Brief Answer: Hi and welcome to XXXXXXX Detailed Answer: Thanks for the query. Pinworms are just one of possible causes. However,most other causes are benign and it rarely indicates some serious disease. First,try to find is there any agent which could cause local irritation or allergy such as perfumed toilet paper,some clothes,sprays,soaps or bedclothes etc. Also,certain food can cause such itch: spicy foods, coffee cola, milk, alcoholic beverages chocolate. Some local anal disease are possible causes too: hemorrhoids(especially if there is discomfort during defecation or blood in stool), anal fisure, poylps, dermatologic diseases. And thirdly, it can infection,not just pinworms but scabies,fungal infection or viral infections. In every case you can try with dietary changes, corticosteroid creams and sitz baths first. If this is not helpful you should do proctologist exam and stool analysis to verify is there infection or some local anorectal disease. As I said,rarely this can be sign of malignant disease and usually pruritus ani is easily treatable. Wish you good health. Feel free to ask. Regards

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