occur at the most inconvenient moments. At that point, most sensible sufferers head to the GP to see if there is more to the problem.
The difficult question is how your doctor decides what is causing your embarrassing problem.
History: Your doctor should first of all take a full history of the problem and ask the right questions, including what you have tried so far. Other issues he will need to know involve the type of diet you have and whether you are on any form of medication or drugs. It’s a good idea to be perfectly honest here – bad diagnosis is often partly caused by patients failing to give the full, even if embarrassing, facts.
Physical Examination: The doctor will need to have a look at the problem area and this can often be more embarrassing for the patient than talking about it. They will be looking for signs such as fecal soilage or haemorrhoids, lesions or fistulas. This may well involve your GP placing a finger inside your anus to assess things like sphincter tone and you may be asked to bear down to see if there are any prolapsing internal haemorrhoids.
The problem with the diagnosing the cause of anal itching is that the doctor often depends on the physical examination as well as the information he or she gets from the patient. Whilst it can often be seen as an embarrassing and invasive moment in your life it pays to be completely honest if you find that you need to pay a visit to the GP. Pruritus ani can be caused by anything from the nature of your diet, the type of underwear you favour, pinworms, haemorrhoids, and anal fissures to medication and more serious problems such as anal cancer.
The other thing to be aware of is that this is a highly common complaint and that doctors have seen it all before. You’re not the first to walk into their practice with the problem of an anal itch so it’s highly unlikely that you are going to cause them any embarrassment.
How your GP treats you will, of course, depend on the diagnosis. This might involve a topical cream that soothes the itching or you may need to change your diet or keep a food diary to discover what is causing the problem. Systematic causes such as fungal or pinworm infections can be easily treated or you may need to be referred to a specialist unit if something more serious is suspected.