A subgroup of patients who persistently present with symptoms despite applicable conservative or non-surgical management should be referred to a colorectal surgeon. However, it is widely accepted and recommended by most in the literature and is discussed later. Classification Hemorrhoidal conditions are classified according to their location. The exact choice of which modality to use depends on local expertise, cost, and the available equipment. Hypnosis has been used, but there is insufficient evidence available for its recommendation. In persistent cases, skin-patch testing should be carried out. Symptoms The patient may complain of drainage, bleeding, pain with defecation or sexual activity, swelling, or diarrhea.
Treatment of anal itching depends on the cause of the problem.
Anal Itch (Pruritus Ani)
Hyperpigmentation is the result of any chronic inflammation, so infection and chronic discharge should be sought. For example, biopsy, culture, or both of visible lesions of uncertain etiology should be considered. Less often, anal itch is a symptom of some illness or condition that either affects the anal area alone, or involves larger areas of the digestive tract or skin. Pathophysiology Although the etiology of this condition is uncertain, the main hypothesis is that the posterior midline area may have decreased blood flow due to the configuration of the vessels of the anus[ 28 ]. American Gastroenterological Association Woodmont Ave.