2021年1月23日星期六

hemorrhoids and anal fissures,Anal itching

    Anal itching

    Anal itching (peritus ani, PA) is a common local pruritus. Sometimes there is slight itching in the anus. If itching is severe, it will become pruritus if it does not heal for a long time. It is a common localized neurological dysfunction skin disease. It is generally confined to around the anus, and some can spread to the perineum, vulva or behind the scrotum. It mostly occurs in middle-aged and elderly people between 20 and 40 years old. It is rare for young people under 20 years old and rarely occurs in children. It is more common in men than women, and people who are accustomed to quiet and infrequent exercise often have this kind of pruritus. Secondary pruritus has obvious causes and is easy to treat; spontaneous or unexplained PA is difficult to cure and often recurs, accounting for about 50% of all patients. Anal pruritus is more common in middle-aged people. Part of the local symptoms of systemic pruritus is more common in the elderly.

    Introduction

    Anal pruritus The pruritus confined to the anus is mostly related to anal and rectal diseases or secondary to anorectal diseases. Local inflammation and congestion increase the circulation of the skin, the temperature rises, and the buttocks are not easy to dissipate heat, which promotes increased sweat excretion, moist and impregnation, causing discomfort and itching. Patients with the initial illness often scald with hot water or apply topical corticosteroids and other drugs for a long time. Although it can relieve the pruritus temporarily, it can form a vicious cycle of itching-bad irritation-more itching over time, causing local symptoms Even more dramatic. Eating spicy food can also cause anal itching, poor hygiene, not cleaning the anus and perineum in time, scratching and rubbing the trousers, can make itching worse. Poorly dressed, wearing narrow clothes, or wearing underwear with uncomfortable texture, such as certain chemical fiber fabrics or thick and rough ones, makes it difficult for hip sweat to spread and rubbing can also induce anal itching. Anal itching in children is mostly in patients with pinworm disease. Female pinworms creep out of the anus to ovulate and form mechanical stimulation to cause anal itching.

    symptom

    In addition to the symptoms of pain, there are also symptoms of itching, which is medically called anal pruritus. Patients will scratch their hands constantly due to itching, even scratching the skin does not solve the problem. The causes of disease are as follows:

    1. The buttocks were not wiped clean, and the fecal residue irritated the skin and caused inflammation.

    2. Inflammation of the anal fossa, caused by its secretion flowing out of the anus.

    3. Prolapse of the rectal mucosa caused by the sequelae of surgery, or prolapse of the anus, caused by intestinal mucus sticking around the anus.

    4. Allergies caused by sitting lotion or antipruritic ointment, such as diabetes or female hormone abnormalities.

    5. Prickly heat, eczema around the anus.

    6. Pinworm.

    7. Special neurosis etc.

    People who suffer from anal pruritus most often are those whose anus is not cleaned. Therefore, do not wipe the anus with paper, but wash it with warm water. However, if you scrub with towel or soap because of itching, it will damage the skin and cause chronic inflammation.

    Go to the bath after defecation, wash the anus with absorbent cotton, and then use a soft cloth to absorb moisture, sprinkle with prickly heat powder, and keep it dry. After four or five days, itching can be relieved. If the itching still cannot be stopped, you need to find a rectal surgeon to diagnose and use drugs for treatment.

    Treatment misunderstanding

    1. Many people in life think that anal itching occurs in a special area, so many people who suffer from anal itching are shy and taboo to see a doctor and abuse some anti-itch ointments. As everyone knows, some antipruritic ointments contain hormones. Although the antipruritic effect was good at the time, the pruritus will recur in the later stage, and there will be many side effects after long use.

    2. Anal itching should pay attention to keeping the anus hygienic and dry. After washing with warm water, gently wipe it dry with a soft tissue. Avoid washing the anus with hot water and soap repeatedly. This will wash off the sebum of the perianal skin, destroy the anal skin environment, and cause anal itching. In addition, excessive use of soap, especially strong alkaline soap, can stimulate the perianal skin and easily cause perianal itching. In addition, do not scratch hard, so as not to scratch the skin to spread the infection and aggravate the condition.

    3. Anal pruritus is a common anal symptom. There are many reasons for anal pruritus. Anal itching may be mild and severe. If the itching period is long and does not heal for a long time, it will become pruritus.

    4. If anal itching is scratched for a long time and does not heal for a long time, the skin will become rough and thickened, chapped in the anus, or even combined with infection, causing flushing, swelling and pain. The disease can also spread to the perineum, scrotum, vulva, and even the skin of the buttocks, which is even more unbearable. Therefore, once you suffer from anal itching, you must not scratch it with your hands, as this will cause secondary infections on the local skin.

    Early performance

    The early manifestations of anal itching are: limited to the itching of the skin around the anus, sometimes light and sometimes heavy, sometimes stinging or burning, sometimes like insects and ants, sometimes like mosquito bites and grilling, sometimes itching is unbearable, and worse at night. It's disturbing. Itching makes the skin ulcerated, exuded, crusted, and does not heal for a long time, resulting in thickening of the perianal skin, thick and rough wrinkled walls, showing radial folds, lichenification, pigmentation or depigmentation, spreading to the perineum, scrotum, and labia Or sacrococcygeal. After being ill for a long time, it is easy to chap afterwards. Over time, it can cause neurasthenia, mental atrophy, lack of taste in food, and sleeplessness at night.

    Causes of anal itching

    From the perspective of local factors, anal itching:

    1. All kinds of anorectal diseases, such as hemorrhoids, thin anus, prolapse, proctitis, and after anal surgery, will cause itching due to increased secretions around the anus, irritating the skin.

    2. Anal skin diseases, such as perianal eczema, neurodermatitis, tinea corporis and other skin diseases can cause anal itching symptoms. In patients with hemorrhoids, the feces attached to the hemorrhoids or in the folds of the anal skin can cause irritation, causing itching and irritation.

    3. Parasitic diseases, the most common is pinworm disease, and its itching is often aggravated during sleep at night. At this time, the anal sphincter relaxes, and the female slough crawls outside the anus to lay eggs, which stimulates the perianal skin and causes itching. In addition, pubic lice, worms, etc. are also easy to cause anal itching.

    From the perspective of systemic factors, anal itching:

    1. It is related to family genetic factors.

    2. Women's menopause and menopause can also cause anal itching.

    3. Anal itching also occurs when there are mental factors such as shock, mental depression or overexcitement.

    4. Allergies to morphine and certain antibiotics can cause symptoms of anal itching.

    5. Food allergies, if you are allergic to eggs, fish, shrimps, and are allergic to drinking, eating chili, mustard and other irritating foods,

    6. Some chronic diseases such as diabetes, rheumatism, gout, etc. and some clinical symptoms such as diarrhea, constipation, and jaundice can be accompanied by anal pruritus.

    Pathology

    Cause

    1. Rectal diseases: Anal fistulas, hemorrhoids, anal sinusitis, anal papillitis, rectal prolapse, anal incontinence, etc., which increase the secretions of the anal orifice, and damp the skin and cause itching.

    2. Dermatological factors: such as anal eczema, neurodermatitis, ringworm, various warts, venereal diseases, hidradenitis, etc. The stool is attached to the anal folds, irritating the skin and causing itching.

    Third, parasitic diseases: it is also easy to cause anal itching.

    1. Systemic causes

    1. Allergic reactions: If you eat irritating foods, such as peppers, mustard, spices, wine or specific protein foods, or take certain substances, such as antibiotics, allergies can cause anal itching.

    2. Parasitic diseases: such as molting, roundworms, trichomoniasis, pubic lice, scabies, etc., can cause anal itching.

    3. Endocrine and metabolic diseases: such as increased sugar content in the skin of diabetic patients, itching caused by stimulating nerve endings; hyperthyroidism skin itching may be related to hyperhidrosis, increased basal metabolic rate, emotional tension, etc.

    4. Blood diseases: iron deficiency anemia, etc.

    5. Gastrointestinal diseases: acute and chronic diarrhea, constipation, gastrointestinal neurosis, etc. [3]

    2. Local factors

    1. Skin diseases: Anal skin diseases such as anal eczema, neurodermatitis, ringworm, various warts, venereal diseases, hidradenitis, etc. The stool is attached to the anal folds, irritating the skin and causing itching.

    2. Microorganisms around the anus: For example, pinworm parasitic is a common cause of anal itching in children. This anal itching can be cured after deworming treatment, frequent changing of underwear and washing.

    3. Anorectal diseases: such as anal fissure, anal fistula, hemorrhoids, anal sinusitis, anal papillitis, rectal prolapse, anal incontinence, etc., increase the secretions of the anal orifice, and irritate the skin with vaginitis secretions and cause itching.

    Traditional Chinese medicine believes that wind pathogens, damp pathogens, heat pathogens, blood deficiency, worms, etc. are the main causes of disease. The treatment is based on the principles of dispelling wind and dampness, clearing heat and detoxification, nourishing blood and moisturizing dryness, and promoting blood circulation to remove blood stasis, so as to achieve exorcism and strengthening of the body. Antipruritic effect.

    It is more common in middle-aged people, some of which are local symptoms of systemic pruritus, and more common in the elderly. The pruritus confined to the anus is mostly related to anal and rectal diseases or secondary to anorectal diseases. Local inflammation and congestion increase the circulation of the skin, the temperature rises, and the buttocks are not easy to dissipate heat, which promotes increased sweat excretion, moist and impregnation, causing discomfort and itching. Patients with the initial illness often scald with hot water or apply topical corticosteroids and other drugs for a long time. Although it can relieve the pruritus temporarily, it can form a vicious cycle of itching-bad irritation-more itching over time, causing local symptoms Even more dramatic.

    The anal itching may also be caused by the addiction to spicy food, poor hygiene habits, not cleaning the anus and perineum in time, scratching and rubbing the trousers, can make the itching worse. Poorly dressed, wearing narrow clothes, or wearing underwear with uncomfortable texture, such as certain chemical fiber fabrics or thick and rough ones, makes it difficult for hip sweat to spread and rubbing can also induce anal itching. Anal itching in children is mostly in patients with pinworm disease. Female pinworms creep out of the anus to ovulate and form mechanical stimulation to cause anal itching.

    Differentiating the different causes of anal pruritus is of great significance to the treatment.

    ① Senile pruritus: It is more common in the elderly. The pruritus is mainly on the trunk and limbs, and can also spread to the anus. Long-term scratching can cause eczema-like changes, which are related to senile dry skin.

    ② Winter pruritus: It occurs in winter or autumn. It usually occurs around the trunk and the joints of the limbs, as well as the anus and the inner thigh. It is mostly related to sudden changes in skin temperature.

    ③ Liver and kidney diseases: that is, due to liver and gallbladder diseases, such as biliary infarction or hepatitis, the liver is injured by taking drugs, so that intrahepatic cholestasis will overflow in the blood, and bile salts will rise in the blood, accumulate in the skin, and irritate the skin. Sensory organs, causing itching. Renal dysfunction can also cause itching, which may spread all over the body.

    ④Endocrine pruritus: Diabetic pruritus can spread to the whole body, perineum, and anus. The reason is that the skin's sugar content increases and the peripheral nerves are stimulated. Patients with hyperthyroidism also have pruritus, which is related to nervousness, hyperhidrosis, and increased basal metabolism.

    ⑤Spiritual pruritus: Symptoms of pruritus can be on the whole body or part of the anus. There are usually no obvious scratches in the part. Generally, the degree of itching is exaggerated. These patients are accompanied by mental symptoms.

    ⑥ Secondary pruritus: mainly secondary to hemorrhoids, fistulas, anal fissures, anal eczema, neurodermatitis, enterobiasis and other diseases.

    pathology

    Traditional Chinese medicine believes that the external causes of anal itching are mainly feelings of wind, dampness, heat, and insect toxic harassment. Therefore, there is a saying that "all itches are deficient, wind, heat is painful, and heat is slightly itchy." The internal cause is often blood. Deficiency and dryness, insufficient liver and kidney, weak viscera, damp-heat betting, etc., so the predecessors said: "Blood deficiency causes wind, and wind gathers itching."

    1. Feeling of external evils: The evil guests of wind, cold, dampness and heat stay in the skin and stay in the skin. If they are not scattered, then itchy rash will occur. As the "Theories on the Sources of Diseases" put it: "The evil spirits are on the skin, and when the wind and cold recur, the rash will develop."

    2. Blood deficiency and wind: The visceral body is deficient, the qi and blood are insufficient, or the qi and blood is depleted for a long-term illness, and the skin can not be replenished. It is itchy when the skin is dry, or it is attacked by the deficiency of wind and external and internal and external.

    3. Liver meridian damp and heat bet: Foot Jueyin liver meridian, pubic hair, yin around, collaterals and veins, if the liver meridian is damp and hot, you can bet along the meridian, the yin stagnated on the anal skin and itching.

    4. Blood stasis and wind: Due to various reasons, the viscera dysfunction, blood stasis blocking the collaterals, long-term stagnation of the skin, stagnation, stagnation, meridian stasis and exogenous wind toxin.

    5. Insect poison harassment: "Theories on the Sources of Diseases" says: "Besides pinworms, one of the small worms is very small, and is caused by weak internal organs, even hemorrhoids, fistulas, and ringworm." That is, itching of the anal skin. Insect poison harassment is one of the important causes of anal pruritus.

    Modern medicine believes that the cause of pruritus is complex and changeable, and it is caused by the mutual influence of many factors.

    Common reasons are as follows:

    1. Allergy: It is an important factor in the pathogenesis, such as focal infection, disease-causing food, drugs or exposure to certain allergenic substances.

    2. Disease factors: Certain diseases such as endocrine disorders, malnutrition, digestive disorders, intestinal parasites, etc. and local perianal lesions such as hemorrhoids, fistulas, fissures, anal incontinence and other symptoms are induced by chronic stimulation.

    3. Partially directly stimulated by iodine, alcohol, strong alkali, etc., induce eczema.

    4. Nervous dysfunction, overwork, mental stress, depression, insomnia, etc. can induce this disease.

    The above-mentioned causes are complicated, and it is difficult to treat with one method alone. We use multiple methods of surgery, local injection of drugs, traditional Chinese medicine fumigation and washing, and external drugs, and the effect is better. The above-mentioned drugs have the effects of clearing heat and dampness, converging and relieving itching, and killing insects. Multiple links destroy sensory nerves, reduce local infections, disappear symptoms, and cure the disease.

    Anal pruritus is more common in middle-aged people. Part of the local symptoms of systemic pruritus is more common in the elderly.

    Anal itching in children is mostly in pinworm patients. Female pinworms creep out of the anus to ovulate and form mechanical stimulation to cause anal itching.

    Disorders that cause anal itching

    1. Perianal dermatitis Itchy, damp, thickened, chapped, and eroded skin around the anus. Occasionally a history of foreign body contact is a contact dermatitis.

    2. Eczema and ulcers in the skin around the anus. There is often a history of triggers and allergies.

    3. Tinea cruris is caused by a fungal infection. Patients often have a history of athlete's foot or fungal infection.

    4. Perianal skin apocrine inflammation.

    5. Anal skin venereal disease, condyloma acuminatum.

    6. Anal disease, anal fistula, internal and external hemorrhoids.

    7. Anal discharge The hypofunction of the anal sphincter and the overflow of rectal mucus can irritate the skin.

    8. Anal neurodermatitis.

    Anal itching in the elderly

    1. Local physiological changes of the perianal skin: the elderly are due to the decreased secretion of sebaceous glands, lack of sebum moisturization, dry skin, and increased skin folds around the anus, and feces, sweat and dirt tend to accumulate in it, often damp and unclean. This is easy for bacteria to breed, and chronic inflammation at the junction of the perianal skin and mucous membranes is prone to cause anal itching.

    2. Fungal infection: In the hot and humid climate, the elderly with obesity and sweating are prone to skin fungal infections that can cause tinea cruris or ringworm of the buttocks, and often cause perianal itching due to the expansion of the skin lesions and spread to the vicinity of the anus. Mainly manifested as circular or semi-circular or map-like erythema with clear boundaries on the inner thigh or buttocks, with a layer of white phosphorous on the surface. The diagnosis can be confirmed when the phosphate scraps are scraped and examined under a microscope, if fungal hyphae and spores are found.

    3. Perianal eczema: mainly manifested as skin damages such as papules, blisters, and even erosions and exudates on the anal circle. The skin around the anus is often thickened and mossized after intense itching and scratching, and the appearance is mostly grayish white.

    4. Neurodermatitis: Neurodermatitis that occurs in the sacrum or near the anus. It often causes anal itching, which is mainly manifested by the appearance of polygonal and fused papules on the local skin. Scratching and scratching often make skin lesions thickened and lichenized. Like bark.

    5. Anal fissure and hemorrhoid fistula: The elderly have weakened gastrointestinal motility and are prone to constipation, and often cause anal fissure due to forced stool. Fresh anal fissures that have just occurred mainly manifest anal pain, itching and bleeding. Old anal fissures are mostly associated with a special type of hemorrhoids-sentinel hemorrhoids, which are itchy and painful. Anal fistulas are mostly an internal rectum left after the ulceration of an abscess around the anus. Externally through the fistula on the skin around the anus, anal itching can be caused by the stimulation of the pus flowing out of the fistula.

    6. Viral warts: Old people suffering from anal condyloma acuminata or molluscum contagiosum can also cause anal itching. The former mainly manifests anal itching. The former is mainly manifested as cauliflower-like or cockscomb-like verrucous growths around the anus, which are moist and dirty and have a foul smell; the form of the latter skin damage is round or hemispherical warty-like growths with a "belly button" in the center In addition to the perianal and scrotum, such depressions can also spread to the skin of the whole body.

    7. Parasitic infection: Enterobiasis causes anal itching in the elderly can account for a considerable proportion. When the anus is loose at night, pinworms often crawl out of the rectum, lay eggs around the anus and mate, and cause anal itching due to stimulation of the perianal skin, and it is characterized by night itching. When suffering from scabies, if skin damage in the vulva spreads to the vicinity of the anus, it can also cause anal itching. In addition, when suffering from senile trichomonas vaginitis due to the stimulation of leucorrhea, it can also cause anal itching.

    In addition to the more frequent causes of anal itching, there are other causes such as fungal infections. No matter what the cause is, formal examination and treatment in the hospital is the guarantee of health.

    Causes of anal itching in men

    Disorders that cause anal itching in men can be found in two types: systemic factors and local factors:

    (1) Systemic factors

    ① Allergic reactions: eating eggs, fish, shrimps, etc. cause allergic reactions; eating peppers, mustard, drinking and other irritating foods and beverages, causing anal itching.

    ②Men's patients with anal itching have diarrhea, constipation, jaundice, diabetes, gout, rheumatism and many other systemic diseases, as well as women's menopause and male menopause can be complicated by anal itching.

    ③Drug effects: Anal itching may also occur if antibiotics are used.

    ④ Mental factors: Anal itching is often accompanied by panic, depression, overexcitation or neurasthenia.

    (2) Local factors

    ① Anal skin diseases: such as anal eczema, neurodermatitis, warts, ringworm, venereal diseases, etc., which cause itching of the anus.

    ②Anorectal diseases and perineal diseases: such as hemorrhoids, anal fistulas, anal fissures, prolapsed anus, anal sinusitis, anal papillary hypertrophy, vaginitis, urethritis, etc., all caused by inflammation, increased secretions and caused anal itching.

    ③ Parasites: such as roundworms, pinworms, trichomoniasis, pubic lice, etc. can cause anal itching, which is also a cause of anal itching in men.

    Eight factors cause anal itching

    1. Anal skin diseases such as anal eczema, neurodermatitis, ringworm, various warts, venereal diseases, sweat

    Adenitis, feces attached to the anal folds, irritating the skin and causing itching.

    2. Anorectal diseases such as anal fissure, anal fistula, hemorrhoids, anal sinusitis, anal papillitis, rectal prolapse, anal incontinence, etc., increase the secretion of the anal orifice, damp and stimulate the skin and cause itching.

    3. Parasitic diseases such as molting, roundworms, trichomoniasis, pubic lice, scabies, etc., can cause anal itching.

    4. Endocrine diseases such as increased sugar content in the skin of diabetic patients, itching caused by stimulating nerve endings; hyperthyroidism skin cancer itching, may be related to hyperhidrosis, increased basal metabolic rate, emotional tension, etc.

    5. Allergic reactions Eating irritating foods, such as peppers, mustard, spices, wine or specific protein foods, and taking certain drugs, such as sulfa antibiotics, can cause anal itching due to allergies.

    6. Mental factors Neurasthenia, hysteria, mental hypertension, excitement, excitement, etc. cause neurological disorders, and can also induce or cause itching, which can be widespread throughout the body, anus, and perineum.

    7. Liver and kidney disease. Patients with primary biliary cirrhosis or biliary obstruction have increased levels of bile salts in the blood and skin, irritating nerve endings and causing itching; anal itching may also occur in uremia in the late stage of nephropathy.

    Diseases that cause wet anus

    1. Hemorrhoids: Internal hemorrhoids and inflammatory external hemorrhoids are most likely to cause the symptoms of itching and moist anus. Internal hemorrhoids prolapse out of the anus repeatedly, which will bring secretions in the intestines to the anus, irritating the perianal skin, causing moist itching in the anus; and inflammatory external hemorrhoids stimulate the perianal skin through inflammatory reactions, which can also cause Symptoms of itching and damp anus.

    2. Anal fissure: If the anal fissure develops to the middle and late stages, the ulcer of the anal fissure cannot be healed, and some viscous secretions will flow out, resulting in damp and itching symptoms around the anus.

    3. Rectal prolapse: Rectal prolapse refers to a disease in which the anal canal and rectal mucosa prolapse outside the anus. When a patient develops rectal prolapse, the rectal mucosa turns out to bring out the secretions in the intestines and cause the anus Symptoms such as dampness and anal itching. [4]

    Night anal itching in children

    In the group suffering from anal itching, infant anal itching is also one of the more common factors. Among them, the cause of infant anal itching is mostly caused by pinworms parasitic in children. Nocturnal pinworm females migrate to around the anus to ovulate and cause itching. Parents should usually pay attention to the cleanliness of the baby's anus. Note: While deworming and treating anal itching, the child should wear a full set of pants. The next day, put the pants in boiling water to kill the early eggs. Keep it for a month and it will disappear. Be careful not to eat your fingers. Personal hygiene prevents the patient from eating this link.

    To prevent and treat infant anal pruritus, we must first treat related diseases in the anal area. Pay attention to keeping the anus hygienic and dry. After washing with warm water, dry it gently with a soft tissue. Avoid washing the anus with hot water and soap repeatedly. This will wash off the sebum of the perianal skin, destroy the anal skin environment, and cause anal itching. Underwear should not be too tight or too hard. Don’t wear uncomfortable textures such as certain chemical fiber fabrics or thick and rough underpants. This will prevent sweat from spreading and rubbing to induce anal itching.

    Children are usually pruritus caused by parasites. If not, you should take your child to see a doctor. In order to avoid anal pruritus and anal diseases, hygiene, bacterial or fungal infections and other factors related. For example, hemorrhoids and anal fistula can cause itching in the anal area.

    Diseases caused by anal itching

    ① Anal eczema: The method chosen by many patients with itching is to scratch with their hands. It is easy to scratch the skin around the anus, causing it to become infected, leaking mucus, and causing anal dampness, which can cause anal eczema and make it more severe.

    ② Endocrine disorders: The metabolism in the body is generated faster, and the sweat glands discharge faster. It is often prone to excessive sweating and cannot get normal volatilization. It is easy to cause endocrine disorders and stimulate skin itching.

    ③ Irregular diet: Excessive consumption of spicy and greasy irritating foods, such as peppers, spirits, fried foods, etc., can cause anal itching. Another is the itching caused by taking allergic drugs or expired food.

    ④ Nervous disorders: Excessive tension, irritability and abnormal excitement, excitement, etc. caused by excessive pressure can cause disorders of the brain and nervous system and cause itching.

    ⑤ Organ diseases: Patients with liver disease and kidney disease have high salt content in the blood, which can cause blockage in the liver tract, which can easily stimulate peripheral nerves and cause itching. [5]

    diagnosis

    Based on a typical history of anal itching, combined with clinical symptoms and signs, it is not difficult to diagnose the disease, but it is more difficult to determine the cause. Generally, the primary disease in the anus becomes secondary pruritus, otherwise it is primary pruritus. In addition, a full physical examination should be carried out, and necessary laboratory tests should be carried out in a targeted manner, such as blood, urine, stool routine, liver and kidney function, urine glucose, blood sugar, glucose tolerance test, and biopsy and smears.

    According to the cause, it can be divided into primary pruritus and secondary pruritus.

    (1) Primary itching

    Primary pruritus is not accompanied by primary skin damage, and pruritus is the main symptom.

    (Two) secondary itching

    Secondary pruritus arises from primary diseases and various skin diseases, accompanied by obvious specific skin damage and primary lesions. Itching is often a symptom of primary lesions. Anal itching caused by anal fistula, anal eczema, genital warts, neurodermatitis, anorectal tumors, pinworms, etc. all belong to this category.

    The anal itching is mild at first, and the anal skin has no obvious changes, mostly paroxysmal. Chronic patients have more severe itching and last longer, especially at night. Excessive scratching or mechanical stimulation makes the perianal skin hypertrophy and roughness, deepening of anal folds, local scratches, blood scabs, exudate, and fold seams Residual fecal dirt, more severe cases may be combined with pustules or purulent secretions, flushing and swelling. The lesion can extend to the skin of the perineum, scrotum, female vulva and even the buttocks. Clinical examination can be found to have internal hemorrhoids, external hemorrhoids, mixed hemorrhoids, anal fistula, or laboratory examinations found to have diabetes, enterobiasis, Candida albicans infection, etc.

    Four measures to prevent anal itching

    1. Clothing: Underwear and underwear should be kept clean. Underwear should be soft and loose. Cotton fabrics should be used as the best. Avoid wearing chemical fiber clothing next to the body.

    2. Food: Pay attention to adjusting gastrointestinal function, preferably light, vitamin-rich fresh vegetables and soy products; taboo smoking, alcohol, pepper, strong tea, coffee and other irritating foods; keep the stool smooth.

    3. Living: Adjust the indoor temperature to 16°C to 20°C, and the relative humidity to 30% to 40%. When the relative humidity is lower than 20%, the indoor air is too dry and dust and other allergens are easy to fly. Therefore, water should be sprayed on the ground, and the humidifier can be activated if conditions permit. The toilet paper should be soft to keep the anus fresh and clean.

    4. Action: People with sensitive skin should not only reduce activities appropriately, but also pay attention to bathing not too often, and the water temperature should not be too high, otherwise the sebum on the skin surface will be washed off, making the skin drier and prone to itching. In addition, do not scratch when itching occurs to prevent the epidermal cells from undergoing proliferative changes and become rough and thick. As a result, the more itching becomes, the more itching becomes a vicious circle. [6]

    Identify

    Differentiation of perianal eczema and anal pruritus: eczema often has papules, erythema, exudation, erosion, and subsequent itching, while the latter is usually mainly itching, without exudate, and after scratching, secondary oozing Bleeding, bleeding, erosion.

    Once secondary skin lesions occur in anal itching, it should be differentiated from the following diseases based on medical history:

    (1) Urticaria: There are specific skin lesions (wind masses) and the course of the disease.

    (2) Insect bites: The typical skin lesions are wind mass-like papules, with small blisters on the top, and most of them have no systemic symptoms.

    (3) Drug eruption: There is a clear medication official, there is a certain incubation period, the skin lesions occur suddenly, except for the fixed drug eruption, the distribution is more symmetrical.

    (4) Scabies: There is a history of contact infection, prevalent sites and typical skin lesions. If scabies mites can be found, the diagnosis can be confirmed.

    prevention

    1. Timely treatment of local and systemic diseases that cause perianal pruritus, such as internal hemorrhoids, anal fissure, anal fistula, diarrhea, diabetes, and parasitic diseases.

    2. Keep the anus clean and dry, wash the anus once every night as much as possible, and use warm water to clean the perianal area.

    3. The underwear should not be too tight or too hard. It is advisable to wear pure cotton and loose fit underwear, do not wear man-made fiber underwear, and wash and change frequently.

    4. Pay attention to the combination of work and rest, keep a happy mood, prevent excessive tension and anxiety, do not scratch the anus, and do not wipe the anus with hard objects.

    5. Eat more fruits and vegetables, and do not eat or eat less irritating foods, such as peppers, strong tea, coffee, high alcohol, etc.

    6. If the perianal itching does not stop but the skin is not damaged, gauze or absorbent cotton can be soaked in the boric acid liquid at a suitable water temperature. Take it out and twist it until there is no dripping. Apply it to the perianal area to stop itching immediately.

    Points to prevent anal itching

    The first thing to do is to treat related diseases in the anal area. Pay attention to keeping the anus hygienic and dry. After washing with warm water, dry it gently with a soft tissue. Avoid washing the anus with hot water and soap repeatedly.

    Underwear should not be too tight or too hard. Don’t wear uncomfortable textures such as certain chemical fiber fabrics or thick and rough underpants. This will prevent sweat from spreading and rubbing to induce anal itching.

    Don't abuse some anti-itch ointments for anal itching. Some anti-itch ointments contain hormones. Although the anti-itch effect was good at the time, the itching will recur later, and there will be many side effects after long use.

    treatment

    Based on a typical history of anal itching, combined with clinical symptoms and signs, it is not difficult to diagnose the disease, but it is more difficult to determine the cause. Generally, the primary disease in the anus becomes secondary pruritus, otherwise it is primary pruritus. In addition, a full physical examination should be carried out, and necessary laboratory tests should be carried out in a targeted manner, such as blood, urine, stool routine, liver and kidney function, urine glucose, blood sugar, glucose tolerance test, and biopsy and smears.

    1. Treatment of primary diseases or complications such as hemorrhoids, anal fistulas, enterobiasis, etc. Give corresponding antibiotics or antibacterial drugs to treat co-infections. [7]

    2. Avoid inappropriate self-treatment. Many patients with anal scrapie do not want to go to the hospital and take improper self-treatment, such as scalding with hot water, topical high-concentration corticosteroids or containing anti-irritant drugs, and buying some crude Home physiotherapy equipment self-treatment, etc., these methods have more harm than good, but can only temporarily suppress itching, which will cause the disease to prolong and increase over time. Patients should be advised to stop using it.

    3. Pay attention to hygiene, and do not eat or eat less irritating food, such as spicy food, strong tea and coffee, strong alcohol, etc. Clothes should be loose and fit, and cotton fabrics are better for underwear.

    4. The drug treatment of localized anal pruritus should be local topical treatment. All kinds of drugs used in systemic treatment, such as corticosteroids, anti-inflammatory mediators, various sedatives, etc., have no obvious antipruritic effect on anal pruritus, but There are many side effects or adverse effects, and should be avoided if there is no clear indication.

    5. For people with only local itching and normal anal skin, wash the anus with boric acid water and apply cold compresses if ice cubes are added to make the water temperature around 4~5℃. Apply gauze or absorbent cotton to the anus in a squatting position to relieve itching immediately. Once a day in the morning and in the evening, each time for about 5 minutes. After the cold compress, wipe the part with a dry towel, and puff with ordinary talcum powder to keep it dry. This type of anal itching is not suitable for external application of ointment, ointment hinders heat dissipation, and increased sweat can easily induce itching. Use cool and dry lotion, such as white lotion, calamine lotion, etc.

    6. Rough and hypertrophic lichenified skin lesions in the anus usually have co-infections. Appropriate antibiotics or antibacterial agents can be used. After infection is controlled, local encapsulation treatment should be performed; after washing the area, local disinfection with alcohol or trigermide solution, strong injection Use the injection needle to drop the drug solution on the skin lesions with the Songlong injection or triamcinolone injection, make sure that the skin lesions are fully immersed in the drug solution, the patient feels less itching, and the local drug solution is dry. Then apply ordinary rubber according to the size of the lesion Ointments or ointments containing antipruritic agents can also be encapsulated in a film-like form with film-forming agents or gels containing drugs. This method should be implemented before going to bed. After 6-8 hours, remove the plaster or film-forming encapsulation, clean the part, and spray with dry lotion or anti-itch aerosol. This method has a good effect on relieving itching and promoting lichenification damage.

    7. Injection therapy The drug is injected subcutaneously or intracutaneously to destroy the sensory nerves, reduce local sensation, disappear the symptoms, and heal the local damage. About 50% of the cases can be cured permanently. However, patients with severe itching are prone to relapse and need to be injected again. Injection of drugs not only destroys sensory nerves, but also damages motor nerves. Sensory anal incontinence and sphincter dysfunction of different degrees often occur, but they can recover on their own after a period of time.

    ⑴ Alcohol subcutaneous injection: Alcohol can dissolve the nerve myelin, without damaging the nerve axis, degeneration of sensory nerve endings, and loss of sensation in the skin until nerve regeneration. There are two injection methods. ①Divided subcutaneous injection method: Divide the area around the anus into 4 areas, one area for each injection. After the skin is disinfected, use a long needle to subcutaneously inject procaine solution, leave the needle in place, and then inject alcohol. The injected drug should be evenly distributed, without leakage or tension. Do not inject into the skin to avoid skin necrosis; not to inject into the anal sphincter to prevent paralysis of the sphincter. After the injection, apply heat to relieve the pain with sedatives, and then inject another area at 5-10 days, and inject the area 4 completely. ②Multiple subcutaneous injection method: After local anesthesia, use a very fine needle to puncture multiple places around the anus and inject alcohol into the skin around the anus. Each place is 0.5cm away, and each place is injected 2 to 3 drops. Avoid injection into the skin or the sphincter. .

    ⑵Intradermal injection of methylene blue: inject the methylene blue solution into the skin around the anus to make the inner nerve endings disappear and the itching subsided. The injection solution is made by dissolving methylene blue and procaine in distilled water. The skin is coated with mercury solution, and the solution is injected into the skin around the anus with a fine needle, with 3 to 4 drops in each place, and all the itching areas are injected. The total amount does not exceed 20ml. After injection, the anus is covered with sterile gauze, and morphine or codeine is used to relieve pain.

    8. Surgical therapy

    If spontaneous pruritus does not improve or recurs after the above treatment, surgery can be used. There are two surgical methods: removing innervation from the skin of the anus and removing the skin of the anus.

    ⑴Subcutaneous incision: Make a half-circular incision on both sides of the anus, 5cm from the anal edge, cut the subcutaneous fat, separate the skin to the inside to expose the lower edge of the external sphincter, and remove the skin from the internal sphincter into the anal canal Separate to the plane of the anal valve. Separate the skin from the front and back of the anus from the deep tissue to allow the wounds on both sides of the anus to communicate. Finally, the skin on the outer edge of the incision is separated by 1 to 2 cm, and the skin is sewn in place after hemostasis. Sometimes drainage is required, and the outer cover compresses the dressing. The bowel needs to be prepared before surgery, and bowel movements are controlled for 3 to 4 days after surgery. The results have been reported by different companies, and most of them have achieved good results, but there are reports of recurrence cases and wound infection and dehiscence.

