Itching in the bottom!!

Itching in the bottom!

In my clinical practice, I routinely see patients with itching around the anal area. Sometimes, it is worse at nights. They usually also complain of wetness, seepage in the anal area, having to clean the bottom several times a day at work. It gets very embarrassing to take frequent bathroom breaks at work.

There were a couple of patients who lost several nights of sleep, thinking it could be related to cancer(in rare cases, yes!). Many got concerned thinking it could be something serious. 

Itching in the anal area could be caused by skin diseases like psoriasis, dermatitis in the area, rarely cancer arising in the anus, rectum or colon, anal fistula/abscess, even certain foods like chocolate, tomatoes, citrus fruits like oranges and grapefruit, coffee, tea, beer and cola, after having diarrhea or soft bowel movements, pinworm infestation (night time itching) etc.

Now, I would not suggest you stopping above foods just because I mentioned it here. Those are all the possibilities!!

The most common reason I see in my practice is hemorrhoids. So, I will discuss how it's caused and what could be done. 

Hemorrhoids act as cushions in the anal area, like a stop cork on a wine bottle preventing the flow of liquid from the inside, making an airtight seal and letting out gas only when you decide to. When you develop external/internal hemorrhoids this cushion effect of the anus is lost and creates physical gaps in the cushion leading to leakage of liquid from inside to the outside(perianal area). Any wetness in the perianal area causes itching and an urge to clean the area.

This could be easily fixed with hemorrhoid banding once hemorrhoids are confirmed. Hemorrhoid banding is a simple office-based procedure whereby rubber bands are deployed on the internal hemorrhoids, a painless way of treating them. This is one in 3 sessions, 2 weeks apart to allow the area to heal. One hemorrhoid column is treated per session to minimize the risk of complications. There could be some pressure in the rectum after hemorrhoid banding akin to stool sitting there which could last 1-2 days. Treating the internal hemorrhoids causes scarring in that area and thereby adjusts the anal canal/external hemorrhoids as well. Of all the procedures I do as a Gastroenterologist, I would say almost 100% of the patients were happy with hemorrhoid banding and the results thereafter. Why would not you like it if you do not have to scratch or clean anymore? 

It is very gratifying for me to cure a lot of discomfort with a simple procedure.


Krishna Rayapudi MD Krishna Rayapudi MD, Gastroenterologist. Trained in world-class facilities with world-class mentors. Managed thousands of patients in all practice setups possible, with experience in seven different US states. You learn more about his practice at

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