What is anal pain?

Anal pain is pain that occurs in or around the anus and rectum (the last section of the large intestine that ends in the anus). Pain and bleeding from the rectum often accompany anal pain. People may feel embarrassed to ask their doctor about anal pain, but it is a common symptom of many different medical conditions and is usually easily treated.

What causes anal pain?

Many different conditions can cause anal pain. Most symptoms are minor and will go away quickly with treatment. In rare cases, anal pain is a symptom of a more serious condition, such as anal cancer.

Common causes of anal pain include:

• Anal abscess: An infected cavity caused by a blockage of glands in the anus.
• Anal fistula: A small tunnel connecting the infected gland in the anus to an opening on the skin around the anus.
• Anal fissure: Small tear in the lining of the anus, like a paper cut.
• Hemorrhoids: Swollen veins in the rectum or anus.
• Infections: Bacteria or viruses, including fungal infections and sexually transmitted infections.
• Inflammatory bowel disease: Conditions such as Crohn’s disease (the intestine becomes inflamed and marked with sores) or ulcerative colitis (tiny ulcers in the colon and rectum that flare up periodically and cause bloody stools and diarrhea).
• Levator ani syndrome: Muscle spasms and pain around the anus.
• Pelvic floor dysfunction: When the muscles of the pelvic floor don’t relax properly.
• Skin conditions: Disorders such as psoriasis and warts.

How is anal pain diagnosed?

Doctors diagnose anal pain in several ways:

• The patient’s medical history, including symptoms.
• Physical examination.
• Rectal exam: A doctor inserts a finger into the rectum to feel for abnormalities.
• Endoscopy: The doctor uses a thin, flexible tube with a camera to look at the lining of the rectum.

How is anal pain treated?

Treatment for anal pain depends on the cause, and includes:

• Medicines such as pain relievers, stool softeners and antibiotics (if there is an infection).
• A high-fiber diet to help ensure soft bowel movements.
• Sitz baths with warm water to clean the anal area and relieve pain.
• Surgery for muscle spasms and to repair fistulas.

Other methods that may help manage the pain include the following:

• To protect the skin, avoid wiping too vigorously after a bowel movement.
• Don’t use perfumed soaps or scented detergents. These may irritate the skin.
• Don’t wear tight clothing so that the anal area can “breathe.”
• To help prevent hemorrhoids, try not to sit for too long.

When should I call the doctor about anal pain?

Many causes of anal pain do not need to be treated by a doctor. Contact your doctor about anal pain that:

• Accompanies a lump or mass.
• Does not feel better after three or four days.
• Occurs with bleeding from the rectum.
• Is severe enough to interfere with daily activities or wake you at night.
• Returns after going away.