intractable pruritus ani

Signs and symptoms
1

5 month sufferer after using Tuck wipes recommended by dermatologist. If you have intermittent infammation and non infectious pruritus ani avoid using soaps (possibly spectroderm gel OK) and wipes (wet toilet paper better) as they are full of chemicals.

Originally used all sorts of creams to no effect although Elidel (dissipates immune system) and vaseline helped.

Had methylene blue injections under full anaesthetic but appears not to have taken after an estimated 80% success rate predicted.

Now on depressant oral drug doxepin in conjucntion with desonide a cortisosteroid ointment. Some relief given to itching soon after application and possibly more to come when the anti depressant kicks in. In my case anxiety seems to be at the base of problem.

Phenytoin seems not to be administered by doctors for prutius ani although it is for epilepsy. Jack Dreyfus seems to have spent his life trying to have this as a standard cure and noted his patients had nervous issues.

Am interested in others experience of dealing with intractable pruritus ani.

2

Seems you've done a fair bit. Did you get it from the tuck wipes, seems that the way you wrote it)?

I use baby wipes but there non perfumed. Do you use witch hazel or apple cider vinegar? They don't seem to get rid of the itch but do help a bit to control it (if you stand the pain).

Have you used capsaicin cream?

Who is this guy you wrote about?

3

Forgot to say have you tried a food intolerance test? I'm going to have one done as this is a maddening infliction.

4

Thanks for writing. I am leery of any wipes as they are full of chemicals although used non fragrant babay wipes for a time. I have not used apple cider vinegar, witch hazel (yes tuck wipes elevated the itching from intermittent and includes witch hazel) or capcaisin cream. I have stuck by traditional medicine advice as I do not want to worsen the situation. As for Jack Dreyfus and Phenyton enter on the web. I think he did a book but doctors think this method is dangerous. I have not had a food allergy test. I believe my case is fed by anxiety although it is just a guess. Lorezepam has worked well for me at night which is often the only relief I get. I have been to a naturopath for excercises/massage/positive thinking etc. It all seems like a bad dream from which you cannot wake.

5

Doctors have done tests using capsaicin cream. The results of the tests are quite good, google and tell me what you think.

I'm surprised that witch hazel made it worse as it's a natural product but then some natural products aren't for everybody, that's probably why the methylene blue injections didn't work for you, am guessing you've vey very sensitive skin.

Reason I'm suggesting the food intolerance tests is that you could be suffering from something like candida, that can cause an itch. The itch may have started from another source but once the body is down maybe the candida or something similar came to the surface if you see what i mean?

TBH I'm not that impressed with the medical cures out there as they seem stumped over what s basically an itch. Also can't find any good sites with other people's stories of their fight against this as there could be something in there that'll help.

6

The other thing I've noticed, lots of people seem to like is aloe vera. They also seem to prefer the actual plant (as in cutting off what you need). I tried it but wasn't that imprseed but the more I think about it the more I think I did it wrong. What i mean is this, I've noticed that if we sweat (maybe it's the same for you?) that we itch more, well I was putting the aloe vera plant around my bottom and would just leave it (therefore the area was moist), maybe after a while long enough for it to do something good would've been a good time too put some toilet paper between my buttucks to stop the moistness. Not sure it'll work but its worth a try.

I've not seen a skin specalist yet, thats next as in if I go back to the doctors (which I'll have too).

7

I had a very itchy bottom for about 1 year, but do not suffer now. It started off when I had some mild constipation, which caused a very small hemorroid to become irritated. This caused mild itchyness around the anus area, but nothing serious. At first I scratched to get rid of the itch and washed more thoroughly with soap because I thought the itch was due to cleanliness. This made the condition much worse, which caused me to wash it more thoroughly with harsher soaps, which made it even worse and so on.

The doctor prescribed some drugs to rub on my anus, and some other drugs to insert up my anus, but these made absolutely no difference. After experimenting with lots of things I have found that the following rules, when followed strictly for (in my case) 5 months, may resolve the issue:

[1] Dont scratch it. Also when you go to the toilet dont use harsh paper, and rub as gently as possible to clean yourself after you are done.

[2] Clean the area daily, with WARM WATER. NEVER USE SOAP. After you are done, dry the area fully with a hair dryer. Do not put any chemical of any kind on the skin. Although these may relieve symptoms they are unlikely to provide a cure (in my opinion). Better I think to let nature run its course.

