Q. I suffered with anal itch for a very long time. Prescribed creams didn’t help. Finally one doctor told me to avoid caffeine. I switched to decaf and it changed my life. He also recommended no spicy food and no chocolate (sorry, no can do), but the switch to decaf was the life changer.
A. Although we found no research on caffeine causing anal itch, we discovered a recommendation that patients be warned about caffeine (Postgraduate Medicine, Nov. 1995).
Other readers have reported that medications sometimes cause itchy bottom. Here is Ann B:
“Honestly, would it be a surprise that a medication could cause this horrific symptom? Of course not!
“In my case, the culprit was lansoprazole (Prevacid). Since Prevacid went OTC, anal itching or pruritus ani isn’t listed now in the PDR as a side effect, but from my experience, it is a definite side effect.
“I determined FOR SURE my cause was Prevacid by eliminating my meds one at a time for three days. Within two days of eliminating Prevacid the itching stopped. That was at least 10 years ago. I have never taken it again and I have never had anal itching again.”
Esomeprazole (Nexium), now a popular OTC (over-the-counter drug), is another medicine that can cause pruritis ani.
The recommendation is frequently made to cleanse the area carefully (and gently), but sometimes the chemicals in wipes designed for this purpose can be irritating and compound the problem. Jillery commented:
“I had what I called ‘cranky crotch.’ It was always easy to get a yeast or vaginal infection or I would develop what I would call ‘hot spots’ (those of you with dogs can laugh now). Outside my labia closer to the bend in my leg I would get itchy spots that I could swear I could feel crack. The skin was always compromised.
“When I read about baby wipes, I stopped using them (at times I could get itchy around my anus too). It’s been over a week and a half and no itchy problems anywhere. I’d gone to the gyno with this problem on and off for a number of years too. She’d take scrapings and after the results would shrug her shoulders. She was thrilled when I told her about the baby wipe issues. She WILL share with other patients too.”
Another reader recommended plain water:
“I had this all my life and discovered the solution with a Hand Bidet Sprayer = it allows you to get clean (cleaner!) than using toilet paper and without irritating the sensitive skin with all the rubbing plus helps keep the natural oils in your skin that you need to keep it from drying out and itching!”
David
Eliminating caffeine (from coffee or other sources) and other possible culprits seems like a good first step to get control of an itchy bottom.
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