Anals itching is a common condition. The itch, situated in or around your anus, is often intense and may be accompanied by a strong urge to scratch. You may find anals itching to be embarrassing and uncomfortable.
Also called pruritus ani (proo-RIE-tus A-nie), anals itching has many possible causes, such as skin problems, hemorrhoids, and washing too much or not enough.
If anals itching is persistent, talk with your doctor. With proper treatment and self-care, most people get complete relief from anals itching.
Anals itching may be associated with redness, burning and soreness. The itching and irritation may be temporary or more persistent, depending on the cause.
When to see a doctor
Most anals itching doesn’t require medical care. See your doctor if:
Anals itching is severe or persistent
You have anal bleeding or stool leakage
The anal area seems to be infected
You can’t figure out what’s causing a persistent itch
Persistent anal itching may be related to a skin condition or other health problem that requires medical treatment.
Sometimes the cause of anal itching isn’t identifiable. Possible causes of anal itching include:
Irritants. Fecal incontinence and long-term (chronic) diarrhea can irritate the skin. Or your skin care routine may include products or behaviors that irritate the skin, such as using harsh soaps or moist wipes and washing too aggressively.
Infections. These include sexually transmitted infections, pinworms, and yeast infections.
Skin conditions. Sometimes anal itching is the result of a specific skin condition, such as psoriasis or contact dermatitis.
Other medical conditions. These include diabetes, thyroid disease, hemorrhoids, anal tumors.
Acanthosis nigricans is a skin condition characterized by areas of dark, velvety discoloration in body folds and creases. The affected skin can become thickened. Most often, acanthosis nigrican affects your armpits, groin and neck.
The skin changes of acanthosis nigrican (ak-an-THOE-sis NIE-grih-kuns) typically occur in people who are obese or have diabetes. Children who develop the condition are at higher risk of developing type 2 diabetes. Rarely, acanthosi nigrican can be a warning sign of a cancerous tumor in an internal organ, such as the stomach or liver.
No specific treatment is available for acanthosis nigricans. Treatment of underlying conditions may restore some of the normal color and texture to affected areas of skin.
Skin changes are the only signs of acanthosis nigrican. You’ll notice dark, thickened, velvety skin in body folds and creases — typically in your armpits, groin and back of the neck. The skin changes usually appear slowly. The affected skin may also have an odor or itch.
When to see a doctor
Consult your doctor if you notice changes in your skin — especially if the changes appear suddenly. You may have an underlying condition that needs treatment.
Acanthosis nigricans has been associated with:
Insulin resistance. Most people who have acanthosis nigrican have also become resistant to insulin. Insulin is a hormone secreted by the pancreas that allows your body to process sugar. Insulin resistance is what eventually causes type 2 diabetes.
Hormonal disorders. Acanthosis nigricans often occurs in people who have disorders such as ovarian cysts, underactive thyroids or problems with the adrenal glands.
Certain drugs and supplements. High-dose niacin, birth control pills, prednisone and other corticosteroids may cause acanthosis nigricans.
Cancer. Acanthosis nigricans also sometimes occurs with lymphoma or when a cancerous tumor begins growing in an internal organ, such as the stomach, colon or liver.
Back pains is one of the most common reasons people go to the doctor or miss work, and it is a leading cause of disability worldwide.
Fortunately, you can take measures to prevent or relieve most back pains episodes. If prevention fails, simple home treatment and proper body mechanics often will heal your back within a few weeks and keep it functional. Surgery is rarely needed to treat back pains.
Back pain can range from a muscle aching to a shooting, burning or stabbing sensation. In addition, the pain may radiate down your leg or worsen with bending, twisting, lifting, standing or walking.
When to see a doctor
Most back pains gradually improves with home treatment and self-care, usually within a few weeks. Contact your doctor if your back pain:
Persists past a few weeks
Is severe and doesn’t improve with rest
Spreads down one or both legs, especially if the pain extends below the knee
Causes weakness, numbness or tingling in one or both legs
Is accompanied by unexplained weight loss
In rare cases, back pains can signal a serious medical problem. Seek immediate care if your back pains:
Chest X-rays produce images of your heart, lungs, blood vessels, airways, and the bones of your chest and spine. Chest X-rays can also reveal fluid in or around your lungs or air surrounding a lung.
