anal pruritus
Introduction
Introduction to anal pruritus Anal pruritus (peritusani, PA) is a common local pruritus, sometimes itchy in the anus, such as severe itching, it becomes pruritus when it is not cured, it is a common localized neurological dysfunction skin. disease. Usually only around the anus, and some can spread to the perineum, vulva or scrotum behind. Most occur in middle-aged and elderly people between the ages of 20 and 40. Young people under the age of 20 are few and rarely occur in children. Men are more common than women, and people who are used to quiet and infrequent exercise often suffer from this pruritus. Secondary pruritus has obvious pathogenic causes. It is easy to treat spontaneous or unexplained PA. It is not easy to cure, and often relapses, accounting for about 50% of all patients. According to the 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. In general, the local anal area has a primary disease that becomes secondary pruritus, otherwise it is primary pruritus. In addition, a full physical examination should be carried out to conduct necessary laboratory tests, such as blood, urine, stool routine, liver and kidney function, urine sugar, blood sugar, glucose tolerance test, and biopsy and smear. basic knowledge Sickness ratio: 0.05% Susceptible people: no special people Mode of infection: non-infectious Complications: perianal eczema
Cause
Causes of anal pruritus
Systemic causes (40%):
1, allergic reactions: If you eat irritating foods, such as peppers, mustard, spices, wine or specific protein foods, there are also some y substances, such as antibiotics can cause anal itching due to allergies. 2, parasitic diseases: such as mites, mites, vaginal trichomoniasis, pubic lice, hemorrhoids, etc., can cause anal itching. 3, endocrine and metabolic diseases: such as diabetes patients with increased sugar content in the skin, stimulate the itching caused by nerve endings; hyperthyroidism skin itching, may be related to hyperhidrosis, increased basal metabolic rate, emotional stress. 4, blood disease: iron deficiency anemia. 5, gastrointestinal diseases: acute and chronic diarrhea, constipation, gastrointestinal neurosis and so on.Local factors (40%):
1, skin lesions: anal skin diseases such as anal eczema, neurodermatitis, sputum, all kinds of sputum, sexually transmitted diseases, sweat gland inflammation, etc., feces attached to the anal folds, irritating the skin and causing itching. 2, microbes around the anus: such as aphid parasites are often a common cause of anal itching in children, this anal itching, after deworming treatment, linings for frequent washing and other health measures, you can cure. 3, anorectal diseases: such as anal fissure, anal fistula, sputum, anal sinusitis, anal papillitis, rectal prolapse, anal incontinence, etc., so that the secretion of anal mouth increased, vaginitis secretions and other moist irritating skin caused by itching.Genetic (10%):
Related to family genetic factors.Prevention
Anal pruritus prevention
(1) Keep the anus clean and clean the anus as much as possible every night.
(2) Wash the anus should be warm water, not too hot water, generally do not need to use soap, especially do not use too much alkaline soap.
(3) The underwear should be changed frequently. Do not wear underwear made of man-made fibers. Use paper that is clean and soft to absorb water. Do not use paper with ink writing or rub the anus with plant leaves and clods.
(4) Keep the anus dry.
(5) Avoid anxiety, anxiety, excessive mental stress, anal itching can not be grasped by hand, itching can be applied to itching cream or hormone cream.
(6) If it affects sleep due to itching, take 1 piece of cyproheptadine before going to sleep.
(7) Etiology treatment: Because some foods may also cause anal itching, it should be determined to remove these things in the diet; systemic causes and parasitic infections must be treated specially; biopsy should be performed on refractory lesions to detect lesions .
(8) Avoid eating and getting into contact with your allergic diet, chemicals, lacquer, irritating foods, and certain medicines.
(9) Slight anal itching is caused by insufficient secretion of mucous membrane near the anus. Hygienic habits are too good and too bad. It may cause health problems. It is too good to wash the bath several times a day, and the mucous membrane near the anus will be washed away, resulting in Too dry near the anus may cause anal itching, but poor hygiene is easy to cause anal itching due to bacterial and viral infections.
(10) Anal pruritus caused by diet and hygiene habits. It is recommended to avoid cola, coffee, chocolate, wine, tea, penetrating cotton, wide underwear, and women should not use cotton pads. Wash a few times, especially after defecation, use less soap to prevent the mucous membranes from washing out. After washing, use a hair dryer to dry and apply the medicine.
(11) It is necessary to pay attention to the anal itching caused by viral infection and sexual infection. In addition to treating the symptoms of anal itching, it is also necessary to treat major diseases such as viral infections and sexually transmitted diseases as soon as possible. Therefore, patients should not ignore the anus. Symptoms of itching.
Complication
Anal pruritus complications Complications, perianal eczema
1. Perianal eczema.
2. Secondary perianal organ infection.
Symptom
Anal pruritus symptoms Common symptoms Anal secretions more perianal skin flushing Anal skin has eczema anal perineal area moist unclean purulent secretion constipation
In addition to the symptoms of pain in the anus, there is also a symptom of itching, the patient will scratch his hand because of itching, and even scratching the skin does not solve the problem.
Examine
Anal pruritus examination
1. Blood, urine, stool routine.
Urine routine is a non-negligible preliminary examination in the clinic. Many kidney lesions can be formed in proteinuria or urine sediment in the early stage. Once a urine abnormality is found, it is often the first indication of a kidney or urinary tract disease and is often an important clue to the nature of the pathological process. In recent years, many people have emphasized that the responsible doctors should do their own routine urine examinations, which is a general diagnostic method for doctors to discover kidney diseases.2. Liver and kidney function.
3. Urine sugar, blood sugar, glucose tolerance test.
4. Check the living tissue and smear.
Diagnosis
Diagnostic identification of anal pruritus
diagnosis
According to the 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. In general, the local anal area has a primary disease that becomes secondary pruritus, otherwise it is primary pruritus. In addition, a full physical examination should be carried out to conduct necessary laboratory tests, such as blood, urine, stool routine, liver and kidney function, urine sugar, blood sugar, glucose tolerance test, and biopsy and smear.
According to the cause can be divided into primary itching and secondary itching.
(a) primary itching
Primary itching is not associated with primary skin damage, with itching as the main symptom.
(B) secondary itching
Secondary pruritus is caused by primary diseases and various skin diseases, with obvious specific skin lesions and primary lesions. Itching is often a symptom of primary lesions. Such as anal fistula, anal eczema, genital warts, neurodermatitis, anorectal tumors, aphids and other anal itching are such.
Initial anal itching is lighter, there is no obvious change in the anus skin, mostly paroxysmal. Itching is more frequent in patients with chronic illnesses, and lasts longer, especially at night. Excessive scratching or mechanical stimulation makes the perianal skin hypertrophy and rough, anal folds deepen, local scratches, blood stasis, exudate, wrinkles In the residual fecal dirt, even more severe can be combined with infection with pus or purulent secretions, flushing and swelling. The lesion can be extended to the perineum, scrotum, female vulva and even double-hip skin. Clinical examination can be found in internal hemorrhoids, external hemorrhoids, mixed hemorrhoids, anal fistula, or laboratory tests for diabetes, tsutsugamushi, Candida albicans infection.
