Pruritis ani is a Latin term meaning “itchy anus” and is a condition that causes an intense, cyclic itching or burning sensation of the rectal opening. Even the most minimal stimulation or irritation of the anal skin can cause severe itching. The subsequent scratching then causes damage to the skin, which leads to more itching and scratching.
Pruritis ani is classified as either primary or secondary. The primary form is idiopathic, which may not have an identifiable cause, while the secondary form has an identifiable cause. The condition affects up to 5 percent of Minnesotans and occurs more frequently in men.
While itching is common to many anorectal diseases, the itching associated with pruritis ani is more intense and cyclic, causing an irresistible urge to scratch. Symptoms manifest more often at night or after a bowel movement.
The exact mechanism of developing pruritis ani is not clear, but there are many risk factors that contribute to the disease, such as:
Pruritis ani is clinically diagnosed by history, a physical examination and an anoscopy. There is no specific test for its diagnosis. During your initial office visit, your doctor may inspect the anus for skin changes or growth in the anus before doing a digital rectal examination with a gloved, lubricated finger, followed by an anoscopy to look for abnormalities in the lower rectum and anal canal. If indicated, your doctor may also perform a biopsy (a small piece of skin is removed for microscopic examination).
An anoscopy is a rectal exam with a very short (3-4 inch), rigid, metal tube used to examine the lower rectum and anal canal. It’s extremely useful in locating hemorrhoids, anal fissures and other anorectal diseases.
The goal of therapy is to reduce or eliminate itching and restore clean, dry and intact skin. To promote healing, the following steps are recommended: