Suffering from Pruritus Ani for 2 years
Posted , 3 users are following.
Hi,
I have been suffering from Pruritus Ani for about 2 years now ever since I had an Anal Fissure. The fissure has healed now, but the area still itches (probably because I didn't treat the area very well at the time). It is especially itchy when there are faeces on it.
I find it difficult to get clean down there; I often find bits of faeces leak out onto the skin around the anus. I have had this for most of my life. As a preventative measure, I would wipe just inside the anus (inside the external sphincter, but not beyond the internal sphincter.... I think?? Sorry I'm no anatomy expert!). I am wondering if I am cleaning too much though?
I have 2 questions:
Is it OK to leave a bit of faeces on the skin? I have just been cleaning the area again whenever this happens, but I figure I'm probably overdoing it since this has been going on for 2 years now. I genuinely think I'm just cleaning too much and am stuck in a cycle... I just need to know if I can 'ignore' this or not.
Is it normal for bits of faeces to leak out like this? It has been this way for as long as I can remember and has never caused me any problems until now. Do I have faecal incontinence?
I saw a dermatologist a few weeks back who gave me pretty decent advice. She advised me to 'calm things down a bit'. She told me to never wipe 'inside' the anus (beyond the external sphincter), and after a bowel motion to apply an emollient cream after gently washing with water. Whilst this seems to be pretty sound advice, which worked for the most part, I ended up cleaning again due to the leaked faeces. I now dab soft toilet paper 'inside' the anus twice only, then apply an emollient cream after gently washing with water. This works even better, but I do still occasionally have a bit of faeces leak out though which makes me itch.
Here's everything else I've tried:
- I have tried avoiding certain foods, but this did nothing.
- I have had food allergy tests; this found no allergies.
- Colorectal doctors could not see anything wrong with me.
- Keeping stools softer helps a bit, but not a lot.
- I have had a sigmoidoscopy, which found no issues.
- I have used many creams, which achieved nothing.
Thanks in advance for any advice!
0 likes, 6 replies
nicole41359 harry17730
Posted
hi, are you still having this issue ? and did your fissure heal?
harry17730 nicole41359
Posted
I believe the fissure has healed; several doctors and nurses have verified this.
But yes, I am still experiencing itching.
I’ve seen another colorectal surgeon who identified that I have an incoordinate pelvic floor, so that could have been the underlying cause of the fissure in the first place. He’s put me in touch with a physiotherapist who verified the diagnosis and is now getting me to do daily bowel exercises.
I’m not really sure this will improve the itching situation though. Several doctors and nurses have described the area around the anus as ‘a bit red’. And I have noticed that if I rest as much as I can then it seems to get gradually better. So I’m trying to get more rest at the moment. I’m doing the following:
1.I used to take 30 min walks per day which often resulted in itching occurring towards the end of the walk. I’m doing shorter walks now.
2.The bowel exercises seem to make me itch a bit more, so I’m taking a short break from those for now.
3.I tend to get a lot of flatulence in the afternoons which I suspect is having an effect on the itching. I’m modifying my diet to reduce this.
4.Still cleaning as gently as I can after a bowel movement.
If the above works then I’m sure it’ll be a long wait until the itch (or ‘red’) is gone, but I’ll have to be patient.
nicole41359 harry17730
Posted
thanks for replying back . how did you heal your fissure ?
how are you cleaning after bm? Are you using soaps?
I believe i have pelvic floor issue, is why my fissure won't heal. would love to know more about the bowel exercises to try.
harry17730 nicole41359
Posted
Healing the fissure: A colorectal surgon I saw about 2 years ago gave me a couple of laxatives to take (I think it was Lactulose and Senakot), and I took that for several weeks. I wouldn't recommend doing anything like that without seeing a doctor first though!
Cleaning: I use water only, by squatting in the bath and using a showerhead. As I understand it, all soaps should be completely avoided.
Pelvic floor: I believe, in layman's terms, it means I was 'pushing' the wrong way during a BM. If this sounds like your issue then maybe tell your doctor about it and see whether they agree.
The physiotherapist gave me this website for info on the bowel exercises: https://pelvicphysiotherapy.com/
She also recommended a diet high in soluble fibre.
Worth noting that the bowel exercises won't fix my incoordinate pelvic floor overnight; it's likely to take many months.
hug95049 harry17730
Posted
This is the first time Ive read my exact problems on a forum. we are suffering from the same thing. i had methelyne blue injections which did not work. do you feel like you create a lot of moisture around the anus throughout the day? are you having never-ending wipes? is the substance yellowish? i believe our fissures are releasing mucus which is causing the itch. that is my theory. been dealing with this for 7 years now. i have much to ask because again we may have the same exact issue
harry17730 hug95049
Posted
I do get a bit sweaty down there sometimes, but I don't think it's mucus. I never see any yellowish substances there.
Sorry to hear that the methelyne blue injections didn't work. The colorectal surgeon I saw wants to try the bowel training first before we explore that route. I had considered requesting them, but I feel like the solution to my issue might be simpler than that...
I wrote my initial post about 9 months ago now and a lot has changed since then. I am now more concerned with gentler treatment of the area and better diet. Rather than write more specifics now, I'll post what turns out to be successful later. Hopefully my findings will be useful for you too.