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What Causes Itching Sensation On Anal Area?
Question: My wife has been having itching on her anus and its near areas from past 10-11 months, initially she was seeing gynaecologist and later we consulted with gastroenterologist on advice from Dr Samir@healthcaremagic (https://www.healthcaremagic.com/AskDoctorInboxServlet?page=viewQuery&queryId=149402).
When we saw gasteroontologist personally, we were referred to skin specialist and then after all the possible treatment from skin specialist, stool test was done which showed presence of CYST (E.H) and metrogyl medication was started which didnt cured the CYST (E.H). We again consulted Dr. Bhagyalaxmi@healthcaremagic (https://www.healthcaremagic.com/AskDoctorInboxServlet?page=viewQuery&queryId=158166)and we were advised to continue treatment of CYST with Tinidazole. After CYST was cured, stoll test showed OVA (Round Worm) now and we again consulted Dr. Sheetal@healthcaremagic (https://www.healthcaremagic.com/AskDoctorInboxServlet?page=viewQuery&queryId=163621) and she was put on mebendazole medicine for OVA. Today her latest stool report came and now she doesn't have OVA or CYST but her anus itching is still persistent. As per her, while taking mebendazole medication itching severity and intensity has increased.
We are looking for medical advice on how to proceed now, her anus itching has been there from past 10-11 months with no permanent solution in sight. Whom we should see and what diagnostic test are required to find the root cause of this itching issue. Please help
Note:
Please let me know if you dont have access to all the threads mentioned above as they contain lab reports also, I would then upload all the lap reports in zip file for your reference.
When we saw gasteroontologist personally, we were referred to skin specialist and then after all the possible treatment from skin specialist, stool test was done which showed presence of CYST (E.H) and metrogyl medication was started which didnt cured the CYST (E.H). We again consulted Dr. Bhagyalaxmi@healthcaremagic (https://www.healthcaremagic.com/AskDoctorInboxServlet?page=viewQuery&queryId=158166)and we were advised to continue treatment of CYST with Tinidazole. After CYST was cured, stoll test showed OVA (Round Worm) now and we again consulted Dr. Sheetal@healthcaremagic (https://www.healthcaremagic.com/AskDoctorInboxServlet?page=viewQuery&queryId=163621) and she was put on mebendazole medicine for OVA. Today her latest stool report came and now she doesn't have OVA or CYST but her anus itching is still persistent. As per her, while taking mebendazole medication itching severity and intensity has increased.
We are looking for medical advice on how to proceed now, her anus itching has been there from past 10-11 months with no permanent solution in sight. Whom we should see and what diagnostic test are required to find the root cause of this itching issue. Please help
Note:
Please let me know if you dont have access to all the threads mentioned above as they contain lab reports also, I would then upload all the lap reports in zip file for your reference.
Brief Answer:
Medicines as advised and local care, avoidance of the instigating foods
Detailed Answer:
Hi.
Thanks for your query and an elucidate history.
I can understand the plight the patient of itching on anus and peri-anal area goes through. Also read the history and seen the reports of the previous threads, the consultations with Gastroenterologist and the Dermatologist, the prescriptions and the medications you have mentioned.
The problem persists.
I think this is the time to think differently as your wife has received the medicines as per the reports and the latest stool test is normal.
Itching for more than 10 months with probably the best available treatment already taken, I would think of the following reasons.
Since your wife is allergic to Sulpha, Penicillin and Cipro, it is possible that she has a FDR- Fixed drug reaction cause at the anal region by Sulpha and the lesion persists. The itching is then instigated by many factors.
I would suggest the following in such a patient: (Some of the medicines will need a valid prescription which you have to get from the local Doctor)
-Medicines:
-Deflazacort 6 mg to be started with 30 mg per day and to be tapered (reduced over 3 weeks.
-Antihistamine like Cetirizine.
-Anti-oxidants in the form of multivitamins to be taken for at least a month and can be continued upto 3 months. To take the therapeutic doses of Vitamin A and D in the beginning.
