What Is Anusitis? – Causes, Symptoms, Treatment

Last updated: February 8, 2026Reviewed date: February 8, 2026Reading time: 10 min read
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What Is Anusitis?/Anusitis may happen secondary to ulcerative colitis (UC), Chronic Radiation Proctitis, Proctopathy (CRP), or Diversion Proctitis (DP). Infectious causes include Clostridium difficile, enteric infections (Campylobacter, Shigella, Escherichia coli, Salmonella, and amebiasis), and STI’s (Gonorrhea, Chlamydia, Syphilis, HSV, Lymphogranuloma venereum, chancroid, CMV, HPV).[rx] Other causes...

For severe symptoms, danger signs, pregnancy, child illness, or sudden worsening, seek urgent medical care.

বাংলা রোগী নোট এখনো যোগ করা হয়নি। পোস্ট এডিটরে “RX Bangla Patient Mode” বক্স থেকে সহজ বাংলা সারাংশ যোগ করুন।

এই তথ্য শিক্ষা ও সচেতনতার জন্য। এটি ডাক্তারি পরীক্ষা, রোগ নির্ণয় বা প্রেসক্রিপশনের বিকল্প নয়।

Article Summary

What Is Anusitis?/Anusitis may happen secondary to ulcerative colitis (UC), Chronic Radiation Proctitis, Proctopathy (CRP), or Diversion Proctitis (DP). Infectious causes include Clostridium difficile, enteric infections (Campylobacter, Shigella, Escherichia coli, Salmonella, and amebiasis), and STI’s (Gonorrhea, Chlamydia, Syphilis, HSV, Lymphogranuloma venereum, chancroid, CMV, HPV).[rx] Other causes include ischemia, vasculitis, toxins as hydrogen peroxide enemas or medication side effects. The most common cause of anusitis is diet,...

Key Takeaways

  • This article explains Causes of Anusitis in simple medical language.
  • This article explains Diagnosis Of Anusitis in simple medical language.
  • This article explains Treatment of Anusitis in simple medical language.
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Seek urgent medical care if you notice

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  • Severe symptoms, breathing difficulty, fainting, confusion, or rapidly worsening illness.
  • New weakness, severe pain, high fever, or symptoms after a serious injury.
  • Any symptom that feels urgent, unusual, or unsafe for the patient.
1

Emergency now

Use emergency care for severe, sudden, rapidly worsening, or life-threatening symptoms.

2

See a doctor

Book a professional medical evaluation if symptoms persist, worsen, recur often, affect daily activities, or occur in a high-risk patient.

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Learn safely

Use this article to understand possible causes, tests, treatment options, prevention, and questions to ask your clinician.

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Definition

What Is Anusitis?/Anusitis may happen secondary to ulcerative colitis (UC), Chronic Radiation Proctitis, Proctopathy (CRP), or Diversion Proctitis (DP). Infectious causes include Clostridium difficile, enteric infections (Campylobacter, Shigella, Escherichia coli, Salmonella, and amebiasis), and STI’s (Gonorrhea, Chlamydia, Syphilis, HSV, Lymphogranuloma venereum, chancroid, CMV, HPV). Other causes include ischemia, vasculitis, toxins as hydrogen peroxide enemas or medication side effects. The most common cause of anusitis is diet, as with excess citrus, coffee, cola, beer, garlic, spices, and sauces. Diarrhea noted after intake of laxatives as in preparation for colonoscopy is noted to cause anusitis and stress may be another etiologic factor.

Anusitis is a disorder that involves infection, or irritation, often causing pain, swelling, heat, or redness. সহজ বাংলা: শরীরের প্রদাহ; ব্যথা, ফোলা বা লালভাব হতে পারে।" data-rx-term="inflammation" data-rx-definition="Inflammation is the body’s response to injury, infection, or irritation, often causing pain, swelling, heat, or redness. সহজ বাংলা: শরীরের প্রদাহ; ব্যথা, ফোলা বা লালভাব হতে পারে।">inflammation of the anal canal. People often mistake anusitis for hemorrhoids. Inflammatory bowel disease, infections, and chronic diarrhea can cause anusitis. However, the most common cause is a diet that contains a lot of acidic or spicy foods, such as coffee, citrus, and spices.