If you go to your doctor or the emergency room with chest pain, a chest injury or shortness of breath, you will typically get a chest X-ray. The image helps your doctor determine whether you have heart problems, a collapsed lung, pneumonia, broken ribs, emphysema, cancer or any of several other conditions.
Some people have a series of chest X-rays done over time to track whether a health problem is getting better or worse.
Chest X-rays are a common type of exam. A chest X-ray is often among the first procedures you’ll have if your doctor suspects heart or lung disease. A chest X-ray can also be used to check how you are responding to treatment.
A chest X-ray can reveal many things inside your body, including:
The condition of your lungs. Chest X-rays can detect cancer, infection or air collecting in the space around a lung, which can cause the lung to collapse. They can also show chronic lung conditions, such as emphysema or cystic fibrosis, as well as complications related to these conditions.
Heart-related lung problems. Chest X-rays can show changes or problems in your lungs that stem from heart problems. For instance, fluid in your lungs can be a result of congestive heart failure.
The size and outline of your heart. Changes in the size and shape of your heart may indicate heart failure, fluid around the heart or heart valve problems.
Blood vessels. Because the outlines of the large vessels near your heart — the aorta and pulmonary arteries and veins — are visible on X-rays, they may reveal aortic aneurysms, other blood vessel problems or congenital heart disease.
Calcium deposits. Chest X-rays can detect the presence of calcium in your heart or blood vessels. Calcified nodules in your lungs are most often from an old, resolved infection.
Fractures. Rib or spine fractures or other problems with bone may be seen on a chest X-ray.
Postoperative changes. Chest X-rays are useful for monitoring your recovery after you’ve had surgery in your chest, such as on your heart, lungs or esophagus. Your doctor can look at any lines or tubes that were placed during surgery to check for air leaks and areas of fluid or air buildup.
A pacemaker, defibrillator or catheter. Pacemakers and defibrillators have wires attached to your heart to help control your heart rate and rhythm. Catheters are small tubes used to deliver medications or for dialysis. A chest X-ray usually is taken after placement of such medical devices to make sure everything is positioned correctly.
Most people who require hemodialysis have a variety of health problems.
Hemodialysis prolongs life for many people, but life expectancy for people who need it is still less than that of the general population.
While hemodialysis treatment can be efficient at replacing some of the kidney’s lost functions, you may experience some of the related conditions listed below, although not everyone experiences all of these issues. Your dialysis team can help you deal with them.
Low blood pressure (hypotension) of health problems. A drop in blood pressure is a common side effect of hemodialysis, particularly if you have diabetes. Low blood pressure may be accompanied by shortness of breath, abdominal cramps, muscle cramps, nausea or vomiting.
Muscle cramps. Although the cause is not clear, muscle cramps during hemodialysis are common. Sometimes the cramps can be eased by adjusting the hemodialysis prescription. Adjusting fluid and sodium intake between hemodialysis treatments also may help prevent symptoms during treatments.
Itching. Many people who undergo hemodialysis have itchy skin, which is often worse during or just after the procedure.
Sleep problems. People receiving hemodialysis often have trouble sleeping, sometimes because of breaks in breathing during sleep (sleep apnea) or because of aching, uncomfortable or restless legs.
Anemia.of health problems. Not having enough red blood cells in your blood (anemia) is a common complication of kidney failure and hemodialysis. Failing kidneys reduce production of a hormone called erythropoietin (uh-rith-roe-POI-uh-tin), which stimulates formation of red blood cells. Diet restrictions, poor absorption of iron, frequent blood tests, or removal of iron and vitamins by hemodialysis also can contribute to anemia.
Bone diseases. If your damaged kidneys are no longer able to process vitamin D, which helps you absorb calcium, your bones may weaken. In addition, overproduction of parathyroid hormone — a common complication of kidney failure — can release calcium from your bones.
High blood pressure (hypertension). If you consume too much salt or drink too much fluid, your high blood pressure is likely to get worse and lead to heart problems or strokes.
Fluid overload. Since fluid is removed from your body during hemodialysis, drinking more fluids than recommended between hemodialysis treatments may cause life-threatening complications, such as heart failure or fluid accumulation in your lungs (pulmonary edema).
