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Diseases of the Colon & Rectum

, Volume 25, Issue 4, pp 358–363 | Cite as

Prospective studies on the etiology and treatment of pruritus ani

  • Lee E. Smith
  • Dean Henrichs
  • Robert D. McCullah
Article

Abstract

Seventy-five patients presented with the complaint of pruritus ani. The following prospective studies were employed to evaluate groups of these patients; (1) laboratory, including blood count, stool examination for ova and parasites, urinalysis, Sequential Multiple Analysis-12 serum studies, stoolpH, and skin scrapings for fungi; (2) Minnesota Multiphasic Personality Inventory; (3) anal manometry; (4) elimination of dietary factors, and (5) topical ointment application. Many patients were concerned that a cancer caused the symptom. Once reassured, they tolerated the pruritus. Forty-eight to 50 per cent of these patients had poorly formed stools or incomplete stool evacuation; thus, soiling was frequent. An underlying skin problem was found in six patients with psoriasis and in one with erythrasma. Patients tended to worsen the problem by application of many medications and overzealous cleaning. Minor surgical problems of the anus should be corrected before other managements are instituted. Idiopathic pruritus ani responds to anal cleanliness, dietary discretion with avoidance of specific items by some patients, bowel habit regulation, and a mild topical hydrocortisone cream.

Key words

Pruritus ani Manometry Psoriasis Prospective study 

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Copyright information

© American Society of Colon and Rectal Surgeons 1982

Authors and Affiliations

  • Lee E. Smith
    • 1
  • Dean Henrichs
    • 2
  • Robert D. McCullah
    • 3
  1. 1.Division of Colon and Rectal Surgery Uniformed Services University of the Health SciencesNational Naval Medical CenterBethesda
  2. 2.Department of Dermatology, Uniformed Services University of the Health SciencesNational Naval Medical CenterBethesda
  3. 3.Mental Health Program Branch (MED-314)Bureau of Medicine and SurgeryWashington, D.C.

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