Do you experience annoying anal itching?  Surprisingly, you are not alone. Many people experience anal itching, or pruritis ani, as it’s a fairly common but of course not talked about problem. I’ll talk about most of the causes of anal itching, and what to do about them.

You might not think of anal itching as having anything to do with IBS, but it’s actually quite common in the patients that we see with IBS. I’ll discuss why that is, and what to do about it.

Let’s go through the main causes of anal itching, starting with the least common but most scary, and working our way up to the most common.

Anal Cancer – quite rare. Less than a 0.5% chance that you have that. But if your itching doesn’t resolve with some of the issues we’ll talk about in this video, then tell your doctor and have it checked out.

Anal Fissure – also quite rare. There is a less than 0.5% chance that you have this. But it happens to men as well as women, so keep it in mind. Your GI doc should be able to rule this out pretty readily.

STDs – STDs can cause anal itching, but basically only if you are engaging in activity that could lead to an STD in that area. So you be the judge, and be sure to tell your doctor about any risk factors for this. And don’t be shy or embarrassed. Doctors have seen it all.

Psoriasis or dermatitis – this is relatively uncommon but can happen. Most people who have psoriasis or dermatitis do not have it around the anus. But most people who experience this cause of anal itching have psoriasis or dermatitis in other areas of the body, not just the anus.  See your doctor to get this checked out.

Hemorrhoids – Hemorrhoids are relatively common, and anal itching from hemorrhoids is quite common. About 5-10% of the population gets hemorrhoids at some point. When they are very irritating you often get a little bleeding with that, and they can be extremely itchy.

Pinworms – These are tiny worms that you might be able to see without a microscope, but the eggs are only visible under a microscope. About 10% of the population gets pinworms at some point, and it’s far more common in children than adults. Anal itching can be the only symptom of pinworms, and it usually occurs at night. The good news is that it’s easily treated.

Candida – Candida is a very common cause of anal itching. Candida is a yeast, and it can cause just as many problems in the digestive system as it can cause in other areas of the body. To learn more about Candida and how it can affect not only digestion but almost any other aspect of your health, watch my other videos on this topic. We deal with Candida in patients every day. I’d say it’s the most underdiagnosed and misunderstood condition in health care today.

Diarrhea or Constipation – both diarrhea and constipation can cause anal itching. What do they have in common?  They both are irritating to the anus. Diarrhea because of the frequent bowel movement and lots of wiping. Constipation because of the pressure and stretching, and thus irritation, that it can also cause to the anus. Diarrhea and constipation are very common. Up to 20% of people suffer from chronic diarrhea or constipation, and most of that is IBS. Which of course is why we see a lot of people at the IBS Treatment Center with an itchy anus. It's also good to know that a lot of people with diarrhea or constipation have a problem with Candida.

[Sev, can you make a pie chart that shows all of these so that people can visualize the difference in their chance of having each one? Put diarrhea and constipation at 55%, Candida at 30%, Pinworms at 5%, Hemorrhoids at 5%, Skin issues at 2%, Everything else in little slivers]  

As you can see from this chart, it’s far more likely that you have anal itching from diarrhea or constipation, or Candida than anything else. And keep in mind that even if you have something like hemorrhoids or psoriasis or dermatitis, or even pinworms, there is still a significant chance that you also have Candida, because it’s so common.