Inflammation of the membrane surrounding the heart (pericarditis). Insufficient hemodialysis can lead to inflammation of the membrane surrounding your heart, which can interfere with your heart’s ability to pump blood to the rest of your body.
High potassium levels (hyperkalemia). Potassium is a mineral that is normally removed from your body by your kidneys. If you consume more potassium than recommended, your potassium level may become too high. In severe cases, too much potassium can cause your heart to stop.
Access site complications. Potentially dangerous complications ― such as infection, narrowing or ballooning of the blood vessel wall (aneurysm), or blockage ― can impact the quality of your hemodialysis. Follow your dialysis team’s instructions on how to check for changes in your access site that may indicate a problem.
Amyloidosis. Dialysis-related amyloidosis (am-uh-loi-DO-sis) develops when proteins in blood are deposited on joints and tendons, causing pain, stiffness and fluid in the joints. The condition is more common in people who have undergone hemodialysis for more than five years.
Depression. Changes in mood are common in people with kidney failure. If you experience depression or anxiety after starting hemodialysis, talk with your health care team about effective treatment options.
How you prepare
Preparation for hemodialysis starts several weeks to months before your first procedure. To allow for easy access to your bloodstream, a surgeon will create a vascular access. The access provides a mechanism for a small amount of blood to be safely removed from your circulation and then returned to you in order for the hemodialysis process to work. The surgical access needs time to heal before you begin hemodialysis treatments.
There are three types of accesses:
Arteriovenous (AV) fistula. A surgically created AV fistula is a connection between an artery and a vein, usually in the arm you use less often. This is the preferred type of access because of effectiveness and safety.
AV graft. If your blood vessels are too small to form an AV fistula, the surgeon may instead create a path between an artery and a vein using a flexible, synthetic tube called a graft.
Central venous catheter. If you need emergency hemodialysis, a plastic tube (catheter) may be inserted into a large vein in your neck or near your groin. The catheter is temporary.
It’s extremely important to take care of your access site to reduce the possibility of infection and other complications. Follow your health care team’s instructions about caring for your access site.
What you can expect
You can receive hemodialysis in a dialysis center, at home or in a hospital. The frequency of treatment varies, depending on your situation:
In-center hemodialysis. Many people get hemodialysis three times a week in sessions of three to five hours each.
Daily hemodialysis. This involves more-frequent, but shorter sessions — usually performed at home six or seven days a week for about two to three hours each time.
Simpler hemodialysis machines have made home hemodialysis less cumbersome, so with special training and someone to help you, you may be able to do hemodialysis at home. You may even be able to do the procedure at night while you sleep.
There are dialysis centers located throughout the United States and in some other countries, so you can travel to many areas and still receive your hemodialysis on schedule. Your dialysis team can help you make appointments at other locations, or you can contact the dialysis center at your destination directly. Plan ahead to make sure space is available and proper arrangements can be made.
During treatments, you sit or recline in a chair while your blood of health problems. flows through the dialyzer ― a filter that acts as an artificial kidney to clean your blood. You can use the time to watch TV or a movie, read, nap, or perhaps talk to your “neighbors” at the center. If you receive hemodialysis at night, you can sleep during the procedure.
Preparation. Your weight, blood pressure, pulse and temperature are checked. The skin covering your access site — the point where blood leaves and then re-enters your body during treatment — is cleansed.
Starting. During hemodialysis, two needles are inserted into your arm through the access site and taped in place to remain secure. Each needle is attached to a flexible plastic tube that connects to a dialyzer. Through one tube, the dialyzer filters your blood a few ounces at a time, allowing wastes and extra fluids to pass from your blood into a cleansing fluid called dialysate. The filtered blood returns to your body through the second tube.
Symptoms. You may experience nausea and abdominal cramps as excess fluid is pulled from your body — especially if you have hemodialysis only three times a week rather than more often. If you’re uncomfortable during the procedure, ask your care team about minimizing side effects by such measures as adjusting the speed of your hemodialysis, your medication or your hemodialysis fluids.
Monitoring. Because blood pressure and heart rate can fluctuate as excess fluid is drawn from your body, your blood pressure and heart rate will be checked several times during each treatment.
Finishing.of health problems.When hemodialysis is completed, the needles are removed from your access site and a pressure dressing is applied to prevent bleeding. Your weight may be recorded again. Then you’re free to go about your usual activities until your next session.