Palliation for Pruritus Ani

For resistant pruritus ani, have patients try using cholestyramine topically. In addition to binding cholesterol and bile salts in the gut, cholestyramine binds bile salts from stool, which can irritate perianal skin. Have the pharmacist compound it with a preservative-free emollient ointment at a strength of 6% to 10%.

---- Richard A. Honaker, MD
      Carrollton, Tex

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