Seriously. What's up with my anus?

November 5, 2007 8:07 PM

Hi there. Remember me? Well, I'm back, and my butt problems continue.

So I went to see my doctor about my itchy butt (he saw through the hair just fine, BTW), and he diagnosed me with pruritus ani, which is latin for "I have no idea why your ass itches." No hemmeys or fissures, no pinworms, just an unidentifiable urge to scratch my anus. He told me to switch from boxer briefs to plain old boxers (to help keep things aired out) and to keep using hydrocortizone cream for the rest of my life... and never, ever, EVER succumb to the urge to itch. Easier said than done.

I followed his advice, and for a short time the itching seemed to go away, but it's recently flared back up. Basically it works like this:

- Nothing feels out of whack down there (no skin flaps or bulging veins).
- No blood on my toilet paper or in my stool.
- No pain from bowel movements. In fact, my BMs don't seem to have any affect on the state of itchiness.
- Sitting alleviates the urge to itch almost immediately.
- Standing and walking aggravate the condition.
- Hydrocortizone doesn't always do the trick, so I've recently started using a generic version of Benadryl cream, which seems to be a little more effective.

Despite having two huge health care systems in my town, neither of them have a Proctologist. Do they go by a different name these days? We have several colo-rectal surgeons, but they seem to extreme for Mr. Itchy Ass 2007. I don't want to go back to my regular doctor, because, frankly, I think his prognosis was a bit weak.

Has anyone out there had a similar affliction? How did you ever find relief? Please help?! My anus is killing me!!! And I don't want to see any IANAD bullshit... I already figured as much.

posted by (bb|[^b]{2}) to Health & Fitness (42 answers total)

Cola drinks are known to cause that. Do you drink a lot of cola?
posted by 45moore45 at 8:10 PM on November 5, 2007

Response by poster: I drink one 20 ounce Dr. Pepper per day. Other than that, it's water or Gatorade. I wouldn't call that "a lot of cola" by a long shot.
posted by (bb|[^b]{2}) at 8:16 PM on November 5, 2007

"keep using hydrocortizone cream for the rest of my life."

Dear god, doesn't that lead to thinning of the skin? I don't think you want to do that at all.

I have suffered as you, though not to same extent, thanks to my muscular hairy arse and vigorous exercise regime.

My discovery (based on suggestions from my very sensible, conservative general practitioner) was that harsh toilet paper and washing with soap were big problems, as was inadequate dietary fibre. Have you tried using a non-soap cleanser with a neutral pH? Or even just water? And increasing your fruit and veg intake?
posted by i_am_joe's_spleen at 8:33 PM on November 5, 2007

Are you making very sure to get the area clean in the shower? Do you wash it after you wash your hair, or could shampoo be dripping down your back to leave a film in the area after you've already washed it? Maybe it's just the hair rubbing around, being irritating, especially if you get sweaty. Perhaps some baby powder sprinkled in the area to dry things out a bit would help.
posted by Inconceivable! at 8:40 PM on November 5, 2007

Response by poster: 1. I read that hard TP and soap could aggravate the problem, so I've just been rinsing it out (last thing) during the shower, then using medicated wipes after I dry off, before applying the butt cream du jour.

2. I'm really not a sweaty person, and I've never had "crack sweat" in the whole of my life, but you never know. Things are typically very dry down there.
posted by (bb|[^b]{2}) at 8:47 PM on November 5, 2007

Medicated wipes?

Dude, have you ever had responsibility for a baby's bottom? Wipes can be highly irritating, even if they say they're not.
posted by i_am_joe's_spleen at 8:57 PM on November 5, 2007

Have you tried stopping the Dr Pepper? That's a 'lot of cola' by my standards, and maybe you have a low threshold for whatever it does.
posted by jacalata at 8:58 PM on November 5, 2007

I know it's going to seem like it'll be less effective than Benadryl, but you might want to try Boiron Calendula ointment. It's managed to immediately stop, and heal, pretty much any itchy skin I've ever had, anywhere. (I would probably skip the medicated wipes beforehand, since, as i_a_j_s points out, they can be irritating.)