[3] The itchyness is often a result of another problem (In my case mild hemorroids that I did not even know were there). Therefore it is a good idea to try to maintain a healthy gut and keep the stools soft, bulky and easy to pass. Therefore I recommend that you change diet if necessary towards consuming much more healthy high fibre foods such as fruit and veg, brown bread, brown pasta and brown rice, and increase you fluid intake. Changes in lifestyle that reduce the stress in your life and make you healthier, for example exercise, can also only be beneficial. I found when I reduced stress by working less, exercising more and eating healthy that not only did my symptoms reduce, but I also cared less and thought less about them.

Recovery in my case was slow and frustrating and at times I wondered whether what I was doing was working at all. But eventually you may turn the corner with this problem if you follow the above recommendations. In my case the itchyness would go for a few days, then would return with a vengeance. After a while, the relapses would become less severe and less frequent. Now I hardly ever feel an itch down there. The skin feels healthy.

8

Thanks for the information friend. It's interesting you saying how it got worse the more you washed with soaps as mine seems to have come about from over cleaning in the first place.

Going to be honest and say I'm not sure if I could go without scratching. I realise that's the wrong attitude but I know me. I hate the scratching but that damn itch is so powerful. Wish I had your courage.

I'm still hopeful of finding a remedy that no one else has thought of or tried if they have thought of. I'm using apple cider, and though it doesn't stop the itch it seems to make it less itchier if that's a word.

Out of interest did your doctor try capsaicin cream or methylene blue injections? I realise the methylene never helped our friend above but apparently they work in 80% of people.

I've already changed my diet and will continue to do sp over the next few weeks as I went onto that p**p site where people have leakage and they recommend fiber to improve that sort of function. And I thought after reading that it may way help me in my problem, certainly no harm in it.

Anymore advice and it would be very much appreciated.

9

Thanks for letters of advice and support to David, Toronto.

I have not had a food tolerance test or tried capsaicin cream. I have changed my diet to diabetic. I agree the itch dominates life; social occasions are ordeals, travelling is no longer fun and people generally avoid the subject. The closest support groups would be for ecxema. My best time is at night having taken 1mg lorazepam for sedation. I am now using lorazepam during the day sometimes. Tucks were the culprit but I doubt it was the witchhazel component. I would recommend methylene blue injections as although they are costly it is a cure and if you are lucky you can get back to leading a normal life. However am concerned if they affect sphincter and bms. On doxepin which certainly helped initially but the impact seemed to wear off it is difficult to see how you get off the capsules.

Has anyone else used Capsaicin cream and was it under a doctor. I am concerned about making the situaton worse. Prurotab is a natural cure.

For short term relief are the caines, I have lidacaine. Username mhairig

10

Totally understand your concerns about making a horrible situation worse, my feelings are the same.

Today I had my food tolerance test done (very easy but not cheap £60). Apparently I'm intolerant too beer (lager), potatoes and tomatoes. Now I love all of these and am gutted there going to have to be cut out of my diet for the next 6 weeks, but then I can put them back into my diet and see what my reaction is. Now the guy who did the test couldn't guarantee that my itch would go, but it's worth a try.

Interestingly I'm ok to eat wheat (pasta etc) which surprised him as many people are wheat intolerant. I'm also ok for wine and chocolate.

Now I was on one pruritus ani site that said that the Daily Telegraph's doctor has a remedy site that people tell of there own remedies and apparently banana skin is a good remedy for anal itch (and other itches). Been trying to find out more about that but could only find one site that said banana's have been used to heal burns and wounds, it said nothing about itching. So I need to do more investigating.

Regarding capsaicin cream. Don't know that much about it (again the net is poor on it). But it's fairly new and I think there still testing it, but defo worth asking your dermatologist about it.

11

I feel there is little knowledge about pruritus ani because either paople are too polite to talk about it or find it amusing, which I suppose it is except for those who have it. I have been trying to get Dr Rosemary in Exress/Mail to comment on it but with no luck. I am therefore surprised to find the Daily Telegraph taking the subject seriously. I will have to google it.

Eventually I will run out of ways the doctors advise and try alternatives. It seems such a simple problem to reduce the inflammation and itching. My second dermatologist advised solid crisco lard rather than vaseline as being more natural. I am contemplating another go with methylene blue if nothing else works.

At the moment I am experimenting with minimising pain. Antihistamines and various caines last a short time. Lorazepam I now sometimes use during the day and that is effective for me for a few hours where I suspect the underlying cause is anxiety. Massages help too.

Thanks for your advice on food tolerance testing. David, Toronto (mhairig)

12

Not saying the food tolerance will work, just that if your body doesn't like certain things it could be a way of telling you. Still I've cut out totally the foods I'm intolerant too (potatos, lager, tea, tomatoes) and we'll know more I'm guessing in a few weeks.