-Probiotics.
-A 5 day course of an antibiotic like cefixime and a repeat course of Dyrade-M DS (Contains Metronidazole and Diloxanide Furoate) and Albendazole with Ivermectin (Single dose on empty stomach) is to be given.
-No local applications at the moment.
-Locally:
To clean the area after passing bowel motion (stool) with plain warm water and to dry the area with a cotton cloth or hair dryer. The clothes must be loose so the aeration is possible. There should be no accumulation of sweat. Area may please be washed 2 to 4 times in a day and after physical (sexual) contact.
-Avoid all the foods and beverages and particularly anything which contains preservatives, colorants and were known to give itching in the past. Both of you must have known such things by this time.
I hope she has no leucorrhea (vaginal white discharge) or any Gynecological problems. I hope you too have no medical or any problems related to your private parts. In a female patient the private parts are in vicinity so the infection can spread from one to another parts easily. If there are no such problems, nothing else to be done.
-About your queries:
You have to consult a Local Doctor with whom you can discuss about our discussion so that you get a valid prescription and can evaluate the progress.
Once the course are over 3 weeks, you can assess the response and if required you can get an opinion of another Dermatologist.
I do not think she needs any tests at the moment except for the following:
Free T3, Free T4 and TSH, for readjustment of the dosage of Thyrox 125 (only if required after the reports, otherwise to continue the same doses).
All these modes of treatment has helped all my patients and may help your wife to get a permanent cure.
Please feel free to share anything which may be more personal yet related to the present problems your wife has.
Medicines as advised and local care, avoidance of the instigating foods
Detailed Answer:
Hi.
Thanks for your query and an elucidate history.
I can understand the plight the patient of itching on anus and peri-anal area goes through. Also read the history and seen the reports of the previous threads, the consultations with Gastroenterologist and the Dermatologist, the prescriptions and the medications you have mentioned.
The problem persists.
I think this is the time to think differently as your wife has received the medicines as per the reports and the latest stool test is normal.
Itching for more than 10 months with probably the best available treatment already taken, I would think of the following reasons.
Since your wife is allergic to Sulpha, Penicillin and Cipro, it is possible that she has a FDR- Fixed drug reaction cause at the anal region by Sulpha and the lesion persists. The itching is then instigated by many factors.
I would suggest the following in such a patient: (Some of the medicines will need a valid prescription which you have to get from the local Doctor)
-Medicines:
-Deflazacort 6 mg to be started with 30 mg per day and to be tapered (reduced over 3 weeks.
-Antihistamine like Cetirizine.
-Anti-oxidants in the form of multivitamins to be taken for at least a month and can be continued upto 3 months. To take the therapeutic doses of Vitamin A and D in the beginning.
-Probiotics.
-A 5 day course of an antibiotic like cefixime and a repeat course of Dyrade-M DS (Contains Metronidazole and Diloxanide Furoate) and Albendazole with Ivermectin (Single dose on empty stomach) is to be given.
-No local applications at the moment.
-Locally:
To clean the area after passing bowel motion (stool) with plain warm water and to dry the area with a cotton cloth or hair dryer. The clothes must be loose so the aeration is possible. There should be no accumulation of sweat. Area may please be washed 2 to 4 times in a day and after physical (sexual) contact.
-Avoid all the foods and beverages and particularly anything which contains preservatives, colorants and were known to give itching in the past. Both of you must have known such things by this time.
I hope she has no leucorrhea (vaginal white discharge) or any Gynecological problems. I hope you too have no medical or any problems related to your private parts. In a female patient the private parts are in vicinity so the infection can spread from one to another parts easily. If there are no such problems, nothing else to be done.
-About your queries:
You have to consult a Local Doctor with whom you can discuss about our discussion so that you get a valid prescription and can evaluate the progress.
Once the course are over 3 weeks, you can assess the response and if required you can get an opinion of another Dermatologist.
I do not think she needs any tests at the moment except for the following:
Free T3, Free T4 and TSH, for readjustment of the dosage of Thyrox 125 (only if required after the reports, otherwise to continue the same doses).