But I would also keep pursuing the proctologist thing.
posted by occhiblu at 9:11 PM on November 5, 2007

to me, 20oz Dr P plus Gatorade IS a lot of cola

I'm not saying that's it, but just sayin'.
posted by unSane at 9:26 PM on November 5, 2007

and by the way, seconding

1. not using hc cream long-term

2. not using medicated anything. Lots of rinsing with nice clear water

3. lots of attention to diet. Improve your diet... what's the worst that could happen?
posted by unSane at 9:28 PM on November 5, 2007

Are you using some kind of scented toilet paper? It makes many women itchy in their girly bits; perhaps it affects your ass?
posted by sephira at 9:29 PM on November 5, 2007

If your newly recommended boxers have a seam up the middle, maybe it's chafing?
posted by Reggie Digest at 9:36 PM on November 5, 2007

Screenname notwitshatdning, I am not a doctor. However, I would suggest:

1) 20 oz a day of soda can indeed be a lot, or at least too much for your system. Cut it out for a week and see what happens.

2) Medicated baby wipes are drying. Don't use those. Which leads me to: You say things are "very dry" down there. Maybe too dry? You do need a certain level of moisture - not too much, but some.

3) White, nonscented TP only. Also, white cotton undies.

4) Washing with water only, although you say you have been doing that.

4) How long has this been going on? Can you try to remember when you first noticed this, and think of any lifestyle changes you may have made?
posted by DrGirlfriend at 9:42 PM on November 5, 2007

It's been happening, off and on, for about two and a half years. I was remodeling my house when it first happened. I believe I gave myself a hemmey from lifting more than I should for too long. The hemmey healed itself in due time, but the itching created an itch/scratch vicious cycle.

It may very well be too dry down there. Often times, it feels as if the skin at 12 and 6 o'clock is cracked... along my crack.
posted by bjork24 at 10:06 PM on November 5, 2007

Cut out pizza, cheese, red meat, all carbonated drinks, tabasco sauce, milk, processed foods, refined flour, etc. Drink plenty of water, eat lots of broccoli, green beans, spinach, avoid carrots, apples, grapes, other hard to digest fruits. Pears are good.

Avoid medicated wipes.

By the way, is the itchiness *inside* your butt, or *outside*, on the skin?
posted by KokuRyu at 10:16 PM on November 5, 2007

Response by poster: Damnit. I replied under my friend's username above (I'm on his computer) ^^^

That's me talking, not bjork24.
posted by (bb|[^b]{2}) at 10:24 PM on November 5, 2007

You might consider this a slight derail, but it's not. I visited Thailand for a month a couple of years ago and noticed that the hotel toilets each had a "sink hose" attached. At first, I figured it was for the maid to clean the toilet, but then I noticed that seemingly every toilet in the country had a hose. A fellow visitor finally clued me in that the hose was for washing your ass after you take a shit. I greeted the news non-chalantly, and continued to use toilet paper as all westerners do. Until...one day I was in a toilet that had no toilet paper. "Fuck", thought I, "this really sucks." But...wait, what about the hose? OK, time to try it...hey, that wasn't too bad...and it worked better and much faster than usual multiple wipes! Long story short, it took a few days to get the aim just right and figure out when I was "done" but I soon became totally adapted to "getting hosed". The very first advantage I noticed I no longer had any traces of smeared shit in my ass crack (which seem to show up no matter how carefully one wipes). And...much less itching and irritation from same. I believe this is also the principle of the "bidet", but implemented in a far less expensive manner. I installed a hose last year in my home in Cali, and use it every time I...you know.
posted by telstar at 10:36 PM on November 5, 2007

It does sound like an allergy, as other posters have noted. Cutting out everything that anyone has ever been allergic to ever is just a recipe for being miserable IMHO. Allergy doctors exist and they can figure out exactly what you really need to cut and what is ok for you.

A proctologist is just going to refer you to an allergy doc if he can't figure out why you itch, but he might also know of some other common ailment. And the allergy doc might want to know that you've already been to the butt doc, so you've got some appointments to make.
posted by TeatimeGrommit at 10:40 PM on November 5, 2007

I'm going to suggest you see a dermatologist, not a procto. I have this problem (sort of? ish) from time to time, but I have psoriasis that sometimes flares up. It sounds to me like a few things, which a dermatologist could diagnose:

• yeast (could be result of sugar consumption - not sure how much 20 ounces is in my mind's eye but others have said it's a lot -- "a lot" is relative to each person)
• eczema
• psoriasis/other inflammatory skin condition
• harsh laundry detergents -- try only natural unscented products on your underclothes for a while
• harsh/drying body products -- try using baby soap
• allergy to body or laundry product ingredient Again: see a dermatologist!

posted by loiseau at 10:50 PM on November 5, 2007

To the cortocosteroid worriers: yes, it does long-term, but I don't think at the level you can buy over-the-counter there would be any discernible thinning any time soon. I've been using hard-core steroid stuff for 20 years for psoriasis and have only noticed a few areas becoming thinned out in the last year or so.
posted by loiseau at 10:52 PM on November 5, 2007

Response by poster: I actually made an appointment to see my dermatologist about this very issue a couple months ago, but when the time came to tell him about my problem I chickened out and told him I was there for a standard mole check-up. :(

Maybe I should muster up the courage and try again.
posted by (bb|[^b]{2}) at 10:55 PM on November 5, 2007

So if you ever get a melanoma on your arse, you'll die.

See the dermatologist.
posted by i_am_joe's_spleen at 11:24 PM on November 5, 2007

I'm n'thing dry skin. I use Preparation H even though I don't have hemorrhoids and it does the trick on the rare occasions something like this crops up (and it used to be fairly common for me).
posted by rhizome at 12:44 AM on November 6, 2007

I do not have the problem but I do covet a Washlet. Such wash-your-nether-parts toilets are fairly standard in Japanese homes, and I love them when I visit the inlaws.

Or going European, there's always the option of a bidet.

Failing that, at a lower price point there is the Bottom Buddy.
posted by derMax at 1:01 AM on November 6, 2007

argh, ignore the Bottom Buddy, I was mistaking it with something else.
posted by derMax at 1:20 AM on November 6, 2007

I had similar itching in that same place for a while, and found that twice-daily applications of hand lotion did the trick -- I guess my skin was just too dry, and the lotion returned things to normal. There are probably better products to use, but I had some aloe-based hand lotion lying around, and it worked.

But the suggestion to see a dermatologist is probably a good one. Take a look at photos of skin diseases -- no matter how embarrassing you think your itching is, it just isn't in the running for "weirdest thing this week a skin doctor will see." Hey, you could always pretend you are on AskMe: "Uh, Doc? I, uh, I'm writing this book, and there's this character who has an itchy butt..."
posted by Forktine at 3:05 AM on November 6, 2007

Do you sweat a lot? Sweat can cause irritation, especially around the backside. You should try plain moisturising cream instead of the hydrocortizone - it may even have been the minor moisturising properties of the hydrocortizone that was helping you initially.
posted by fire&wings at 3:06 AM on November 6, 2007

I had the same problem until I started using Metamucil twice a day. A couple of benefits were expected, but this one was unexpected and welcome.
posted by megatherium at 4:12 AM on November 6, 2007

As far as I am aware a colo-rectal surgeon is the same as a proctologist. Go see one.
posted by roofus at 4:22 AM on November 6, 2007

You might try a bit of unscented lotion (Cetaphil is the market leader for being hypoallergenic) while you're still shower-damp. To start with, you may want to mix a dab of the hydrocortisone in with it. That's my dermatologist's fix-all for nonspecific itching.