    ⑵Excision and suture: Make an incision from front to back along the anal margin, and make a curved incision on the outside of the incision to include the diseased skin in the incision. The two ends of the incision are connected, and the half-moon skin between the two incisions is removed. Suture the wound. The contralateral side was resected in the same way. After the skin is removed, itching can be relieved, but the wound sometimes becomes infected.

    Another: Propolis is anti-bacterial and anti-inflammatory, can cure anal itching

    The main components of propolis are flavonoids, organic acids, enzymes, vitamins and minerals. Propolis has a wide range of functions, one of which is antibacterial and anti-inflammatory. Therefore, for some anal itching caused by infection factors, you can try the above methods. But to prevent anal itching, you must pay attention to personal hygiene, such as keeping the area dry, clean, changing underwear frequently, do not scald the area with hot water, and do not blindly use some powerful hormone ointments to stop itching.

    Do not use drugs for anal itching

    If you suffer from anal itching, do not avoid seeing a doctor because you are embarrassed. You abuse some antipruritic ointments. Some antipruritic ointments contain hormones. Although the antipruritic effect is good at the time, the pruritus will recur in the later period, and it will occur after a long time. Many side effects.

    Excessive use of soap, especially soap with strong alkalinity, can stimulate the perianal skin and easily cause perianal itching. At first, it is limited to mild itching of the skin around the anus. If it does not heal for a long time, the itching will gradually spread. Especially at night or in a humid environment, the itching will increase.

    TCM treatment methods

    1. Wind-heat stagnation type anal itching

    The symptoms of itching around the anus are unbearable, burning and swelling, such as hoarseness of fire and insects, and even skin scratches and bleeding, upset, difficult to sleep soundly, dry mouth and throat, constipation, irritability and irritability. The tip of the tongue is red and red, and the pulse string is counted or slightly counted.

    Treatment method: To clear wind and clear heat, laxative and relieve fire, and treat with Longdan Xiegan Decoction. Recipe: Mulberry leaf, Sophora flavescens, Black Snake, Rhubarb, Alisma, Scutellaria, Poria, Gardenia, Habitat, Angelica, Gentian, Phellodendron, Atractylodes, Nepeta, Parsnip, Licorice.

    2. Anal itching of blood deficiency and wind

    Such manifestations are perianal skin itchy, dry skin, loss of luster and elasticity, wrinkles such as spider webs, or even involving the scrotum and labia, accompanied by bitter mouth and dry tongue, restless sleep at night, red tongue, and thin pulse. This type is mostly caused by blood deficiency, wind and dryness, and perianal skin loss.

    Treatment method: Nourish blood and stop wind, nourish yin and moisturize dryness, and treat with addition and subtraction of Angelica decoction. Recipe: Shouwu, Angelica, donkey-hide gelatin, white peony root, Habitat, Ligusticum chuanxiong, Astragalus, Ophiopogon japonicus, Stiff silkworm, Nepeta, Parsnip, Duckweed, Tribulus terrestris, Licorice.

    3. Rheumatism hot type anal itching

    The symptoms of this type of anal itching are painful, with exudative mucus, more painful movement and friction, the anus feels uncomfortable from falling, the body is tired and the body is heavy, and it is difficult to sleep at night. The tongue is red, the coating is thick yellow, and the pulse string is slippery. This type is mostly caused by wind evil and damp heat in the anal skin. Treatment method: disperse wind and clear heat, invigorate the spleen, remove dampness and detoxify.

    Recipe: Smilax glabra, Atractylodes japonicus, Phellodendron amurense, Rhizoma Astragalus, wild chrysanthemum, Habitat, Angelica, Parsnip, burdock seed, Chanyi, Sophora flavescens, Nepeta, Flax seed, Raw licorice.

    4. Anal itching caused by parasites

    The symptoms of this type of anal itching are especially severe at night, and the skin is unbearable. This type is more common in roundworms, pinworms, tapeworms, and pubic lice.

    Treatment method: insecticide and antipruritic, commonly used prescription is the addition and subtraction of ebony pill.

    Recipe: ebony plum, betel nut, junzi, Sichuan pepper, Citrus aurantium, dried ginger, pumpkin seeds, Chuanlian, scutellaria, baibu, Kochia scoparia, licorice. Chinese medicine external washing: Baibu Kushen decoction external washing and treatment. Recipe: Cnidium, Sophora flavescens, Alum, Sichuan pepper, Stemona, Dandelion, Pulsatilla. In the prescription, Cnidium, Sophora flavescens, Alum damp and insecticidal, Sichuan pepper, Baibuxian insecticidal and antipruritic, Dandelion, Pulsatilla detoxify heat, cool blood and detoxify, all medicines have the effect of clearing heat, drying dampness, killing insects and relieving itching.

    Four standards for cleaning

    Requirements for water: Generally, the water should not be too hot to avoid damage to the skin. The water temperature should be kept at about 37℃. You can try it with the back of your hand. The water should not be hot. Sensation of the local skin of the elderly is reduced, and the skin is often scalded during cleaning, or the water temperature is too high, leading to anal pruritus. Therefore, sufficient attention should be paid.

    Selection of cleaning equipment: Many people have the habit of cleaning before and after every day. If possible, you can use the more popular bidet (ie a rinse-dryer after toilet), but most people use ordinary washbasins to clean the front and back yin. Therefore, be careful not to wash the lower part with a footbasin or others The basin to wash. In clinical work, it is often seen that anal eczema, fungal infection, and even gonorrhea caused by the use of the foot basin.

    Disposal of the front and back after cleaning: the front and back after cleaning, can be dried (be careful not to burn), you can also use disposable toilet paper to dip in local moisture, or let it dry naturally, do not use dirty underwear and socks Wipe dry with rags, etc. If you use a towel to wipe the part, you need to scald it with boiling water before using the towel and basin to avoid contamination.

    Reasonable medication: Some people are used to adding some disinfectants when cleaning, but it is not necessary. Every part of the human body has normal flora. The use of disinfectants destroys the normal flora, which can lead to more serious consequences.

    Correct way

    1. Pay attention to the combination of work and rest, keep a happy mood, prevent excessive tension and anxiety, do not scratch the anus, and do not wipe the anus with hard objects.

    2. It can be applied externally with anti-itch cream or hormone ointment, such as fluocinolone acetate ointment, etc. When itching at night affects sleep, you can take a tablet of phenacin or cyproheptadine before going to bed.

    3. Chinese medicine sitz bath: 15 grams of Sophora flavescens, 3 grams of alum, 10 grams of Kochia scoparia, 10 grams of comfrey, 10 grams of Indigo Naturalis, 10 grams of wild chrysanthemum. Add 1000ml of water, decoct the dregs, add 15ml of rice vinegar, 1 dose a day, sit in the bath for 20 minutes. The symptoms of anal itching will be significantly improved.

