From the Guidelines
For rectal itching caused by pinworms, the most effective prescription treatment is a single dose of Albendazole 400 mg or mebendazole 100 mg. This recommendation is based on the study by 1, which provides guidance on the investigation and initial management of eosinophilia in returning travelers and migrants from the tropics. The study highlights the clinical presentation of pinworm infection, which includes intense pruritis ani, and recommends the use of Albendazole or mebendazole as a single dose for treatment. Some key points to consider when treating rectal itching include:
- The prepatent period of pinworm infection is 2-4 weeks, during which time the patient may not show symptoms 1
- The mode of transmission is faeco-oral, and good hygiene practices are essential to prevent reinfection 1
- Diagnosis can be made using the "sellotape test", which involves placing the sticky side of sellotape on the perianal skin and examining it under the microscope for ova 1
- It is essential to rule out other causes of rectal itching, such as inflammatory bowel disease or colorectal cancer, if symptoms persist despite treatment. In terms of management, it is crucial to:
- Maintain good hygiene practices to prevent reinfection
- Avoid irritating soaps and wear loose cotton underwear to reduce irritation
- Keep the area dry to reduce itching and discomfort.
From the Research
Rectal Itching Prescription
- Rectal itching can be a symptom of various conditions, including hemorrhoids and cutaneous candidiasis.
- For hemorrhoids, medical therapy can be initiated with stool softeners plus local therapy to relieve swelling and symptoms 2.
- Topical preparations such as clotrimazole, nystatin, and miconazole can be effective in treating cutaneous candidiasis, which can cause rectal itching 3.
- In some cases, oral fluconazole may be prescribed for systemic treatment of cutaneous candidiasis 3.
- For grade 1 and 2 hemorrhoids, rubber band ligation is the treatment of choice, while excisional hemorrhoidectomy or stapled hemorrhoidopexy may be recommended for grade 3 and 4 hemorrhoids 2.
- Postoperative pain from excisional hemorrhoidectomy can be treated with nonsteroidal anti-inflammatory drugs, narcotics, fiber supplements, and topical antispasmodics 2.