Proctitis and anusitis (also known as pruritus ani) are two unpleasant conditions affecting the anal region. In proctitis there is inflammation of the mucosal lining of the rectum, while in anasitis the inflammation is in the anal canal itself. Inflammation in these parts can then cause similar unpleasant symptoms, and similar treatments. These symptoms include:
- Pelvic pressure
- Fecal urgency (though diarrhea is uncommon)
- Odorous discharge
- Rectal bleeding (generally bright red in color)
- Changes in bowl habits
- Abdominal cramping (due to additional swelling in the pelvis)
- In some severe cases constipation
In some cases abnormal passages between the small intestine or colon to the skin around the anus can form and this can then result in the seepage of irritant fluid.
There are many causes for inflammation in these areas and they are often the result of infection – a result of gonorrhea, salmonella, shigella, yeast infection etc. In other cases they may be caused by inflammatory bowel disease, radiation, ischemic diversion and idiopathic causes. Depending on the causes, anusitis and proctitis can be either chronic or acute.
In other cases anusitis may be the result of more common every day occurrences. For instance simple perspiration can cause many of the symptoms of anusitis, as can chronic diarrhea especially if this leads to frequent wiping and therefore inflammation. Some foods are believed to contain substances that when excreted can irritate the anus and cause inflammation.
In many cases no treatment will be necessary and the problem will subside on its own. However it is important to make sure you treat the area correctly to improve recovery. This means keeping it dry and protected. Wear comfortable underwear, and use protectants such as cocoa butter and aluminum hydroxide gel in order to provide a physical barrier for the skin to prevent it from contacting the liquid or stool. Local anesthetics or pain killers can be used to treat the pain.
In other more serious cases other methods will be used in order to treat the problem. These may include the use of corticosteroids to reduce inflammation and itching – though these may cause damage to the skin if used over long periods of times. Likewise astringents can cause the coagulation of proteins in the skin in order to dry it out. An example of an astringent is witch hazel. Vasoconstrictors meanwhile work to reduce the size of blood vessels and thereby prevent swelling.
Where the anusitis is caused by infection then often antibiotics will be used to treat the problem. However in some cases this will not be recommended as they can upset the natural balance of intestinal bacteria and thus lead to thrush or yeast infection. Antiseptics may be used to prevent the growth of bacteria.