Evaluation, management and future perspectives of anal pruritus: a narrative review

Abstract

Purpose The without a time limitation. Most recent search was performed on 1st June 2022. Results Thorough history and physical examination are very important in view of multiple possible causes of anal pruritus. Most of the focus during examination is drawn on to the perianal region. A digital rectal examination and an anoscopy are essential. It is necessary aim of this narrative review is to overview the classification, diagnostics, possible treatment options and future perspective of anal pruritus. Methods The search was performed by two authors (AD and MJ) independently in the following electronic databases: PubMed, EMBASE, Web of Science, Cochrane Library, CENTRAL and the Allied and Complementary Medicine Databases (AMED). Search was restricted to English language only to avoid moisture and the use of soaps in the perianal region. Furthermore, the patient should avoid certain foods and increase the intake of fiber. If the symptoms do not resolve, topical steroids, capsaicin (0.006%) and tacrolimus (0.1%) ointments may be used. For intractable cases, intradermal methylene blue injection might give a long-lasting symptom relief. Conclusion Anal pruritus is a long-term deteriorating quality of life issue. Most of the time it is a symptom with a difficult diagnosis. Thorough history and examination should be performed for the best possible treatment.

Anal pruritus: Don’t look away

“…There are also several secondary causes that might be associated with anal pruritus[ 6 ]. Benign and malignant anorectal conditions such as hemorrhoids, fissures, fistulas, rectal prolapse, condylomas, Crohn’s disease, squamous cell carcinoma, colorectal cancer, Paget’s disease and melanoma are all possible secondary causes[ 6 , 7 ]. Hemorrhoids and anal fissures are the most common anorectal diseases associated with pruritus[ 8 ].…”

“…Hemorrhoids and anal fissures are the most common anorectal diseases associated with pruritus[ 8 ]. Dermatological and sexually transmitted diseases, fungal infections and systemic diseases such as diabetes mellitus, lymphoma, renal failure, hyperthyroidism disorders or iron deficiency anemia can also be associated[ 6 , 7 ].…”

“…A proper anorectal digital examination should then be performed, with a search for suspicious masses. If possible, this should be followed by an anoscopy[ 7 ]. This detailed examination of the perianal area, combined with digital anorectal examination and an anoscopy, will allow a correct evaluation and classification of the situation, and should exclude anorectal diseases that might be associated with anal pruritis.…”

Experience of using homeopathic ointment in the treatment of patients with anal itching

“…В настоящее время методы лечения анального зуда крайне ограниченны и заключаются в восстановлении кожи перианальной области и устранении первич ной причины заболевания [12,13].…”