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Published on: 2/23/2026

Anal Pain? Why Your Body Is Hurting and Medically Approved Next Steps

Anal pain is most often caused by treatable issues like hemorrhoids or anal fissures, but infections or abscesses, fistulas, proctitis, pelvic floor muscle spasms, and rarely cancer can also be responsible. For mild symptoms, doctors commonly advise fiber, hydration, avoiding straining, and warm sitz baths, but seek urgent care for severe or worsening pain, fever, pus drainage, heavy bleeding, or inability to pass stool or gas, and get evaluated if symptoms persist or recur. There are several factors to consider for your exact next steps and when to see a clinician; see the complete guidance below.

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Explanation

Anal Pain? Why Your Body Is Hurting and Medically Approved Next Steps

Anal pain is common, but many people feel embarrassed to talk about it. The truth is, anal pain affects millions of adults every year. In most cases, it's caused by a minor issue that can be treated easily. However, sometimes anal pain can signal a more serious condition that needs medical attention.

If you're experiencing anal discomfort, sharp pain, pressure, itching, or burning, this guide will help you understand why it may be happening and what you should do next.


What Is Anal Pain?

Anal pain refers to discomfort in or around the anus — the opening at the end of your digestive tract where stool leaves the body. The area contains many sensitive nerves, which is why even small problems can feel intense.

Anal pain may feel like:

  • Sharp or stabbing pain
  • Burning or itching
  • Throbbing discomfort
  • Pressure or fullness
  • Pain during bowel movements
  • Pain when sitting

The timing, severity, and associated symptoms often give clues about the cause.


Common Causes of Anal Pain

Most cases of anal pain are caused by conditions that are not life-threatening. Here are the most frequent reasons.

1. Hemorrhoids (Most Common Cause)

Hemorrhoids are swollen veins in the lower rectum or anus. They can be:

  • Internal (inside the rectum)
  • External (under the skin around the anus)

Symptoms may include:

  • Anal pain or pressure
  • Itching
  • Swelling
  • Bright red blood on toilet paper
  • A tender lump near the anus

Hemorrhoids often develop due to:

  • Constipation
  • Straining during bowel movements
  • Sitting for long periods
  • Pregnancy
  • Chronic diarrhea

External hemorrhoids are more likely to cause anal pain, especially if a blood clot forms (thrombosed hemorrhoid).


2. Anal Fissures

An anal fissure is a small tear in the lining of the anus. This is one of the most painful causes of anal pain.

Common symptoms:

  • Sharp, severe pain during bowel movements
  • Pain lasting minutes to hours afterward
  • Bright red blood on toilet paper
  • A visible crack in the skin

Fissures are often caused by:

  • Passing large or hard stools
  • Chronic constipation
  • Chronic diarrhea

The pain can be intense, but many fissures heal with proper treatment.


3. Anal Abscess or Infection

An anal abscess is a pocket of infection near the anus. This condition requires medical treatment.

Symptoms include:

  • Constant, worsening anal pain
  • Swelling
  • Warmth near the anus
  • Fever
  • Pus drainage

This is not something to treat at home. If you suspect an abscess, speak to a doctor urgently.


4. Anal Fistula

An anal fistula is an abnormal tunnel that forms between the inside of the anus and the skin around it. It often develops after an abscess.

Symptoms may include:

  • Ongoing anal pain
  • Drainage of pus or blood
  • Skin irritation
  • Recurrent infections

This condition usually requires surgical treatment.


5. Proctitis (Inflammation of the Rectum)

Proctitis is inflammation of the lining of the rectum. It may be caused by:

  • Inflammatory bowel disease (IBD)
  • Infections
  • Radiation therapy
  • Sexually transmitted infections

Symptoms include:

  • Anal pain
  • Rectal bleeding
  • Urgency to have bowel movements
  • Mucus discharge

If symptoms are persistent, medical evaluation is important.


6. Muscle Spasms (Proctalgia Fugax or Levator Ani Syndrome)

Sometimes anal pain is caused by muscle spasms in the pelvic floor.

These spasms can cause:

  • Sudden, sharp anal pain
  • Episodes lasting seconds to minutes
  • No visible external problem

Though painful, these conditions are not dangerous. However, recurring episodes should still be evaluated.


7. Anal Cancer (Rare but Serious)

Anal cancer is uncommon, but it must be ruled out when symptoms persist.

