What is anal pain?

Anal pain is pain that you get in your anus (bottom). It is common.

Your anus is the opening at the end of your large bowel. It's made up of the anal canal (the last few centimetres of bowel) and the skin around the opening.

While most causes of anal pain aren't serious, the pain can be very bad. This is because there are a lot of nerve endings in this part of your body.

What symptoms are related to anal pain?

As well as pain in your bottom, you may have:

• pruritus ani (an itchy anus)
• constant, throbbing pain
• pain when defecating (pooing)
• the need to pass a lot of stools
• the need to pass stools in a hurry (urgency)
• blood or pus on the toilet paper when you wipe

Your symptoms will depend on the cause of your anal pain.

What causes anal pain?

Anal pain can be caused by many different things. These include:

• anal fissure — a small tear in the lining of your anal canal
• anal fistula — an abnormal channel between your anus and the skin near your bottom
• anal abscess — a collection of pus in the tissue near your anus
• haemorrhoids (piles)
• constipation
• proctitis (inflammation of your rectum), which may be due to inflammatory bowel disease
• tailbone (coccyx) pain
• rectal prolapse

Less often, anal pain is due to:

• sexually transmitted infections (STIs) — such as genital warts, gonorrhoea, chlamydia and syphilis
• fungal infections

Very rarely, anal pain may be a sign of anal cancer.

Find out more about anal injuries that may cause anal pain. If you are concerned about an anal injury, talk with your doctor, or a health professional at a sexual health clinic.

How is the cause of anal pain diagnosed?

The cause of anal pain can usually be easily diagnosed. Your doctor will ask about your symptoms and examine you.

Depending on what your doctor thinks may be causing your anal pain, they may do:

• a digital examination of your rectum (back passage) — where they gently put a gloved finger into your back passage
• an anorectal swab — to test for STIs

They may also arrange for you to have other tests, such as:

• blood tests
• urine tests
• x-rays, a CT scan or an MRI scan
• an endoscopy

Your doctor may refer you to a colorectal surgeon (specialist in conditions affecting your large bowel, rectum and anus).

When should I see my doctor?

See your doctor if:

• your anal pain doesn't get better after a couple of days
• the pain in your bottom is very bad
• you've had blood in your stool (poo) or bleeding from your bottom

When to seek urgent care

Go to your nearest emergency department if you have:

• anal pain that gets worse
• anal pain with a fever — 38°C or higher
• anal pain with anal discharge — blood or pus
• a large amount of bleeding from your bottom
• your stool (poo) is black or dark red
• bleeding from your bottom that won't stop

How is anal pain treated?

Your treatment will depend on what is causing your anal pain.

Self-care at home

There are things you can do at home that may help ease anal pain, such as:

• taking paracetamol
• taking a short warm bath (sitz bath) to ease the pain — you can do this several times a day
• putting an ice pack in a towel and placing it where it hurts — do this for 20 minutes every 2 to 3 hours
• wiping your bottom with damp toilet paper

Remember to also:

• drink lots of fluids
• eat a balanced diet with lots of fibre — fruits, vegetables and whole grains
• do some gentle physical activity

The following are things that can make your anal pain worse. Do not:

• eat spicy food
• drink caffeine or alcohol
• use fragranced bath or shower products around your anus
• lift heavy things
• push too hard when defecating (pooing)

Learn more about good anal care.

Medicines for anal pain

Your doctor or pharmacist may suggest medicines that will help with your anal pain. These will depend on the cause of your anal pain but may include:

• pain-relief medicines — such as paracetamol
• creams or suppositories to ease your pain and swelling
• laxatives to make it easier to empty your bowels (poo)
• antibiotics

Other treatment options

You may need surgery for some causes of anal pain. This may be recommended with:

• an anal abscess
• an anal fissure that has not healed with other treatments
• an anal fistula
• rectal prolapse — when some part of your bowel is outside of your anus
• thrombosed haemorrhoids (when a clot forms in the haemorrhoid) — this is called a haemorrhoidectomy

Can anal pain be prevented?

You can help prevent some types of anal pain by:

• drinking lots of water
• eating a balanced diet that has lots of fibre
• exercising regularly

What are the complications of anal pain?

Any complications from anal pain will depend on their cause and treatment. Speak with your doctor if you have any concerns.

Resources and support

• The Colorectal Surgical Society of Australia and New Zealand (CSSANZ) has information on anal and bowel problems. This includes information on both anal fissures and anal fistulas.
• The Australian dietary guidelines give advice on the amount and kinds of food that you need to eat to keep your bowel and anus healthy.
• For information on the health of your bowel in English and other languages, go to healthtranslations.vic.gov.au.
• You can also call the healthdirect helpline on 1800 022 222 (known as NURSE-ON-CALL in Victoria). A registered nurse is available to speak with 24 hours a day, 7 days a week.