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November 29, 1965

Management of Pruritis Ani

JAMA. 1965;194(9):1024. doi:10.1001/jama.1965.03090220080034

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To the Editor:—  In "Management of Pruritis Ani" (194:184, 1965), Copland gives a brief and highly erudite study of classification and a form of treatment which he finds highly successful.I appreciate his acceptance of steroids as a treatment of choice in cases which are otherwise intractable. Many patients obtain relief from itching of various parts by administration of steroids, but, for the patients who obtained relief but no cure, a frequent return to steroids could create a new problem.Not included in his list of treatments are instructions for meticulous cleanliness which especially apply in cases classified as "primary," "digestive," and "rectal."Maximum cleanliness can be better obtained by the patients as follows: While at stool, using a 3-ounce infant rectal syringe; the patient administers a 2-ounce, very low, tepid, tap-water enema until the return is clear. Gentle washing of the perianal area with soap followed by flushing

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