Itchy Bottom? Why You Shouldn’t Blame Hemorrhoids

You may be causing the problem yourself

Itchy Bottom? Why You Shouldn't Blame Hemorrhoids

A lot of patients come to my office and announce that they have hemorrhoids.

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“What are your symptoms?” I ask.

They tell me their bottoms itch and they feel extra skin down there as they wipe. Must be hemorrhoids, right?

So they treat themselves with medicated wipes or cream. And yet the “hemorrhoids” don’t go away — they itch even more.

For most, I have a simple answer: You don’t have hemorrhoids, and what you’re doing to treat this non-issue is likely making the problem worse.

The trouble with self-diagnosing hemorrhoids

People self-diagnosing hemorrhoids is something I see almost daily in my practice. Hemorrhoids are the favorite scapegoat for many of my patients.

Certainly bring up any concerns you have with your doctor. And if you notice rectal bleeding along with the other symptoms I mentioned above, be sure to talk to your doctor about further treatment.

But we all have hemorrhoids. They only become an issue when they become swollen and irritated. You can’t diagnose that yourself; your doctor needs to examine you.

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RELATED: Hemorrhoids fact sheet

So what’s causing my itchy bottom?

What my patients often suffer from is the result of, ironically, being too clean.

What happens is a circular process. Filled with good intentions, you try to keep yourself scrupulously clean by using flushable wipes. But the unexpected result is that this leads to itching and the feeling that you have hemorrhoids.

Why overcleaning can lead to feeling “dirtier”

The problem is the chemicals in the wipes dry out your bottom with the result that your skin works to produce more oil. And it still feels “dirty” down there.

Then, the more you try to clean, the more trauma to the skin, causing micro-tears and cracks. The result is pruritis. Or, itchy bottom.

And those skin flaps? They’re normal for many of us as we age. Women who’ve had children often have hemorrhoids that have stretched the skin in the perianal area and those folds are what they feel.

This is the point where you self-diagnose hemorrhoids and start using medicated wipes and creams, adding more chemicals that continue to overdry you. Even the “alcohol-free” wipes contain chemicals. And so the cycle continues.

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The shockingly simple fix

I often surprise patients with my solution, which is … splash some water on it.

Rather than cleaning yourself with flushable wipes, use a bidet — a water spray which can you install on your toilet, or even a portable, spray bottle version — or a plastic sitz bath which is available at any drug store.

Whatever method you choose, rinse the area with water to clean it, then pad dry. Don’t use soap and water, unless it’s very mild like Ivory® or Dove®; the chemicals in soap dry the area too. Just plain water works fine.

My patients tell me that after they started doing this, their itching and discomfort went away.

So the moral of the story: don’t overclean yourself with chemicals. Let water do the work.

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Meagan Costedio, MD

Meagan Costedio, MD, is a surgeon in the Department of Colorectal Surgery whose interests include minimally invasive techniques.