All these modes of treatment has helped all my patients and may help your wife to get a permanent cure.
Please feel free to share anything which may be more personal yet related to the present problems your wife has.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thanks Dr Chandrakant for your detailed response and guidance. My wife also develop heat rashes (we can see like blisters on her hand, legs, stomachs and shoulders skins), normally it used to happen more when we were in US like if we increase heat in the house or when she is nervous or having anxiety. In XXXXXXX its occurrence is not prominent but it do happens sometimes due to anxiety. We visited multiple specialist while we were in USA but no conclusive root cause was identified. Also, we came back from USA after staying there for 2.5 years in Feb, 2014. her itching on and near anus area started in USA few weeks before we came back to XXXXXXX finally. Hope this provides you more background information which might be helpful in the diagnosis.
Can you please provide more details on the medicine plan recommended. I am summarizing my queries below
1. Deflazacort 6 mg to be started with 30 mg per day and to be tapered (reduced over 3 weeks.
- what should be the reduction amount and interval? like 6 mg per day reduction every 5 days?
- medicines should be taken spread over 3 times a day or once a day?
- should it be taken after food or empty stomach?
2. Antihistamine like Cetirizine.
- What should be the potency? 5 mg or 10 mg?
- In case of persistent itching she takes (Zertec or Cetrizine 5 mg) once a day, would once a day would suffice?
3. Anti-oxidants in the form of multivitamins to be taken for at least a month and can be continued upto 3 months.
- Any specific multivitamins which would be recommended. Like recommended name or composition?
- what should be the frequency? Once a day?
4. To take the therapeutic doses of Vitamin A and D in the beginning.
- What should be the potency of the vitamin which needs to be taken?
- how long vitamin need to be taken and its frequency per day?
- any recommended vitamin which has both of them present in required amount?
5. Probiotics.
- Any specific probiotic ? I have Spring Vally 10X Digective Care Probiotic available from US, can we use it?
- How long probiotic needs to be taken and its frequency per day?
- what should be the potency of pro-biotic?
6. A 5 day course of an antibiotic like cefixime and a repeat course of Dyrade-M DS (Contains Metronidazole and Diloxanide Furoate) and Albendazole with Ivermectin (Single dose on empty stomach) is to be given.
- Dyrade-M DS course should be done after cefixime course?
- Dyrade-M DS should be take for same 5 day?
- When is Albendazole with Ivermectin need to be taken in last after cefixime and Dyrade-M DS course or in the beginning?
- what should be the potency of these medicine?
Can we start all the six category of medicine plan (1..6)on same day or we need to follow them in sequence or in any other order?
Also, do we need to repeat stool test after 30 days to check if OVA is again reported?
Thanks once again for going through all the historical reports, prescription and medication and suggesting alternate path which could resolve her almost year long itching problem.
Thanks
XXXXXX
Can you please provide more details on the medicine plan recommended. I am summarizing my queries below
1. Deflazacort 6 mg to be started with 30 mg per day and to be tapered (reduced over 3 weeks.
- what should be the reduction amount and interval? like 6 mg per day reduction every 5 days?
- medicines should be taken spread over 3 times a day or once a day?
- should it be taken after food or empty stomach?
2. Antihistamine like Cetirizine.
- What should be the potency? 5 mg or 10 mg?
- In case of persistent itching she takes (Zertec or Cetrizine 5 mg) once a day, would once a day would suffice?
3. Anti-oxidants in the form of multivitamins to be taken for at least a month and can be continued upto 3 months.
- Any specific multivitamins which would be recommended. Like recommended name or composition?
- what should be the frequency? Once a day?
4. To take the therapeutic doses of Vitamin A and D in the beginning.
- What should be the potency of the vitamin which needs to be taken?
- how long vitamin need to be taken and its frequency per day?
- any recommended vitamin which has both of them present in required amount?