The banana thing; I'd leave you the url from the site I found it but I'm not sure they'd allow it.

13

OK, just done my first 5 days of the new diet (i.e no lager, beer, cider, potatos, tomatos). Can't say I've noticed anything different yet. Itch is as persistant as ever, but it is early days and will kepp you informed.

14

David, Toronto (mhairig)

I have turned a corner with Crisco all vegetable shortening aka lard. Someone told me never to put on my skin what I would not put in my mouth. All the expensive injections and drugs and creams seem to be less effective than 4 applications a day as instructed by my second dermatologist. However I am still taking 2 capsules of doxepin and had methylene blue injections so I cannot entirely discount these. My backup is the sedative lorazepam which I use to help me sleep. For some reason the doxepin needs to be taken earlier in the evening and not together with lorazepam. The redness is still there but the pain is less and it makes the difference between surviving the day rather than seizing it. I feel I can actually plan ahead. Why is this not common knowledge although perhaps it only works for me. It may be worth a try for those with non hemorroidal non infectious perianal inflammation.

15

Cheers Dave. I replied to you in your other post. Be interested in what you think of my questions mate.

Ok nearly into my second week (2 days off) of this diet (no lager, tea, potatoes or tomatoes). Can't say I'v noticed any improvement. Will do at least 4 weeks of the 6 though before I give up.

16

Prurotab natural cure? Googled it and can't find it anywhere.

17

They have a web page www.prurotab.com Good luck with your food experiment. I tried avoiding coffee, spice and alcohol to no avail. The crisco is not as affective as it first was so am upping the doxepin. However I have had my best week for several months. See my dermatologist June 4 after my trip to UK. Any questions you need answering? I want her to tell me the underlying cause. I want to sound her out about neuragen, basically geranium oil. (originbiomed.com) It states that it treats neuropathic pain including chronic itching. mhairig

18

Cheers.

Ask her about capsaicin. I know you we're worried about making it worse (and believe me I do understand), but all I've read about say's it's definately been researched by dermotologists (sp) so it's not a run of the mill natural cure that no one really knows anything about.

Someone below wrote that they used wipes to scratch themselves and it caused less pain and cuts and blood. I've been doing the same over the last few days and they are right. A lot less cuts and bleeding. I obviously use unperfumed wipes.

That site above that I put about poop has a site about itchy anal. a lot in there seem to have used alchohol and though it burns like hell for a few minutes they claim it does work. My worry there would be what are the long term effects? Could be great for a couple of months and then hell, but then again you never know with these things. Whats needed is someone who has used the alchohol for years and been ok.

I will check out the site yo've mentioned. It might be worth lasking your dermo when you see her about things like apple cider vinegar, maluka honey, even emu oil (been reading it's a good healer of all sorts of ailments). My only concern with some of the medical practinors is they seem set minded and don't belive in anything alternative, which is fair enough as most of it is bullshit.

Trouble with my food experiment is the foods that I'm banned from eating aren't really the exact same as what web sites about pruritus say we should avoid. As an example I can't drink lager/beer/cider/spirits but can drinl wine, where as web sites about pruritus say all alchohol should be avoided. Also I'm banned from potatoes and i've not read that on a pruritus site. So once my 6 weeks is up and if it hasn't worked I shall find the foods that pruritus web sites say we should avoid and try that diet. When you did your diet how long did you do it for? As I was told it takes around 4 weeks before you'd notice a change (only just under two weeks left for me then).

I'm wondering if that lard you used is still worth trying but chaning how you do it. What i mean is the itch will come back if your damp or moist. The lard will make you damp down there all day. So maybe you need to rub it in gently and then after say 10 mins put some aloe vera tiolet paper btw your cheeks until the area is dry. Don't rub the area dry just put them btw yout buttucks until the area is dry and then the lard asfter 10 mins has had a chance to do some good. Or you could just dry the area with a hair dryer.

Anyway when you see your dermo sound her out about everything and anything (write it down on some paper mate), even stuff where you think no way like apple cider vinegar. You never know she may surprise you with something.

Have a good holiday mate. I'll catch up with you when your back and will defo have a look at those sites and things you've mentioned.

19

Another thing mate. Ask her how long you should wait before you know something isn't working? I'm not very patient and give up after a couple of day's, maybe I should take longer.

20

I applied to be a guinea pig on that Neuragen site as there doing more trials. Told them what I suffer from. Other site I had to down load acrobat or something to look at there trials. Will try and do that when I have some more time.