Warning signs include:

  • Ongoing anal pain
  • Bleeding not linked to hemorrhoids
  • A lump near the anus
  • Unexplained weight loss
  • Persistent itching

While most anal pain is not cancer, persistent or worsening symptoms should never be ignored.


When Is Anal Pain an Emergency?

Seek urgent medical care if you experience:

  • Severe, worsening pain
  • Fever with anal pain
  • Pus drainage
  • Heavy bleeding
  • Inability to pass stool or gas
  • Fainting or weakness

These could signal a serious infection or other urgent condition.


What You Can Do at Home (If Symptoms Are Mild)

If your anal pain appears related to hemorrhoids or fissures, these steps are often recommended by doctors:

Improve Bowel Habits

  • Drink more water (6–8 glasses daily unless medically restricted)
  • Increase fiber intake gradually
  • Avoid straining during bowel movements
  • Don't sit on the toilet for long periods

Soothe the Area

  • Warm sitz baths (10–15 minutes, a few times daily)
  • Over-the-counter hemorrhoid creams
  • Gentle cleaning with unscented wipes
  • Avoid harsh soaps

Relieve Constipation

  • Fiber supplements (if recommended)
  • Regular physical activity
  • Consistent bathroom schedule

If symptoms don't improve within a week or two, speak to a doctor.


How Doctors Diagnose Anal Pain

A medical professional may:

  • Review your symptoms and medical history
  • Perform a visual exam
  • Conduct a digital rectal exam
  • Use a small scope to look inside the rectum (if needed)

While this may feel uncomfortable to think about, these exams are quick and help ensure nothing serious is missed.


When Should You Speak to a Doctor?

You should speak to a doctor if:

  • Pain lasts more than a few days
  • Symptoms keep returning
  • You notice bleeding
  • Pain interferes with daily life
  • You develop fever or swelling
  • You feel a persistent lump

Even if the cause is likely minor, confirmation can bring peace of mind and proper treatment.


Not Sure What's Causing Your Anal Pain?

If you're unsure whether your symptoms are minor or require medical care, you can use a free Anal pain symptom checker to quickly assess your symptoms and get personalized guidance on what to do next.

However, online tools are not a replacement for a medical diagnosis. If symptoms are severe, worsening, or concerning, seek medical care directly.


Reducing Risk of Future Anal Pain

Prevention often focuses on bowel health:

  • Maintain a fiber-rich diet
  • Stay hydrated
  • Exercise regularly
  • Avoid prolonged sitting
  • Address chronic constipation early
  • Practice safe sexual health

Taking care of digestive health can significantly lower your risk of recurring anal pain.


The Bottom Line

Anal pain is uncomfortable, but it is usually caused by treatable conditions like hemorrhoids or fissures. Infections, inflammatory conditions, and rarely cancer can also be responsible.

Don't ignore persistent or severe anal pain. Your body uses pain as a signal that something needs attention.

If your symptoms are mild, you may try home care measures. But if you experience bleeding, fever, swelling, worsening pain, or symptoms that don't improve, speak to a doctor promptly. Some causes of anal pain can become serious if left untreated.

There is no reason to feel embarrassed — healthcare professionals deal with anal conditions every day. Early evaluation leads to faster relief and better outcomes.

If something feels wrong, trust that instinct and seek medical advice. Your health is worth it.

(References)

  • * Al-Khamis, A. A., & Al-Amri, A. H. (2022). Common Anorectal Disorders. *Sultan Qaboos University Medical Journal*, *22*(4), e474–e481.

  • * Bharucha, A. E. (2020). Anorectal Pain: Functional Anorectal Pain. *Clinics in Colon and Rectal Surgery*, *33*(2), 99–106.

  • * Schiess, B. D., & Raffals, L. E. (2019). Evaluation and management of chronic anorectal pain. *Translational Gastroenterology and Hepatology*, *4*.

  • * Wu, J. D., Lee, S. P., Bharucha, L. M., & Rao, A. K. (2019). Chronic Pelvic Pain Syndromes and Functional Anorectal Pain: Diagnosis and Management. *Gastroenterology Clinics of North America*, *48*(3), 515–532.

  • * El-Hussuna, A., Gormsen, L., Krogh, K., Ljungqvist, O., Nordstrand, N., Norderval, S., … & Laurberg, S. (2023). Management of chronic proctalgia in tertiary referral centres: A consensus opinion. *Colorectal Disease*, *25*(8), 1544–1553.

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