Itchy Anus Before Bowel Movements, Unable To Control Bowel Movements. What Could Be Causing This?

Posted on Wed, 13 Jun 2012

Question: I have a very itchy anus immediately before bowel movements, occasionally during or after instead. What could be causing this? I am 65, female, 5 ft 3", and 12st 12 lb. Also, I am unable to control bowel movements and have to go with 5 minutes of warning signal. If not I have an accident. I was checked last year with barium enema and sigmoidoscopy and nothing was found.

Answered by Dr. Vaibhav Banait (17 hours later)

Hi,

Thanks for the query.

Itching around the anal regions can be seen in few conditions such as

1. Worm infestation (trichuris)
2. Anal fissure
3. Anal incontinence
4. Perianal fungal infection
5. Other non-specific conditions related to stress and psychological factors.

It is good to know that barium enema and endoscopy examinations were normal. A few more tests may help to reach a diagnosis:

1. Perinal examination/ proctoscopy by an expert
2. Perianal swab for pin worm examination
3. Stool examination x 3 days

Consult a competent physician / gastroenterologist to guide you through the test.

Meanwhile, seitz bath with XXXXXXX warm water twice or thrice a day for a week; practicing kiegel's exercise and worm eradication medications will help in treating the symptoms

Hope I have answered your query and you find them useful. If there are any more queries, I will be available to address them.

Regards
DR XXXXXXX XXXXXXX

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Vaibhav Banait (8 hours later)

Thank you for your response.
However you did not mention the foecal incontinence which is more of a problem than the itching. The itching basically is the signal that I am about to have a bowel movement in 5 minutes time or less. Sometimes I am not able to make it to the toilet which is very embarrassing and messy.

This incontinence began within a day or two of recovering from a particularly bad 3 day attack of diarrhoea, nausea and stomach cramps 12 years ago. Prior to that I had no problem controlling my bowel movements.

My doctor has checked my sphincter muscle and says that it works perfectly well so that is not the problem.

Answered by Dr. Vaibhav Banait (13 hours later)

Hello.

Thanks for the reply.

I did mention anal (fecal) incontinence as a cause for itching.

I think you need to reinforce pelvic floor by doing pelvic floor exercises. Any good physiotherapist should help you with that.

Anal manometry may provide objective data regarding your anal tone and ability to contract it.

Kindly consult a Gastroenterologist to guide you with necessary investigations.

Hope, this answers your query.

Wish you good health.

Regards.

Above answer was peer-reviewed by : Dr. Jyoti Patil

Follow up: Dr. Vaibhav Banait (3 days later)

Hello again,
Thank you for your response.

A couple of final questions:

When I go on holiday I take Immodium every day for up to 3 weeks to avoid accidents. I just wondered if there is any harm in taking it for so long?

And secondly, I saw a man on Embarrassing Bodies on TV with similar symptoms to mine and he was diagnosed with a fistula. Do you think that may be a possibility?
Many thanks

Answered by Dr. Vaibhav Banait (25 hours later)

Hi,

Thanks again,

The literature accompanying use of Imodium suggests ‘not to use’ loperamide for more than two days. But in cases like yours, Imodium is required for a longer time and frequently.
The side effects are in my opinion reported in less than 1 percent patient, commonest being constipation and dizziness.

You can have a look at literature here. WWW.WWWW.WW
About your second question, be assured. Nothing of that kind will happen with you.

Hope this answers your query.

Wish you good health.

Regards

Dr Vaibhav Banait

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Above answer was peer-reviewed by : Dr. Prasad