Causes of Anusitis

There are lots of possible causes. See the separate leaflets linked to each condition below for more detail. These are just some of the possible causes:

Skin conditions

There are a number of skin conditions which may affect the skin around the anus and cause itch. For example:

  • Eczema.
  • Psoriasis.
  • Lichen sclerosis.
  • Lichen planus.
  • Seborrhoeic dermatitis.

An allergic or irritant dermatitis. Dermatitis means infection, or irritation, often causing pain, swelling, heat, or redness. সহজ বাংলা: শরীরের প্রদাহ; ব্যথা, ফোলা বা লালভাব হতে পারে।" data-rx-term="inflammation" data-rx-definition="Inflammation is the body’s response to injury, infection, or irritation, often causing pain, swelling, heat, or redness. সহজ বাংলা: শরীরের প্রদাহ; ব্যথা, ফোলা বা লালভাব হতে পারে।">inflammation of the skin. This may be caused by:

  • Excess sweat and moisture around the anus. Young children who may not wipe themselves properly, adults with sweaty jobs and adults with a lot of hair round their anus may be especially prone to this.
  • Excess cleaning of the anal area.
  • Some soaps, perfumes, creams, or ointments, or the dye in some toilet tissue, may irritate (sensitise) the skin around the anus in some people. You may be ‘allergic’ to one or more of the ingredients in these products.

Skin conditions cause about half of all cases of secondary pruritus ani.

Infections

  • Thrush and fungal infections are caused by germs that thrive in moist, warm, airless areas, such as around the anus. Thrush is more common in people with insulin is low or not working well. সহজ বাংলা: রক্তে চিনি বেশি থাকার রোগ।" data-rx-term="diabetes" data-rx-definition="Diabetes is a condition where blood sugar stays too high because insulin is low or not working well. সহজ বাংলা: রক্তে চিনি বেশি থাকার রোগ।">diabetes.
  • Threadworms are a very common cause in children. Up to 4 in 10 children in the UK have threadworms at some stage. Threadworms live in the gut and lay eggs around the anus which cause itch. Children may pass them on to adults in the same home. Consider this cause particularly if there is more than one person in the home with an itchy bottom. Also, with threadworms, the itch is mainly at night.
  • Other infections such as scabies, infections with germs (bacteria), herpes infection, anal warts and some other sexually transmitted infections can cause itch around the anus. You are likely to have other symptoms too such as a rash, lump or discharge.

Conditions affecting the anus

These include:

  • Anal fissure. This is a small crack in the anal skin. It is usually painful as well as itchy.
  • Piles (hemorrhoids).
  • A tumor of the anus or lower gut (bowel and rectum) is a rare cause of an itch around the anus.

Some diseases
Generalized itch, which may seem more intense around the anus at times, maybe caused by some diseases. For example:

  • Lymphoma
  • Certain liver diseases
  • Iron-deficiency anemia
  • Thyroid gland problems
  • insulin is low or not working well. সহজ বাংলা: রক্তে চিনি বেশি থাকার রোগ।" data-rx-term="diabetes" data-rx-definition="Diabetes is a condition where blood sugar stays too high because insulin is low or not working well. সহজ বাংলা: রক্তে চিনি বেশি থাকার রোগ।">Diabetes

With these conditions you are likely to be unwell with other symptoms.

Some foods

When certain foods are not fully digested, they may irritate the skin around the anus after you have gone to the toilet to pass stools. These include:

  • Citrus fruits.
  • Grapes.
  • Tomatoes.
  • Spices and chilli peppers.
  • Large amounts of beer.
  • Milk.
  • Caffeine – in coffee, tea or cola.

Some medicines

  • Some antibiotics can lead to diarrhoea. Passing lots of diarrhoea can irritate the anal skin and cause an itchy bottom.
  • If you are taking steroid medication or other medicines that can weaken your immune system, you are at increased risk of developing skin infections which may affect the skin around the anus.
  • Other medicines such as colchicine (for gout) and peppermint oil (for wind and bloating) may cause an itchy bottom as a side-effect.
  • Medicines that are put on to the skin near the anus to treat problems such as haemorrhoids may irritate the anal skin and cause a type of dermatitis.

