I have an embarrassing problem - an itchy bottom. Can you tell me how to get rid of it Please help

asks Jarnold:
A. Don't worry - you're not alone. This itchiness - the medical term is pruritus ani - is common. It's estimated that everyone will have an itchy bottom at some time or another. Most people get it at bedtime, but some people suffer from constant itching in this area.

Q. What causes it
A. It happens for a number of reasons - it also depends on your age. Common causes include:

• Sensitivity. Research has shown that the following can cause an itchy bottom: citrus fruit, sugar, spicy foods, coloured toilet paper, washing powders or fabric conditioners.
• Piles (varicose veins of the anus). These tend to be more common as you age, or during pregnancy. Piles are due to a reduced blood flow in the area or too much straining (from giving birth or constipation). You can't always see piles as they can develop inside the anus.
• Threadworms. They usually affect young children or those who are in close contact with them. The female threadworm lays her eggs inside the anus during the night, which is why the itching tends to happen then. The worms resemble threads and can easily be seen by the naked eye. It is extremely easy to spread threadworms - they can get under the fingernails after scratching - so good hygiene is important.
• Cracks or splits in the skin around the anus (fissures and fistulas) can also cause itching.
• Thrush can sometimes take hold on the perineum and around the anus. Here, the skin will be red and inflamed as well as itchy.

Q. What can I do
A. See your GP first: threadworms or thrush need quick treatment. And don't be embarrassed - this is a common problem.

Q. Can I help myself, too
A. Yes. First, try not to scratch as this can damage the delicate skin in this area.

• Wash carefully after going to the loo, and use moist toilet wipes inside of loo paper.
• Test whether it is a sensitivity issue. Change your washing powder and fabric conditioner for a more gentle one. Use soap substitutes and avoid anything perfumed in the bath or shower. Use white toilet paper. Avoid citrus fruit, spicy foods and cut right down on sugar.
• Complementary therapies that may help include homeopathy and herbalism www. Always use properly trained practitioner.

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By Sheena Miller