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What Causes Recurrent Persistent Itching Around Anus?
Question: Hi
This is in regard to health issue which my wife has been facing from last 10 months. We came back from USA in Feb 2014 afetr staying there for over 2 years) and this problem started in last month of our stay in USA. She started complaing about itching near her anus and on the opening of anus and it used to vary on severity intensity. Sometimes no or very less itching and other times too much itching. Some times it used to itch so much that she use to itch hard and cause injury there.
On return to XXXXXXX she visit her gynecologist several times and she was given anti-fungal, anti-itch, stomach worm medicines over the period of 4-5 month but permanent resolution was not there. there were temporary relief but itching used to come back (All previous reports are attached date wise for reference - 001_Gyane_March26, 002_Gynae_Apr26, 003_Gynae_July8, 004_GYnae_July15)
Later we were advised to visit gastroontologist for prutus ani sympton and we viisted the specialist and then doctor asked her to visti skin specialist. Skin specialist again gave her anti fungal cream and medicines (Prescription attached - 006_Gastro_Nov30, 007_SKIN_SPECIALIST_Dec6, 008_SKIN_SPECIALIST_Dec28). Also skin specilits asked her to undergo stool test and sugar test. sugar test came out negative but stool test shows presence of cyst.(Report attached - ANJUM_STOOL_REPORT, ANJUM_SUGAR_PP_FASTING_REPORT) Now skin specialist has prescribed some worm medicines along with anti fungal medicines. Still there is no permanent relief and she do get itching problem while she is on medication
I am looking to get direction on below questions as this problem has been in existince for several months and we are not sure what to do next
1. If her itching is due worm, then shouldn't we see some specialist in that area which can really provide expert guidance to resolve this problem?
2. Over the course of 10 months she has been on anti-itch, anti-fungal, steriod cream and none of them yieleded permanent resolution. So can we rule out skin disease here?
3. Who is the best type of doctor for her problem.
Also, we have got her health check-up blood work done whose report is also attached (ANJUM_HEALTH_PROFILE_REPORT). In her health check-up report we have "HDL CHOLESTEROL - DIRECT" reported as LOW and "TC/ HDL CHOLESTEROL RATIO" reported as BIT HIGH. I am not sure if this can be linked to her current problem of itching, so attaching that as well.
Please let me know if you need more details so that you can advice us better
Thanks
XXXX
This is in regard to health issue which my wife has been facing from last 10 months. We came back from USA in Feb 2014 afetr staying there for over 2 years) and this problem started in last month of our stay in USA. She started complaing about itching near her anus and on the opening of anus and it used to vary on severity intensity. Sometimes no or very less itching and other times too much itching. Some times it used to itch so much that she use to itch hard and cause injury there.
On return to XXXXXXX she visit her gynecologist several times and she was given anti-fungal, anti-itch, stomach worm medicines over the period of 4-5 month but permanent resolution was not there. there were temporary relief but itching used to come back (All previous reports are attached date wise for reference - 001_Gyane_March26, 002_Gynae_Apr26, 003_Gynae_July8, 004_GYnae_July15)
Later we were advised to visit gastroontologist for prutus ani sympton and we viisted the specialist and then doctor asked her to visti skin specialist. Skin specialist again gave her anti fungal cream and medicines (Prescription attached - 006_Gastro_Nov30, 007_SKIN_SPECIALIST_Dec6, 008_SKIN_SPECIALIST_Dec28). Also skin specilits asked her to undergo stool test and sugar test. sugar test came out negative but stool test shows presence of cyst.(Report attached - ANJUM_STOOL_REPORT, ANJUM_SUGAR_PP_FASTING_REPORT) Now skin specialist has prescribed some worm medicines along with anti fungal medicines. Still there is no permanent relief and she do get itching problem while she is on medication
I am looking to get direction on below questions as this problem has been in existince for several months and we are not sure what to do next
1. If her itching is due worm, then shouldn't we see some specialist in that area which can really provide expert guidance to resolve this problem?
2. Over the course of 10 months she has been on anti-itch, anti-fungal, steriod cream and none of them yieleded permanent resolution. So can we rule out skin disease here?
