Itchy Butt: Why You Squirm and What to Do About It
Itchy butt is more common than you think
Having an itchy butt is the nightmare scenario for dates, long car rides, sitting at work, going on runs, etc. Itchy butt is also something people very rarely share with anyone else. It’s embarrassing. It’s uncomfortable. It can be kind of funny. It has some very clear causes.
And guess what. Many, many people are refraining from scratching it right now. Just think, tomorrow at work you are talking with a coworker. You are trying your best to ignore that creepy-crawly feeling around the event-horizon between your cheeks. It’s very possible that your coworker is having the same exact experience.
This rather funny and potentially true scenario highlights the fact that an itchy rear end is not only common, it’s a natural response to any number of things.
What are those things? An itchy rear end is medically known as pruritus ani (literally “severe itching” + “anus”). Patients often tell us about this symptom in a whispered, hushed-confessional tone, as if it were a sin. Just ask yourself, when was the last time your health care provider asked you if your rear is the source of distressful itching and creepy-crawling-feeling? Maybe never – this just proves how awkward this symptom can be to discuss.
Yet, it’s the tell-tail marker in a number of bowel problems, infections, skin diseases, and lifestyle problems. Most sites refrain from discussing it. This is too bad, because millions of people with an itchy Gluteus-Foraminis (literally “buttocks” + “hole” ) are dealing with (i.e., squirming) right now.
Symptoms of anal itching
You would think that the primary symptom for an itchy anus is fairly obvious: an itchy anus. But there are many elements of the itch to pay attention to that can help you and/or your healthcare provider narrow down the cause of your pesky posterior prickling:
- Frequency: how often is it happening?
- Persistency: when it starts to itch, how long does it itch?
- Timing: does it itch at certain times of day?
- Intensity: how would you describe the itch? Is it like an ants-nest invasion, or a gentle tickle?
- Pattern: does it occur after certain activities?
- Condition: is your anus red, raw, leathery?
Before reading on, consider all sides of your particular itch.
Parasites and other infections
An excessively itchy rear has traditionally been associated with parasites – especially worms. Though some (very reputable) sources cite parasites as a “less common” problem for anal itching, parasitic infections are actually quite common – to the tune of over 60 million infections per year in the US alone (CDC).
Now, don’t get worried (yet). The intensity and persistence of your itch says a lot about the cause(s) of your itchy rear. In the case of parasites, the itchiness is often worse at night. This is because common parasites like pinworms take a nightly trek from the inside your rectum, out along your Hershey Highway, in order to set up camp on your butt cheeks where they lay their eggs.
That itchiness you feel could either be parasites wriggling around, or inflammation causes by their residence on the inside of your back door. Other than parasites, other infections such as Candida (yeast infection), tinea infections (same as athlete’s foot and jock itch), scabies, psoriasis, and pediculosis, among others, can cause an itchy anus.
For more information about parasites, please see these comprehensive resources:
Irritable bowel syndrome (IBS) or IBD
IBS and IBD can cause your chocolate star to itch, but for slightly different reasons.
One of the lovely hallmarks of IBS is muscle spasms in the GI tract, which can cause the rectum to itch. Another common symptom of IBS is “leakage” or fecal incontinence. Even a small amount of poo (feces) residue on the anus can irritate the skin and make it itch.
Irritable bowel disease, such as ulcerative colitis, causes inflammation of the bowel – inflammation which can irritate your rear spoke wheel.
For a great overview of what IBS is, telltale markers of IBS, etc. check out our report or quiz on IBS:
Diet and allergies
You have probably noticed a pattern emerge for the cause of an itchy butt: inflamed tissue of the anus. Your diet and/or allergies can certainly contribute to this problem. For example:
- Spicy foods can irritate your anal skin (as the saying goes about spicy food, “Hot in, hot out”)
- Other foods may cause slight irritation as they are expelled, such as caffeine, chocolate, beer, nuts, dairy, etc.
- Allergic reactions to products that come into contact with our anus can cause irritation, such as toiletries, soap, perfumes, chemicals, etc. Just say NO to anal-anaphylaxis
Unlike say, parasite infections, itching from diet or allergies will probably be less persistent. This itching will follow contact with the irritant. If your rear itches intermittently, you might see if there is a pattern to the itching such as:
- After eating a certain food
- After wiping
- After doing certain activity like showering
If a pattern does emerge, you should be able to narrow the focus to the specific cause.
Improper wiping technique
Just as fecal incontinence can leave poo on your brown growler that causes itching, improper wiping technique can cause it too. Ironically, of all causes of an itchy anus, this is one people tend to be the most embarrassed about because of a perceived inability to perform even the most basic task.
Actually, wiping technique can have as much to do with wiping-form as wiping-function. Common culprits of wrong-wiping are:
- Low quality toilet paper
- Too-dry wiping material
- Not wiping enough
- Excessive cleaning of the anal-event-horizon
A couple of good rules-of-thumb to maintain top-notch wiping mechanics are:
- Use decent toilette paper that is comfortable enough to apply the right amount of pressure needed for a squeaky-clean rear
- Don’t wipe/clean too hard, don’t wipe/clean too soft
- Use wipes or slightly dampen the toilette paper
- “Trust but verify,” which means trust that your anus is clean but give one more wipe for good measure
- After wiping, return to bathroom 10-15 minutes later to clean up any residual seepage
When wiping and cleaning, just make sure to “TUG” your rear-end: Thoroughly, Unsoiled, Gently.
Fecal incontinence and anal leakage
As just pointed out, leaking and seepage can be the criminals in your victimized itchy rear. There are two primary scenarios for anal itching to seepage:
- Incontinence, where waste will trickle out because the sphincter muscle, which controls the tightening strength of the anus, or pelvic floor is weak/damaged/etc.
- Post-power-movement draining, whereby a little bit of extra poo creeps out (or craps out) after wiping
Either way, this extra unintended poo will anger the soft tissue of your brown star. Something that may help with this type of cause of an itchy butt are:
- Practice Kegeling (Kegeling for men and Kegeling for women) to strengthen the pelvic floor
- Sphincter strengthening exercises
- 10-15 minutes after a power movement, revisit the bathroom for a follow up, post-movement wipe
Some broad-spectrum antibiotics can disrupt the ecology of your gut flora.
These changes in gut flora can trigger itching my removing/introducing different bacteria to the rectal area.
Hemorrhoids (i.e., piles, fissures)
Hemorrhoids don’t always cause anal itching. But they can provide you with a catastrophically itchy rear if they are prolapsing – that is, if they protrude from the anus. In addition to being a physical obstruction that can cause itchiness by rubbing against your anus, they can cause anal fluid to secrete from inside your back-door and irritate the anus.
The bad news about this type of itching is that the itching can be severe, and it will worsen over time. The good news is that it should be a fairly clear diagnosis if your healthcare provider finds prolapsing hemorrhoids during an examination. Moreover, surgical correction of the hemorrhoids should correct the itching.
Final notes on causes of an itchy anus
If you are suffering from an annoying case of butt-itch, hopefully this article has shed some light in a dark-place. At the very least, we hope you found it edutaining.
Uncovering the root cause of your itch is something that you can do through self-analysis or with your healthcare provider. Narrowing down the frequency, potential pattern, and severity of the itch will certainly help you/healthcare provider find the cause.
Let’s have a great day. Here’s to being itch-free!
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