Ongoing, the best thing you could probably do is invest in one of the recommended aftermarket toilet rinsers and avoid wipes and toilet paper as much as possible.
posted by Lyn Never at 6:04 AM on November 6, 2007

Have you tried Body Glide? Available at your local sporting goods store, eliminates problems caused by chafing between your buttocks as you walk.
posted by M.C. Lo-Carb! at 7:44 AM on November 6, 2007

As far as I am aware a colo-rectal surgeon is the same as a proctologist. Go see one.

This is correct. I have been seeing one (okay once, but I need to go back) for a similar problem. I've cut out coffee and beer (gasp!) on their recommendations, but it did not help. Lots of good stuff in this thread I'm gonna try though.
posted by Big_B at 9:36 AM on November 6, 2007

Response by poster: Lots of good stuff here. Thanks everyone! I think I'll make an appointment to see a colo-rectal surgeon soon.
posted by (bb|[^b]{2}) at 9:46 AM on November 6, 2007

Response by poster: After reading about the guy who had to give up beer (gasp!), I wanted to point out one more oddity of my condition: when I drink beer or smoke, it subsides. I drink excessive amounts of beer and smoke with my poker buddies on Thursday nights, and my butt stops itching leading up to poker night (Thursday afternoon) with residual effects lasting well into Friday.

Maybe I should drink and smoke more than once a week!
posted by (bb|[^b]{2}) at 9:53 AM on November 6, 2007

The itching is hemorrhoids; inflamed veins. More non-caffeinated fluids. More fiber, both the oat bran(indoluble) and dried apricot(soluble) variety. More exercise. These things are all very good for you.

Use the hc cream to get the inflammation under control. Use a bit of cornstarch as a powder if things are damp. The calendula cream sounds promising.
posted by theora55 at 10:58 AM on November 6, 2007

Re: smoking

I have actually heard of some sort of booty disease that goes away when a person starts smoking. For the life of me, I cannot remember what it is though.

Perhaps a second opinion would be good.
posted by idiotfactory at 1:52 PM on November 6, 2007

idiotfactory: I have actually heard of some sort of booty disease that goes away when a person starts smoking. For the life of me, I cannot remember what it is though.

My late ex had ulcerative colitis and was told smoking would help. I'm not sure if this is the only one though.
posted by loiseau at 5:15 PM on November 6, 2007

(And I'm not sure it could really be considered a "booty disease".)
posted by loiseau at 5:15 PM on November 6, 2007

Ditto loiseau...could be a yeast thing what with all that sugar you are drinking (and maybe eating). Do you also have bouts of jock itch or athlete's foot? Look up yeast infection for natural remedies. Improving your diet (less sugar is the most important, and that means carbs, alcohol etc.) will help a lot, as well as adding probiotics (you can eat good yogurt that contains the probiotics you need like acidopholus etc.) and more fiber. For the short-term, wash well with natural soap (no fragrance etc.), use natural laundry detergent, and put lotion on the area to calm the itching sensation.
posted by kenzi23 at 9:48 AM on November 7, 2007

Could be yeast. Use some acidophillus tablets or powder for a few days - it's good for the entire digestion system and it's a painless and easy thing to try.
posted by agregoli at 7:56 PM on November 9, 2007

Response by poster: I don't sweat. I've never had jock itch or athlete's foot. Besides drinking Dr. Pepper and Gatorade (on occasion), my sugar intake is minimal. I have a very high fiber / carb diet, consisting of lots of breads, pasta, beans (pinto and black mainly), vegetables, and cereals. I'm not a vegetarian though, and occasionally enjoy chicken. I hate seafood.

And my butt still itches.
posted by (bb|[^b]{2}) at 9:30 PM on November 11, 2007

Have you tried Bikini Zone? It's got lidocaine, and it's not just for girls, you know.

It tingles at first, but oh man does it feel better than itching and scratching your delicate nether regions.
posted by mynameismandab at 8:52 PM on January 21, 2008