Does anal itching indicate the presence of roundworms?

Intense itching around the anus is typically caused by perianal diseases and is generally not closely related to intestinal abnormalities. Perianal eczema, for instance, often causes localized anal itching—particularly at night—and warrants routine testing and a definitive diagnosis. In some cases, anal itching may result from intestinal parasitic infections, such as ascariasis (caused by *Ascaris lumbricoides*), with adult worms migrating to the perianal region. Consequently, patients may develop perianal erythema and swelling due to secondary bacterial or viral infection.