    Treatment of anal itching

    (1) Internal governance law:

    ⑴ Wind-heat attacks the lungs and moves to the anus of the large intestine. When it encounters heat and itching, it will be relieved by a slight cold, or if the body is hot, red miliary particles will appear when turning, or blood spots will appear after turning, yellow fur, and floating pulse. It should be used for clearing heat and purging fire and laxative, and then use Lianggesan.

    ⑵Wind pathogens hold dampness or liver and gallbladder damp-heat, betting along the meridian, depression on the anal skin, anal wrinkled skin swelling, local eczema, soaking and nourishing water, often have a fishy smell, the patient may appear due to itching or scratching Irritable, unable to sleep at night. The tongue coating is yellow and thick, and the pulse is slippery. The prescription is to disperse wind, clear heat and promote dampness, and use Xiaofeng Powder and Ermiao Powder or Longdan Xiegan Decoction.

    ⑶ Blood deficiency produces weathering dryness, skin loss of nourishment, dry skin or white dandruff, severe itching after scratching, blood stains after scratching, and itching of blood spots may be slightly reduced, dull tongue, and weak pulse. It is suitable to nourish blood and eliminate wind, nourish yin and moisturize dryness, and use angelica decoction.

    ⑷Patients with blood stasis, wind, and persistent accumulation, thickened skin, lichenification, dull red tongue, petechiae, and stringy pulse. The prescription is to expel stasis and dispel wind, and use Shufeng Jiedu Decoction.

    ⑸ Insect poison harassment, invades the perianal skin, or after damp poison or drug poisoning hinders the vagina, itching like insects, and itching at night, it is suitable for curing insects, detoxification and relieving itching, and use ebony pills.

    2. External governance method:

    1. For moist skin, dry alum powder on the affected area 3 times a day.

    2. For dry skin, use Huanglian ointment or Qingdai ointment for external application, 3 times a day.

    3. Enema

    4. Acupuncture

    5. Antihistamine therapy

    6. Hormone therapy

    7. Antibiotic treatment

    8. Drug washing treatment

    9. External drug treatment:

    10. Closed therapy:

    11. Physical therapy:

    12. Surgical therapy

    Eight External Remedies

    1. For dry skin, use Huanglian ointment or Qingdai ointment for external application, 3 times a day.

    2. For moist skin, use dry alum powder to spray the affected area 3 times a day.

    3. Enema can be used if conditions permit: if it is caused by pinworms, use 30 grams of 100 pieces, add 250 ml of water, and decoct into 80 ml. Keep the enema every night before going to bed for 1 week. Or mash with garlic heads, add 200 ml of water, decoct to 70 ml, and keep the enema with warm medicinal solution every night for 5 days.

    4. Phellodendron 30 grams, Baibu 30 grams, decoction and hot compress the anus part.

    5. 30 grams of Kochia scoparia, 30 grams of Cnidium, decoction and hot compress.

    6. 0.5% to 2% calamine lotion (water powder) plus camphor or mint, thymol, etc., has the effects of local cooling, anti-inflammatory, dryness, and itching.

    7. Acupuncture: Changqiang, Yaoshu, Chengshan, Sanyinjiao, Yinling gland and other points can be used for strong stimulation, once a day.

    8. Chinese medicine decoction for washing outside the bath: 30 grams of Sophora flavescens, 30 grams of Phellodendron amurense, 30 grams of Smilax glabra, 30 grams of Di Ding, 30 grams of black snake, 15 grams of Coptis, 30 grams of Kochia, 30 grams of Cnidium, 10 safflower Grams, 20 grams of hematoxylin, 2 grams of borneol.

    Treatment for anal itching women

    1. Women with anal itching should use warm water to clean the anus. You can use warm water to bathe or use salt water to clean the affected area to reduce inflammation and prevent itching from ulceration due to infection. It is also to maintain the anus. Cleansing also has the effect of promoting blood circulation and can prevent the occurrence of hemorrhoids.

    2. Female anal itching should not be often scratched because of itching. There are bacteria in the nails. Long-term scratching can cause infections in the affected area. In addition, if the nails are too hard, it is easy to damage the affected area. The affected area will ulcerate and become infected. At the time, you can take a warm water bath or use anti-itch medicine under the guidance of a doctor, but the medicine is best not to be used for a long time. After all, "the drug is three points of poison", long-term use is very harmful to the body.

    3. Eat more laxative foods, such as bananas, fungus, honey and other foods. These foods have a laxative effect and can promote the probability of defecation, because during anal itching, if it is difficult to defecate, the stool will stay in the anus for a long time It can cause the affected area to be stimulated by harmful substances in the stool, inflammation, and edema, aggravate itching, and can also cause other anorectal diseases.

    4. For women with anal itching, do not use drugs indiscriminately. Any disease has a cause, so anal itching must also have a cause. Many people buy antipruritic medicine for the first time when anal itching occurs. In fact, There are many types of antipruritic drugs, so it is best to consult a doctor before using them, so as not to aggravate the condition of the medicine.

    diet

    The ancients have said: "Irregular diet, drunk and full time, regular food is fatty, pepper is pungent... the wind and heat will cause five hemorrhoids." Many patients usually drink too much alcohol or prefer spicy food, and then have stools. Will feel burning pain, which is enough to induce or aggravate anorectal disease. Among them, drivers, salespeople, teachers, white-collar workers, and heavy manual workers are all high-risk groups of anorectal diseases such as hemorrhoids. So how to prevent anorectal diseases from occurring?

    Patients with anal itching should have a light diet, not smoking, alcohol, strong tea, coffee, and spicy foods. Animal protein foods such as fish, shrimp, crab, beef, etc. should also be eaten less or not, and eat more vegetables and fruits. Smooth stools. Appropriate increase in the daily diet. Avoid eating and contacting foods that you are allergic to, chemicals, raw lacquer, irritating foods, and certain drugs and other refreshing products, such as sand ginseng, polygonatum, snow fungus, and snow clams. It should be particularly emphasized that those who like tonic in autumn and winter should not unrealistically consume too much ginseng, beiqi, longan meat, donkey-hide gelatin, angelica, red dates, rehmannia glutinosa, etc., so as to avoid committing the “fire if you have more energy”; Such as hot pot, stew, and old hot soup are all right and wrong things.

    It is also necessary to pay attention to anal itching diet to maintain emotional stability, sleep in a timely manner, have a regular life, and be open-minded and cheerful when things happen. Try to restrain yourself, resist the temptation to scratch, and avoid scratching to cause damage to the skin.

    The dangers of anal itching

    Anal itching, everyone must be familiar with it, so what harm does anal itching bring to our health? How should we actively prevent it? Experts from the Anorectal Hospital have explained to us: It is often secondary to various skin diseases or other diseases, with obvious specific skin damage and primary lesions. Clinically, the anal canal and perianal skin have severe itching. At first, it is limited to the perianal skin. The degree of itching varies. If it does not heal for a long time, it can spread to the scrotum or labia, especially the itching between the front and back of the perineum is more severe. It is more pronounced at night than during the day, with insect crawling, ant walking, and burning sensation, which affects falling asleep and rest. Partial skin scratches, blood scabs, pigmentation, lichen-like sclerosis or eczema-like changes due to scratching, and secondary infections may also occur.

