Itchy Bottom

Itchy bottom (pruritus ani) means unpleasant itchy sensations around anus. Although it is seemingly trivial problem, it may also accompany some diseases that are usually (but not always) related to the digestive system.


Insufficient hygiene

Inadequate personal hygiene after toilet is a typical cause of itchy anus. After defecation it is suitable not only wipe with toilet paper, but also to take a shower with lukewarm water. Paradoxically, excessive hygiene is also incorrect as it may cause skin dryness and result in the same symptoms.

Pinworm infection (enterobiasis)

This is a parasitic infection that typically causes itchy bottom. It occurs mainly in children and spreads by close contact with dirty hands. The female pinworm resides in bowels, in the night it climbs up to anal area and lays its eggs. This is accompanied by itching, the child scratches, the eggs can get on fingers and later into digestive tract of another child. Special antiparasitic drugs are used to kill pinworms.


Hemorrhoids are dilated venous plexuses in the rectal area. This condition also manifests by anal itching. In addition, there is a typical symptom of finding fresh blood in stool and on the toilet paper. Hemorrhoids are treated either conservatively (by sitz baths, ointments and medications), by using a special ligation device or by surgical intervention. More information is written in article dedicated to hemorrhoids.

Anal fissure

This acute or chronic injury of rectal wall is caused by its excessive dilation and often accompanies constipation. Itchy bottom, bleeding and pain during defecation are typical symptoms.


Diabetes is a widespread disease affecting substantial part of adult population. There is reported more frequent itchy bottom in diabetics because of their impaired immunity that is followed by rectal yeast infections. Patients with AIDS have often similar difficulties.

Diagnostic approach

We should start with medical history and physical examination including inspection of anal area and digital rectal exam. Stool examination is important mainly in excluding bowel infections. Blood tests help us to check glucose blood level. In case of need rectoscopy or even colonoscopy may be performed.

Jiri Stefanek, MD  Author of texts: Jiri Stefanek, MD
 Sources: basic text sources