Treatment and patient education

1. Patients should clean the perianal area with water following defecation, but avoid soaps and vigorous rubbing. Following this, the patient should dry the anus with a hair dryer or by patting gently with cotton. Between bowel movements a thin cotton pledget dusted with unscented cornstarch should be placed against the anus. A high fiber diet is recommended to regulate bowel movements and absorb excess liquid. All foods and beverages that may be exacerbating the itching should be eliminated.

2. Topical medications generally are not recommended because they may cause further irritation. If used, a bland cream such as zinc oxide or 1% hydrocortisone cream should be applied sparingly two to three times a day.

3. Systemic therapy with an antihistamine such as diphenhydramine (Benadryl) or hydroxyzine (Vistaril) may relieve the itching and allow the patient to sleep.

Breaking Bulimia

Breaking Bulimia

We have all been there: turning to the refrigerator if feeling lonely or bored or indulging in seconds or thirds if strained. But if you suffer from bulimia, the from time to time urge to overeat is more like an obsession.

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