5. Probiotics.
- Any specific probiotic ? I have Spring Vally 10X Digective Care Probiotic available from US, can we use it?
- How long probiotic needs to be taken and its frequency per day?
- what should be the potency of pro-biotic?
6. A 5 day course of an antibiotic like cefixime and a repeat course of Dyrade-M DS (Contains Metronidazole and Diloxanide Furoate) and Albendazole with Ivermectin (Single dose on empty stomach) is to be given.
- Dyrade-M DS course should be done after cefixime course?
- Dyrade-M DS should be take for same 5 day?
- When is Albendazole with Ivermectin need to be taken in last after cefixime and Dyrade-M DS course or in the beginning?
- what should be the potency of these medicine?
Can we start all the six category of medicine plan (1..6)on same day or we need to follow them in sequence or in any other order?
Also, do we need to repeat stool test after 30 days to check if OVA is again reported?
Thanks once again for going through all the historical reports, prescription and medication and suggesting alternate path which could resolve her almost year long itching problem.
Thanks
XXXXXX
Brief Answer:
Please consult a Local Doctor , discuss and get a prescription
Detailed Answer:
Hi XXXXXX
I remember responding to similar query in the past.
Well, I can not really give you a prescription due to the the limitations of the net and possibility of Medical store owner not giving you the medicines without a proper prescription. I request you humbly to talk to / consult a local Doctor who is at least MBBS and discuss all the points we discussed and get a valid prescription.
The medicines mentioned above is a suggested line of treatment.
I can add on some points and request you to talk to the local Doctor, discuss the case and get a valid prescription....
1 . you are absolutely correct for Deflazacort. (The blood sugar is normal).
2 . Cetirizine should be taken 10 mg per day - once daily.
3. Any Anti-oxidants available with your store or whichever your Doctor prescribes -
Once a day is fine
4. Vitamin A one capsule twice daily for 5 days.
5. Probiotics - whichever you have and once a day , can continue for 5 days up to 1 month.
6. Cefixime and Dyrade M can be taken together. Albedazole with Ivermectin can be taken on any day.
All medicines can be started together. Please check if she has a known allergy
to any of the medicines written here before starting...
Yes, you can repeat stool test after 30 days.
So I request you to talk to your Local Doctor- MBBS or so and get a valid prescription.
We have a facility, you can call the Ibix office and they can connect you to me, so that you can discuss more if you need to.
Our ultimate aim is to get a cure for your wife who is suffering since long.
I hope this answer helps you...
Thanks for your appreciation.
Please consult a Local Doctor , discuss and get a prescription
Detailed Answer:
Hi XXXXXX
I remember responding to similar query in the past.
Well, I can not really give you a prescription due to the the limitations of the net and possibility of Medical store owner not giving you the medicines without a proper prescription. I request you humbly to talk to / consult a local Doctor who is at least MBBS and discuss all the points we discussed and get a valid prescription.
The medicines mentioned above is a suggested line of treatment.
I can add on some points and request you to talk to the local Doctor, discuss the case and get a valid prescription....
1 . you are absolutely correct for Deflazacort. (The blood sugar is normal).
2 . Cetirizine should be taken 10 mg per day - once daily.
3. Any Anti-oxidants available with your store or whichever your Doctor prescribes -
Once a day is fine
4. Vitamin A one capsule twice daily for 5 days.
5. Probiotics - whichever you have and once a day , can continue for 5 days up to 1 month.
6. Cefixime and Dyrade M can be taken together. Albedazole with Ivermectin can be taken on any day.
All medicines can be started together. Please check if she has a known allergy
to any of the medicines written here before starting...
Yes, you can repeat stool test after 30 days.
So I request you to talk to your Local Doctor- MBBS or so and get a valid prescription.
We have a facility, you can call the Ibix office and they can connect you to me, so that you can discuss more if you need to.
Our ultimate aim is to get a cure for your wife who is suffering since long.
I hope this answer helps you...
Thanks for your appreciation.
Note: For further inquiries on surgery procedure and its risks or complications book an appointment now
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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