Anal Pain: Your Guide to Causes, Diagnosis & Treatment Options

Anal pain is any pain, aches, and discomfort in and around your anus or rectum.

It is a common occurrence for people of any age and lifestyle.

The majority of anal pain cases and reasons are benign; however, the pain itself can be severe and cause a hindrance to your life.

If you are concerned about anal pain that does not go away after a day or two, it could be caused a different underlying condition. 

In this article, we’ll explore the main causes of anal pain and look at symptoms of each cause to look out for.

We’ll also look at treatment options for anal pain, when you would need to seek professional help, and how K Health could help you.

What is Anal Pain?

Anal pain is pain that occurs in or around the anus and rectum.

Pain, swelling, lesions, and bleeding from the rectum are often accompanied by anal pain.

Although you may feel embarrassed to seek medical advice for this issue, it is important to remember that it is a common symptom of many different medical conditions and can often be easily treated. 

You can experience anal pain at any time of the day or night and during any activity, and it can also occur while sitting still or sleeping. 

Symptoms

Apart from anal pain, keep an eye on the below additional symptoms to tell your medical professional so they can make an accurate diagnosis:

• Pain and soreness around the anus and rectum area
• Pain, soreness, and difficulty while passing stool
• Itchiness, lumps, swelling, and lesions around the anus
• Bleeding while, before, or after passing stool
• Stinging, burning, and painful pulsing sensations while passing stool
• Noticeable discharge or bleeding on under clothing and underwear

Causes

Many different conditions can cause pain in the anus and rectum area, but many of these are not serious and the pain should go away naturally.

Here are some common causes and their symptoms. 

Minor Injury / Trauma

Minor injuries in the anus and rectum area are quite common and can occur during physical activity such as sports and sexual intercourse.

If objects and other body parts are inserted into the rectum through the anus too roughly, it can tear the sensitive skin in the area causing pain and sometimes bleeding. 

These injuries can also occur during fast and vigorous activities that are conducted without ample protection to your perineal area, such as horseback riding, jet skiing, or any falls and accidents.

If you have faced any trauma that gives you anal pain, or if there is an object that is obstructing your anus, do not attempt to fix this yourself. Seek medical help from a professional immediately. 

Hemorrhoids

Piles, or hemorrhoids, occur when the veins in your anus and rectum get swollen.

These occur quite frequently, affecting millions of people in the world, and are more prevalent in adults with penises.

Most of the time, hemorrhoids get better on their own and many people don’t even notice that they have them. They can occur when too much pressure is put during bowel movements.

Sitting on the toilet for long periods of time, a diet that is low in fiber, lifting heavy objects too suddenly, and chronic constipation or diarrhea can all lead to hemorrhoids as well.

One of the first signs of piles is anal pain alongside itching, swelling, bleeding, lumps, and skin tags.

A hemorrhoid becomes a thrombosed hemorrhoid when a blood clot forms inside it and can be treated easily when diagnosed early. 

Anal Fissures

A tear, cut, or crack in the lining of the anus or anal canal is known as an anal fissure.

These can occur due to constipation, physical activity, sexually transmitted diseases (STDs), pregnancy and childbirth, and several other conditions.

They are very common and heal naturally in most cases.

Signs to watch for include anal pain, especially during bowel movements, blood when passing stool, and visible lesions or cracks around the anus.

Inflammatory Bowel Disease (IBD)

Ulcerative colitis (tiny ulcers that form around the colon and rectum) and Crohn’s disease (inflamed and sore intestine) are types of disorders that describe inflammatory bowel disease (IBD).

A virus or some form of bacteria can attack your immune system, and some people develop IBD because of genetics or environmental triggers as well.

Apart from anal pain, you may experience pain in the abdomen, fatigue, persistent diarrhea, and blood while passing stool. 

Another symptom of IBD is tenesmus, the feeling of needing to pass stool even though the bowels are empty.

It can happen to people without IBD as well and there are several accessible treatments for tenesmus available. 

Sexually Transmitted Infection (STI)

Some sexually transmitted infections (STIs) can lead to bacterial or fungal infections, and these are contracted by anal intercourse.

You may notice lesions and pain around the anus and spasms during bowel movements.

Practicing safe sex can help curb the spread of STIs and STDs such as herpes, syphilis, chlamydia, and gonorrhea. 

Muscle Spasm

Proctalgia fugax, muscle spasms, or pain that occurs around the buttocks, rectum, and pelvic floor areas can happen at any time and to anyone.

They usually go away within a short period of time.

Some could be psychologically induced through trauma, anxiety, and stress, while it could also be caused by physical activity such as sexual intercourse, constipation, and menstruation.

If the spasms persist for several hours, relief can be found by taking over-the-counter (OTC) painkillers and muscle relaxers. 

Perianal Hematoma

A collection of blood that collects in the tissue surrounding the anus is called a perianal hematoma.

This can cause a lump to form, giving you anal pain, bleeding, and difficulty in passing stool.

Most can be treated at home by resting and making lifestyle changes, however, if the condition is severe, your healthcare professional will recommend draining the hematoma.

Proctitis

Proctitis is when the lining of the rectum gets inflamed and it can lead to anal pain, soreness, cramping, and diarrhea.

Many go away naturally, and some can be treated using topical ointments. 

Levator Syndrome

Also known as levator ani syndrome, levator syndrome causes pain across the anus, rectum, coccyx, and across the pelvic muscles, and buttocks.

Symptoms usually ease with time. 

Fecal Impaction

A common condition that can lead to anal and rectal pain, fecal impaction is when a large mass of hard stool gets stuck in the rectum.

It is important to consume a diet rich in fiber, drink plenty of water, and take part in plenty of regular exercise to avoid chronic constipation that leads to fecal impaction.

Solitary Rectal Ulcer Syndrome

A very rare and benign condition, solitary rectal ulcer syndrome (SRUS) leads to ulcers in the rectum.

It can cause anal pain, swelling, constipation, and uncomfortable bowel movements. 

Perianal or Perirectal Abscess and Anal Fistulas

Perianal and perirectal abscesses are common issues that affect the anus and rectum.

They can appear as red lumps under the skin and most result in anal fistulas (an irregular connection between the anal canal and the skin of the buttocks).

Symptoms of these conditions include anal pain, red and sore skin, bleeding from the rectum and anus, itchiness of the area, and in some cases, fevers.

Rectal Prolapse

Rectal prolapse is a condition that occurs when the rectum, or parts of the rectum, falls or moves from its normal position.

Along with anal pain, rectal prolapse can give you chronic constipation, could lead to other complications and infections, and in some cases may damage the nerves around the rectum and anus.

Treatments will depend on the severity of the condition and are rarely considered a medical emergency.

Diagnosis

Only a medical professional can diagnose which one of the above conditions you may have based on the signs and symptoms you show, alongside an examination.

Having anal pain for a few hours alone is not a sign of serious concern.

When it persists for more than a day and is coupled with the various other symptoms of each cause mentioned above, some form of treatment may be necessary to help you. 

Treatment

To ease mild and temporary anal pain, make sure you consume a diet that is rich in fiber and keep the area around your anus and rectum clean.

Each of the above conditions may have its own treatments as well:

Anal injuries and trauma: Leave injuries alone for a day or two to heal naturally. You may apply a cold compress or ice pack to soothe the pain, but do not insert or apply anything into the anus before consulting a medical provider. If an object is stuck in your anus or rectum or you suspect a severe injury or trauma, consult professional help immediately. You may be prescribed an ointment to soothe the pain, or surgery if the object needs to be removed. 

Hemorrhoids and anal fissures: These conditions usually subside on their own, but in more serious cases a medical practitioner will give you ointment to apply, advise you to include more fiber in your diet, avoid spending long periods of time on the toilet, and in rare cases, you may be advised to try treatments such as sclerotherapy and hemorrhoidectomy.

Inflammatory bowel disease and STIs: While IBD cannot be cured, there are various medicines available to reduce inflammation and surgeries that your medical expert will recommend after an examination. Sexually transmitted infections can be treated with antibiotics and antiviral drugs. 

Perianal or perirectal abscess and anal fistulas: After a thorough medical examination and diagnosis, these conditions are usually treated with surgeries that attempt to drain the fistula or abscess. If adequate treatment and healing take place, it is unlikely that anal fistulas and abscesses will reoccur. 

When to See a Medical Provider

Seek professional medical help if your anal pain gets much worse after a day or two.

If you notice any discharge, abnormal bleeding and swelling around the rectum area, and blood in your stools then you will need to visit a healthcare professional and get yourself checked for the above conditions. 

How K Health Can Help

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Download K Health to check your symptoms, explore conditions and treatments, and, if needed, text with a clinician in minutes. K Health’s AI-powered app is based on 20 years of clinical data.