Are symptoms like anal sensitivity and digestion problems related to pruritus ani?

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Hi,

Welcome to icliniq.com.

I have reviewed your case history in detail.

So, you have had a recent H.pylori infection but have an almost normal endoscopy except for minor gastritis. It is reassuring that there is nothing major inside. You must have taken appropriate antibiotics for that, and usually, antibiotics are very effective, so nothing alarming at that end. The second issue is perianal itching or discomfort (pruritus ani), which is definitely disturbing and it is a separate issue (not related to H.pylori or treatment of H.pylori). You have already tried first-line medicine for this, which includes Clotrimazole and sitz baths. I would suggest the following treatment for you, and it would resolve your issues:

1. There is a local application tube known as Itch Guard (benzyl alcohol and Terbinafine hydrochloride), either always with the same brand name at your end, or I will write a generic name as well (Terbinafine). Take pea sized cream tube and apply it at the anal verge and a little inside two to three times per day after passing stools or cleaning that area properly with water and dry it with tissue paper. This should be applied for at least two to three hours before washing.

2. Continue warm water sit baths, but add antiseptic (commonly available at homes like Dettol antiseptic or any suitable one at your end) around 5 to 10 mL in a small water tub and sit on it for around 10 to 15 minutes twice daily.

3. For recurrent irritation, there is a Lidocaine (local anesthesia) tube available. You can apply it locally at the anal verge multiple times, at the time of discomfort or pain, or even a few minutes before passing stools to avoid discomfort.

4. There are certain foods that are partially digested by our gut. So, I suggest you avoid such foods for a couple of days until these issues are sorted out.

Wishing you excellent health.

Kind regards.