    ① Anal itching is not cured for a long time, and it can easily spread to the vagina and buttocks. Especially at night, the vaginal itching is unbearable, as uncomfortable as a knife, and it is scorching, making the patient unable to sleep. For a long time, the patient's mental state is not good. Fidgeting, restless sleep and eating, etc. occur.

    ②Itching is unbearable, and you can't control it with your hands. Although it is temporarily relieved, it will scratch the skin around the anus and cause bacterial infection of the skin, causing skin ulcers, redness, and bleeding around the anus. More importantly, it makes the pruritus more intense and makes patients wonder what to do, which leads to loss of appetite, malaise, nervous system disorders, and various mental illnesses.

    ③ Cause other complications, such as hemorrhoids, anal fissure, anal eczema and other anorectal diseases. If not properly treated, the disease will have an opportunity to endanger the life and health of the patient.

    ④ Itching and pain seriously affect the work, study and rest time of patients. [8]

    Frequently Asked Questions

    Do not wash hot for anal itching

    Anal itching is clinically divided into simple anal itching and secondary anal itching. For simple anal itching, washing with water at a suitable temperature may temporarily relieve the pain and itching, but once the moisture in the affected area has evaporated and dried , The itching will become worse; if you use boiling water to scald the affected area, it is easy to scald the skin tissue around the anus, and it will also cause skin ulcers and aggravate the condition!

    Why does anal itching arise

    More secretions around the anus are one of the common symptoms of anorectal diseases, often caused by perianal skin lesions, such as anal eczema, hidradenitis suppurativa, etc.; it can also be seen in other diseases, such as anorectal fistulas, anal defects , Anal fissure, anal incontinence, stage III hemorrhoids, rectal prolapse, etc. If it is caused by skin diseases, the perianal area must be kept clean, dry, and hygienic, and necessary treatments must be used, which is generally easier to control. Those who are secondary to other diseases must be actively treated for the primary disease. If the disease requires surgical treatment, it should be treated as soon as possible.

    Analysis of anal itching

    Anal pruritus is a common anal disease. It is different from pruritus in other parts of the body. It is characterized by intense itching and a long course of disease. It is more common in young and middle-aged people aged 20 to 40. Anal itching is usually limited to mild itching of the skin around the anus at first. If it does not heal for a long time, it will spread to the scrotum or labia, especially around the perineum. The itching is worse at night, and the humid environment is aggravated, sometimes like insects crawling away, sometimes like mosquito bites and roasting, making people unable to sleep, restless and unbearable. So scratch the skin, temporarily relieve the itching, scratching the skin can cause bleeding, erosion, and tingling, making the itching worse and more uncomfortable. The patient is extremely distressed, and will cause neurasthenia, listlessness, lack of taste, and sleeplessness at night. Anal pruritus is a neurological dysfunction skin disease with only severe itching and no primary skin damage.

    Anal itching is often a symptom of primary lesions, secondary to various skin diseases or other diseases, accompanied by obvious specific skin damage and primary lesions.

    Intractable itching of the anal canal and around the anus is the main symptom of this disease. It is usually limited to the skin around the anus at first. It is mostly paroxysmal. The degree of itching varies. If it does not heal for a long time, some can spread to the scrotum or The labia, especially between the front and back seams of the perineum, is more itchy, and it is more pronounced at night, sometimes like insects crawling, ants walking; sometimes like mosquito bites, fire roasting, making it difficult to sleep, restless and intolerable.

    At the beginning of the disease, there is no damage to the skin. Due to the continuous scratching of itching, scratches, erosions, bleeding, swelling, scratching, tingling, etc. are often seen. Sometimes secondary infections may occur, with foul-smelling liquids. Unhealed for a long time, the skin may appear rough, chapped, weakened elasticity, loss of luster and pigmentation, lichen-like sclerosis or eczema-like changes. Over time, it can cause symptoms such as neurasthenia, lack of taste, and lack of energy.

    Many people have had the uncomfortable symptoms of anal itching, but due to face problems, they are embarrassed to go to the hospital. In fact, although anal pruritus is not a serious disease, it is a sign of many diseases, such as hemorrhoids, viral infections, For sexually transmitted diseases, if you have anal itching, you should still seek medical attention to avoid delaying the treatment of serious diseases. Because part of the anal pruritus is caused by parasitic infection, hygiene, and poor eating habits, the other part of the patients with anal pruritus may be suffering from hemorrhoids, constipation, anal fissure, viral infections, sexually transmitted diseases, etc.

    What are the symptoms

    Early manifestation: The clinical manifestations of anal pruritus are discomfort or mild itching on only one side or a small area of ​​the anus, and gradually increase the itching. If it does not heal for a long time, it will spread to the scrotum or labia, especially around the perineum. The itch is the heaviest.

    Mid-term performance: it will be worse at night, such as insects crawling ants, or mosquito bites, fire-roasted, it is difficult to sleep; mental stress, eating, drinking or eating seafood can cause itching episodes, every few minutes or hours , And some are often itchy.

    Severe manifestations: itching may be mild and severe, irregular, and after scratching, it can cause local skin bleeding, erosion, and tingling; over time, it can cause neurasthenia, listlessness, inability to eat, and sleeplessness.

    In the early stage of anal itching, it is limited to the itching of the skin around the anus, sometimes light and heavy, sometimes stinging or burning, sometimes like insects and ants walking, sometimes like ants biting and roasting, sometimes itching is unbearable, and it becomes worse at night, making people sit and sleep disturbed.

    Scratching can cause skin ulceration, exudation, crusting, and long-term non-healing, resulting in thickening of the perianal skin, thick and rough folds, radial folds, lichen-like changes, pigmentation or loss, spreading to the perineum, scrotum, and labia Or sacrococcygeal. It is prone to chapped after long-term illness. Over time, it can cause neurasthenia, affect sleep, and depression.

    Difference from anal warts

    Anal pruritus is one of the common genital pruritus. There are many causes of anal pruritus, such as unclean anus and pinworm parasitism. If the cause can be clarified and targeted treatment can be carried out, it is not difficult to cure. But there is another type of anal itching with unknown etiology, which is often stubborn and difficult to heal due to misdiagnosis and treatment. The most common one is anal wet diagnosis.

    Anal eczema is not difficult to treat, but because patients are often washed with hot water and syrup, doctors often combine the topical application of ointments containing "pine" hormones. Although it can temporarily improve, it eventually makes the eczema worse and the itching more intense. Stubborn disease. Therefore, to cure anal eczema, the most important thing is to stop all physical and chemical irritation, do not scratch, do not scald with syrup, and do not apply drugs containing "pine" hormones. The itching may be heavier in the first few days, but as long as the cold and wet compress therapy is adhered to, it can be cured without medicine. The specific method is: take a towel soaked in clean water and stack it into 8 layers, and apply it tightly to the anus to the degree that no water can come out. Throw and wash the towel every 3 minutes without heating the towel. As long as the anus is itchy, apply cold compresses until healed.

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