3. Who is the best type of doctor for her problem.
Also, we have got her health check-up blood work done whose report is also attached (ANJUM_HEALTH_PROFILE_REPORT). In her health check-up report we have "HDL CHOLESTEROL - DIRECT" reported as LOW and "TC/ HDL CHOLESTEROL RATIO" reported as BIT HIGH. I am not sure if this can be linked to her current problem of itching, so attaching that as well.
Please let me know if you need more details so that you can advice us better
Thanks
XXXX
Brief Answer:
Consult a general surgeon
Detailed Answer:
Hello XXXXXXX
I have read your query; I can understand your concern.
I have gone through your reports.
It seems like she is having chronic pruritus ani. It is mostly due to recurrent infections caused by lack of hygiene which can cause worm infestation.
Since her stool report shows ova (Entoameoba histolytica), I suggest her to do not eat outside food. Wash her hands with anti septic lotions like Dettol hand wash frequently especially before having food.
Do not scratch her anal area which leads to recurrent infections.
I suggest you continue anti histamines, anti worm medications and steroids according to doctor advice. And also repeat stool test. If she is not feeling better with current ant worm medications then ask doctor to better change medications.
Sometimes thyroid and liver problems can persist itching.
Also check her blood test to find out that weather she has iron deficiency anemia which may increase itching.
She needs consult and follow up with general surgeon. She also needs to be ruled out other possibilities like rectal or anal fissure. General surgeon will do anoscopy to rule out this.
If you have any queries I will be happy to help you.
Thank you.
Consult a general surgeon
Detailed Answer:
Hello XXXXXXX
I have read your query; I can understand your concern.
I have gone through your reports.
It seems like she is having chronic pruritus ani. It is mostly due to recurrent infections caused by lack of hygiene which can cause worm infestation.
Since her stool report shows ova (Entoameoba histolytica), I suggest her to do not eat outside food. Wash her hands with anti septic lotions like Dettol hand wash frequently especially before having food.
Do not scratch her anal area which leads to recurrent infections.
I suggest you continue anti histamines, anti worm medications and steroids according to doctor advice. And also repeat stool test. If she is not feeling better with current ant worm medications then ask doctor to better change medications.
Sometimes thyroid and liver problems can persist itching.
Also check her blood test to find out that weather she has iron deficiency anemia which may increase itching.
She needs consult and follow up with general surgeon. She also needs to be ruled out other possibilities like rectal or anal fissure. General surgeon will do anoscopy to rule out this.
If you have any queries I will be happy to help you.
Thank you.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thanks Dr Bhagyalaxmi for the detailed response. In regard to "lack of hygiene" that can be ruled out as my wife is extra hygiene conscious, like washing hands extensively after stool, cleaning the anus area after passing stool etc.
Would it be more helpful to see Female Gastroenterologist instead of General Surgeon if the issue is wrt to work and anus area? please advice?
Would it be more helpful to see Female Gastroenterologist instead of General Surgeon if the issue is wrt to work and anus area? please advice?
Brief Answer:
Can see Gastroenterologist
Detailed Answer:
Hello XXXXXXX
Thanks for your follow up.
Along with personal hygiene she needs to maintain food hygiene as well.
General surgeon can do anal examination by anoscopy to rule put internal lesions like fissures. First she needs to be completed the treatment for cysts in stool which indicates worm infestation. Repeat the stool test to know that weather she is cleared from worms or not.
If your doctor says that she needs colonoscopy or sigimoidoscopy then Yes, you can see female or male Gastroenterologist.
If you have any queries I will be happy to help you.
Can see Gastroenterologist
Detailed Answer:
Hello XXXXXXX
Thanks for your follow up.
Along with personal hygiene she needs to maintain food hygiene as well.
General surgeon can do anal examination by anoscopy to rule put internal lesions like fissures. First she needs to be completed the treatment for cysts in stool which indicates worm infestation. Repeat the stool test to know that weather she is cleared from worms or not.
If your doctor says that she needs colonoscopy or sigimoidoscopy then Yes, you can see female or male Gastroenterologist.
If you have any queries I will be happy to help you.
Note: For further follow up on digestive issues share your reports here and Click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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