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Suggest Treatment For Persistent Itching On The Buttocks And Anal Area

Posted on Mon, 13 Apr 2015

Question: My wife (44 yrs) is suffering from itchy bottom since the last one year. We have done all tests - not worm related. But has some link with acidity. She had a gall bladder surgery two years back. This itch issue came within six months after that. She is lactose intolerant. Most of the night she can't sleep due to this.

Answered by Dr. Praveen (2 hours later)

Brief Answer:
I would like to know some more information

Detailed Answer:
Hi dear.Thanks for your query.

I would request you to attach the scans of the reports or the discharge summary using the reports tab on your page.

I would like to know some more information-
Does she have itching any where else in the body?
Presuming that she has local itch and the worm infestation is ruled out, I were to suspect a skin infection(yeast which is most common).Have you visited dermatologist regarding the same problem?
Does she have a history of piles or haemorrhoids?
Does she experience painful belching, acid taste in the mouth, bloating or indigestion?

Await your reply soon.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Praveen (38 minutes later)

Hear issue is with peri anal itching. Apart from that she gets itching on her palms. We have taken gyanaec opinion and all ok. No piles or haemorroids. No sour belching. No local skin infection. Very tiny skin tag exists. Her symptoms are simillar to irritably bowel syndrome. She cant tolerate lactose, high fiber foods, wheat products, or spicy foods. Condition is better with very bland food - mostly with rice items (dosa, idly). Gets headache after gas formation. Cant sleep at night when itching gets worse. She is taking probiotic medicine since the last three days to improve on gut flora. Had taken lot of antibiotics and antacids over the last two/three years as prescibes by different doctors. For endoscopy done at Apollo about six months back and they found some little infection - prescribed her SOMPRAZ-HP two doses in a gap of few weeks. Her periods are normal - though she gets pain from blood clotting during periods. She is undergoing severe mental stress due to several reasons - not sure if this has a relation to this matter. Please help us.

Answered by Dr. Praveen (1 hour later)

Brief Answer:
Consult dermatologist, plan for skin tag removal

Detailed Answer:
Hello again.Thanks for your quick reply and sharing relevant information.

According to me-
a. Skin tag removal(by burning or freezing therapy by a surgeon) shall help since this is the most likely cause of itching as per your description.Since she does not have any identifiable local cause (skin condition/infection/worm infestation).

b. In order to control itching, I would recommend a short course of topical steroid ointment for a weeks time(hydrocortisone cream) till then. Consult a dermatologist and take his opinion as discussed above.

c. Avoid milk & milk products and other foods which troubles her bowels for awhile. In case she needs to take milk it can be diluted and taken in small volumes(25-50ml) at a time.Recommend Lactobacillus tablets available over the counter before intake to alleviate symptoms.

d. Long term antibiotics and antacids use cause bowel irregularities and restoration of flora is very important.Continue probiotics as advised by your doctor.

Once her bowel habits regularise consult a gastroenterologist for his advice on irritable bowel syndrome and follow-up regularly.

I would wish to do a Complete blood count and serum bilirubin levels to rule out other systemic causes of itching.

Keep the anal region dry, clean and intact.

Please feel free to write for further queries.

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar