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Examples of possible causes of anal itching include hemorrhoids, anal fissures, pinworms (enterobius vermicularis), spicy foods, and medications. Additional symptoms associated with anal itching include burning and pain if the anal skin is traumatized by scratching. The diagnosis of the cause of pruritis ani requires examination of the anus for. Inflammation happens when a physical factor triggers an immune reaction. Inflammation does not necessarily mean that there is an infection, but an infection can cause inflammation. About 50 of patients with an anal abscess will develop a complication called a fistula. A fistula is a small tunnel that makes an abnormal connection between the site of the abscess and the skin. They can be temporary or permanent, and may be painless or painful. Other differentials are herniation of anal mucosa or rectum, a polyp or skin tag especially if there is no bleeding present. Conservative treatment including avoidance of straining, increased fluid intake and high fiber diet. anal skin tags in inflammatory bowel disease new observations and a clinical review. Author information (1)department of gastroenterology, lenox hill hospital, and new york university school of medicine, new york, new york 10021, usa.