Stephen J. Schueler, M.D.

Overview Incidence Risk Factors Symptoms Evaluation Treatment specialist Home Care dietary fiber warning signs Prevention Outlook Complications Underlying Cause

Pruritus Ani Home Care

Home care for pruritus ani includes:

  • Apply medicated cream to the anus for itching:
  • Take a warm bath twice a day:
    • Gently rinse the anus while bathing
    • Do not clean the anus with soap.
    • Do not scrub the anus with a brush.
  • Wipe the anus gently after bowel movements.
  • Use toilet paper that does not contain perfume.
  • To help keep the anus dry:
    • Wear moisture-wicking underwear.
    • Wear loose-fitting clothes.
  • Avoid spicy foods that may irritate the anus.
  • Eat a high-fiber diet.
  • Oral antihistamines for itching:
  • Take prescribed medications as directed.

Pruritus Ani Dietary Fiber

The symptoms of pruritus ani may worsen with a diet that is low in fiber.

Fiber works by increasing the amount of stool in your large intestine. This can help prevent constipation and reduce anal discomfort.

The most well known fiber is bran. Common fiber supplements include Citrucel and Metamucil. Regular use of these high-fiber products is safe. They are also more effective when used regularly. Drink plenty of water when taking extra fiber.

Dietary fiber is a plant material that humans cannot digest. Fiber is made of large carbohydrate molecules that pass through the intestinal tract without being used by the body.

Fiber comes in two forms, based on whether it will dissolve in water. These are called soluble and insoluble fiber. Most experts believe that about 3/4 of fiber intake should be the insoluble form.

Water soluble fiber

ExamplesDietary Sources
Pectins, gums, & mucilagesfruits, vegetables, oats, bran, barley, legumes

Insoluble fiber
ExamplesDietary Sources
Cellulose, hemicellulosevegetables, wheat bran, & whole grains

Fiber tends to bind water, which leads to softer stools and a more rapid passage of material through the intestines. This rapid transit may reduce the exposure of the bowel to toxic substances and improve overall bowel health. Fiber can also bind fats and cholesterol. As an added benefit, high fiber foods usually contain important vitamins and minerals.

Use of a High Fiber Diet
Most people in developed countries do not eat enough fiber. A healthy diet should include more than 25 grams of fiber each day, or 10-13 grams per 1,000 calories. Some experts believe that every extra gram of fiber eaten each day can lower the risk of heart disease by as much as five percent.

This diet is often recommended for preventing or treating the following:

General Guidelines
In general, fruits, vegetables and whole grains are high in fiber. Check food labels of prepared products to see if there are at least 3 grams of dietary fiber per serving. Look for the term 'whole grain' as a major part of the food.

Raw foods tend to have more fiber than cooked, canned or pureed items. Even chopping and peeling skins removes some fiber. Dried fruits are especially high in fiber. Beans, black-eyed peas, brans and oatmeal are very high in fiber.

Unprocessed wheat bran can be added to many home meals and most baked foods. Bran is the outer layer of the wheat grain, and is present in 'whole grain' foods. Adding 2-3 teaspoons of bran per serving is a great way to increase the fiber content of casseroles, meat loaf, and baked goods. Whole grain flour has 6 times the fiber of standard, bleached flour. Oat bran can be used in place of about 1/3 of regular flour when baking.

Try adding nuts or bran to dairy foods such as yogurt or cottage cheese, which normally have very little fiber. Avoid white bread and flour pasta.

Change your diet slowly and drink plenty of fluids to allow the fiber to do its work. Rapid changes in the diet can cause bloating, gas and diarrhea. A varied, high-fiber diet is much better than taking fiber supplements.

Example High-Fiber Diet
Breads and Grains
Eat at least 3, and as many as 10 servings each day of various whole grain foods. Any grain food should say 'whole grain' and contain at least 3 grams of fiber per serving.

Examples include:
  • Barley
  • Brown rice
  • Oatmeal or oat bran
  • Rye bread
  • Wheat germ
  • Whole grain bagels
  • Whole grain breads
  • Whole grain muffins
  • Whole grain or bran cereals
  • Whole grain pita bread
  • Whole wheat crackers
  • Whole wheat pasta

Fruit:
Eat at least 3-4 servings each day. Fruits are very good, and dried fruits are especially high in fiber. Examples include:
  • Apple
  • Banana
  • Berries
  • Grapefruit
  • Nectarine
  • Orange
  • Peach
  • Pear

Vegetables:
Eat at least 3-5 servings per day, preferably raw and unpeeled. Examples include:
  • Asparagus
  • Broccoli
  • Cabbage
  • Carrots
  • Green beans
  • Green pepper
  • Onions
  • Peas
  • Potatoes with skin
  • Snow peas
  • Spinach
  • Squash
  • Sweet potatoes
  • Tomatoes
  • Zucchini

Meat substitutes:
Meat has no fiber and contains various amounts of cholesterol and saturated fats. There are many high-fiber foods that can partially or completely replace meat in the diet. Using several servings of meat substitutes each day will greatly increase total fiber intake.

Examples include:
  • Almonds
  • Brazil nuts
  • Cashews
  • Garbanzo beans
  • Kidney beans
  • Lentils
  • Lima beans
  • Peanut butter
  • Peanuts
  • Pinto beans
  • Sesame seeds
  • Soybeans, but not tofu
  • Split peas
  • Sunflower seeds
  • Veggie burgers
  • Walnuts

Snacks:
  • Bean dip
  • Cookies made with oatmeal, whole wheat flour, fruit and nuts
  • Popcorn
  • Tortilla corn chips (baked)
  • Trail mix
  • Whole wheat pretzels

Pruritus Ani Warning Signs

Notify your doctor if you have pruritus ani and any of the following:

Continue to Pruritus Ani Prevention

Last Updated: Jan 3, 2011 References
Authors: Stephen J. Schueler, MD; John H. Beckett, MD; D. Scott Gettings, MD
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PubMed Pruritus Ani References
  1. Daniel GL, Longo WE, Vernava AM 3rd. Pruritus ani. Causes and concerns. Dis Colon Rectum. 1994 Jul;37(7):670-4. [8026233]
  2. Eusebio EB, Graham J, Mody N. Treatment of intractable pruritus ani. Dis Colon Rectum. 1990 Sep;33(9):770-2. [2390913]
  3. Mazier WP. Hemorrhoids, fissures, and pruritus ani. Surg Clin North Am. 1994 Dec;74(6):1277-92. [7985064]
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