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Test your knowledge. Pruritus ani can happen to anyone but is said to be more common in men than women and more common in adults than children or the elderly. Sometimes, a anal swelling and itching can diagnose an anal disorder upon visual inspection or with a digital exam, which involves inserting a gloved finger into the anal canal. Medically reviewed by Saurabh Seth Sethi, M. Share on: Facebook Twitter. Warning signs When anal swelling and itching see a doctor What the doctor does Testing. An anal fistula is a large tear or tunnel that develops under the skin and connects the end of the bowel to either the anus or an abscess.