Diagnosis Of Anusitis

  • Physical exam and history – An exam of the body to check general signs of health, including checking for signs of disease, such as lumps or anything else that seems unusual. A history of the patient’s health habits and past illnesses and treatments will also be taken.
  • Blood tests – These can detect blood loss or infections.
  • Stool test – You may be asked to collect a stool sample for testing. A stool test may help determine if your proctitis is caused by a bacterial infection.
  • Scope exam of the last portion of your colon – During this test (flexible sigmoidoscopy), your doctor uses a slender, flexible, lighted tube to examine the last part of your colon (sigmoid), as well as the rectum. During the procedure, your doctor can also take small samples of tissue (biopsy) for laboratory analysis.
  • Scope exam of your entire colon – This test (colonoscopy) allows your doctor to view your entire colon using a thin, flexible, lighted tube with an attached camera. Your doctor can also take a biopsy during this test.
  • Tests for sexually transmitted infections – These tests involve obtaining a sample of discharge from your anus or from the tube that drains urine from your bladder (urethra).
  • Digital anus exam (DRE) – An exam of the anus. The doctor or nurse inserts a lubricated, gloved finger into the lower part of the rectum to feel for lumps or anything else that seems unusual. In women, the vagina may also be examined.
  • Biopsy – The removal of cells or tissues so they can be viewed under a microscope to check for signs of the anus. Anus tissue that is removed during the biopsy may be checked to see if the patient is likely to have the gene mutation that causes HNPCC. This may help to plan treatment.

The following treatment is available for anusitis

  • bacterial infections. সহজ বাংলা: ব্যাকটেরিয়ার সংক্রমণের ওষুধ।" data-rx-term="antibiotic" data-rx-definition="An antibiotic is a medicine used to treat bacterial infections. সহজ বাংলা: ব্যাকটেরিয়ার সংক্রমণের ওষুধ।">Antibiotic – Gonococcal proctitis is treated with ceftriaxone 250 mg intramuscular one time plus azithromycin 1 gram oral one time.
  • An alternative regimen is cefixime 400 mg -moral one time plus doxycycline 100 mg oral twice daily for seven days.mChlamydia is treated with azithromycin.
  • Doxycycline – erythromycin, ofloxacin, or Levofloxacin may be used as an alternative regimen.
  • LGV – has treated with doxycycline 100 mg twice daily for 21 days.
  • Erythromycin or azithromycin – may be used as alternative regimens for the same period of 21 days.
  • Herpes proctitis – is treated with acyclovir 400 mg oral three times daily or valacyclovir 1 gram twice daily or famciclovir 250 mg three times daily for 7 to 10 days. The course of treatment may be extended if no complete healing is achieved by the end of the 10-day course of treatment.

For patients with mild to moderate UP, guidelines from American College of Gastroenterology (ACG) and American Gastroenterological Association (AGA) recommend

  • Rectal 5-Aminosalicylic Acid (5-ASA) – mesalamine rather than oral mesalamine. Suppositories are more effective than enemas. For induction of remission, the dose is 1 g/day and this is to be continued at the same dose to maintain remission.
  • Anus therapy – In cases of intolerance, refractoriness, hypersensitivity to mesalamine suppositories, inability to retain rectal therapy, rectal corticosteroid therapy is suggested for induction of remission rather than no therapy, despite the superiority of rectal 5-ASA over rectal steroids.
  • Corticosteroids – are not recommended and are not effective in the maintenance of remission secondary to side effects and long-term complications. Up to 46% of patients with UP may develop extensive colitis. This should be especially suspected in patients refractory to topical treatment and follow-up is recommended.
  • UP is treated with topical mesalazine – in the form of suppositories, enemas, foams, and gels in severe cases combined with oral mesalazine with topical steroids or systemic corticosteroids in more severe cases.
  • In steroid-resistant cases – the addition of cyclosporine or immunomodulators; thiopurines as azathioprine (AZA) and 6-mercaptopurine (6-MP) is considered. Other options include anti-TNF-α (infliximab, adalimumab, and golimumab), anti-integrin antibodies as vedolizumab, and certolizumab, or oral tacrolimus.

A particular treatment may be advised by a doctor or pharmacist. For example

  • You may be advised to use a steroid cream for a short while if there is eczema (dermatitis) around the anus.
  • An antifungal cream will clear fungal infections and thrush.
  • Antibiotics may help with certain other types of infection.
  • Anal conditions such as piles (haemorrhoids) or anal fissure may need treatment.
  • A medicine can clear threadworms if they are the cause.

This is a common situation. The following tips often help to stop the itch

Avoid any potential irritants

  • Stop using scented soaps, talcum powder, bubble bath, perfume, etc, near your anus.
  • Use plain, non-colored toilet tissue. Wipe your anus gently after passing stools (feces).
  • If any foods or medicines could be causing the itch, try avoiding for a while the foods and drinks listed above (such as fruits and tomatoes). If you take laxatives regularly, some of your stool may be leaking on to your anal skin.

Pay special attention to hygiene around your anus

  • Wash your anus after going to the toilet to pass stools. The aim is to clear any remnant of stool which may irritate the skin. Also, wash your anus at bedtime.
  • When washing around your anus, it is best to use water only. If you use soap, use bland non-scented soap.
  • When you are not at home, use a moistened cloth or a special moistened tissue to clean your anus. You can buy moistened tissues from pharmacies. Avoid scented or perfumed versions.
  • Have a bath or shower daily. If possible, wash your anus with water only. If you use soap around your anus, rinse well.
  • Change your underwear daily.

Avoid excessive moisture around your anus

  • After washing, dry around your anus properly by patting gently (rather than rubbing) with a soft towel. Even better, use a hairdryer, especially if your anal skin is hairy.
  • Do not put on underwear until your anus is fully dry.
  • Wear loose cotton underwear (not nylon). Avoid wearing tight-fitting trousers. If possible, do not sit for long periods and try not to get too hot. The aim is to allow air to get to your anus as much as possible and to avoid getting too sweaty.
  • If you sweat and moisture gathers around your anus, put a cotton tissue in your underwear to absorb the moisture.

Consider the ‘itch-scratch cycle

  • Scratching can make the itch worse – which makes you want to scratch more, etc.
  • As much as possible, try not to scratch. This is especially difficult at night when the itch tends to be worse while you are trying to get to sleep.
  • You may also scratch in your sleep without realising. To help this:
    • Keep your fingernails short to limit any damage done to the skin by scratching.
    • Consider wearing cotton gloves at night to prevent sharp scratching with fingernails.
    • An antihistamine medicine that makes you drowsy may be worth a try at bedtime. Your doctor will advise.

Your doctor may advise a short course of a cream or ointment

  • A bland soothing ointment may be recommended to use after going to the toilet and at bedtime. There are many to choose from. (However, remember an ingredient of an ointment may sometimes cause sensitivity and itch around the anus.) You should not use a cream such as this for longer than two weeks unless you are advised otherwise by your doctor.
  • A short course (up to 14 days but no more) of a mild steroid cream may ease symptoms if there is inflammation of your anal skin. Steroids reduce inflammation (but should not normally be used on infected skin).

References

Doctor visit helper

Prepare before seeing a doctor

A simple rural-patient checklist to help you explain symptoms clearly, ask better questions, and avoid unsafe self-treatment.

Safety note: This is not a prescription or diagnosis. For severe symptoms, pregnancy danger signs, children with serious illness, chest pain, breathing difficulty, stroke-like weakness, or major injury, seek urgent care.

Which doctor may help?

Start with a registered doctor or the nearest qualified health center.

What to tell the doctor

  • Write when the problem started and how it changed.
  • Bring old prescriptions, investigation reports, and current medicines.
  • Write allergies, pregnancy status, diabetes, kidney/liver disease, and major past illnesses.
  • Bring one family member if the patient is weak, elderly, confused, or a child.

Questions to ask

  • What is the most likely cause of my symptoms?
  • Which danger signs mean I should go to hospital quickly?
  • Which tests are necessary now, and which can wait?
  • How should I take medicines safely and what side effects should I watch for?
  • When should I come for follow-up?

Tests to discuss

  • Vital signs: temperature, pulse, blood pressure, oxygen saturation
  • Basic physical examination by a clinician
  • CBC, urine test, blood sugar, or imaging only when clinically needed

Avoid these mistakes

  • Do not use antibiotics, steroid tablets/injections, or strong painkillers without proper medical advice.
  • Do not hide pregnancy, kidney disease, ulcer, allergy, or blood thinner use.
  • Do not delay emergency care when danger signs are present.

Medicine safety and first-aid guide

This section is for patient education only. It does not replace a doctor, pharmacist, or emergency care.

Safe first steps

  • Avoid heavy lifting, sudden bending, and prolonged bed rest.
  • Use comfortable posture and gentle movement as tolerated.
  • Discuss physiotherapy, X-ray, or MRI only when clinically needed.

OTC medicine safety

  • For mild back pain, pain-relief medicine may be discussed with a doctor or pharmacist.
  • Avoid repeated painkiller use if you have kidney disease, stomach ulcer, uncontrolled blood pressure, or are taking blood thinners.

Avoid these mistakes

  • Do not start antibiotics without a proper medical decision.
  • Do not use steroid tablets or injections casually for quick relief.
  • Do not delay emergency care because of home remedies.

Get urgent help if

  • Back pain with leg weakness, numbness around private area, loss of urine/stool control, fever, cancer history, or major injury needs urgent care.
Medicine names, dose, and timing must be decided by a qualified clinician or pharmacist after checking age, pregnancy, allergy, other diseases, and current medicines.

For rural patients and family caregivers

Patient health record and symptom diary

Write your symptoms, medicines already taken, test results, and questions before visiting a doctor. This note stays on your device unless you print or copy it.

Doctor to discuss: Doctor / qualified healthcare provider
Tests to discuss with doctor
  • Basic vital signs: temperature, pulse, blood pressure, oxygen level if needed
  • Relevant blood, urine, imaging, or specialist tests only after clinical assessment
Questions to ask
  • What is the most likely cause of my symptoms?
  • Which warning signs mean I should go to emergency care?
  • Which tests are really needed now?
  • Which medicines are safe for my age, pregnancy status, allergy, kidney/liver/stomach condition, and current medicines?

Emergency warning signs such as chest pain, severe breathing difficulty, sudden weakness, confusion, severe dehydration, major injury, or loss of bladder/bowel control need urgent medical care. Do not wait for online information.

Safe pathway to proper treatment

Care roadmap for: What Is Anusitis? – Causes, Symptoms, Treatment

Use this simple roadmap to understand the next safe steps. It is educational and does not replace examination by a doctor.

Go to emergency care if you notice:
  • Severe or rapidly worsening symptoms
  • Breathing difficulty, chest pain, fainting, confusion, severe weakness, major injury, or severe dehydration
Doctor / service to discuss: Qualified healthcare provider; specialist depends on symptoms and examination.
  1. Step 1

    Check danger signs first

    If danger signs are present, seek emergency care and do not wait for online information.

  2. Step 2

    Record the symptom story

    Write when symptoms started, severity, medicines already taken, allergies, pregnancy status, and test results.

  3. Step 3

    Visit a qualified clinician

    A doctor, nurse, or qualified healthcare provider can examine you and decide which tests or treatment are needed.

  4. Step 4

    Do only useful tests

    Do tests after clinical assessment. Avoid unnecessary tests, random antibiotics, or repeated medicines without diagnosis.

  5. Step 5

    Follow up and return early if worse

    If symptoms worsen, new warning signs appear, or treatment is not helping, return for review quickly.

Rural patient practical tips
  • Take a written symptom diary and all previous prescriptions/test reports.
  • Do not hide medicines already taken, even herbal or over-the-counter medicines.
  • Ask which warning signs mean urgent referral to hospital.

This roadmap is for education. A real diagnosis and treatment plan requires history, examination, and clinical judgment.

RX Patient Help

Ask a health question safely

Write your symptom story. A health professional or site editor can review it before any answer is prepared. This box is not for emergency care.

Emergency first: Severe chest pain, breathing trouble, unconsciousness, stroke signs, severe injury, heavy bleeding, or rapidly worsening symptoms need urgent local medical care now.

Frequently Asked Questions

Is this article a replacement for a doctor?

No. It is educational content only. Patients should consult a qualified clinician for diagnosis and treatment.

When should I seek urgent care?

Seek urgent care for severe symptoms, rapidly worsening condition, breathing difficulty, severe pain, neurological changes, or any emergency warning sign.

References

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