Anal pain

Anal pain

Anal pain or proctalgia is pain in the anus or rectum. This condition is generally harmless and can subside on its own. However, in some conditions, anal pain can be a symptom of a serious illness.

The skin around the anus and rectum has many nerves. This causes any disturbance that occurs in the area to cause pain.

Sufferers of anal pain can experience pain that varies, ranging from mild, moderate, to severe pain. In addition to interfering with daily activities, severe anal pain can be a sign of a medical condition that needs immediate treatment, especially if it lasts for days.

Causes of Anal Pain

Anal pain can be caused by certain conditions or diseases, such as:

  • Anal fissures ( anal fissures ), for example due to complications of normal childbirth
  • Sores to the anus from injury or anal sex
  • Hemorrhoids or hemorrhoids
  • A hematoma (a collection of blood) that forms around the anus
  • Anal fistula or anal abscess
  • Hardened stools ( fecal impaction ) due to constipation
  • Warts on the anus

In addition to the causes above, there are several conditions that are often associated with or trigger anal pain, namely:

  • Suffering from proctalgia fugax , namely pain in the anus or rectum that appears suddenly and goes away quickly
  • Suffering from levator ani syndrome, which is a collection of symptoms caused by stiffness or tension in the muscles around the rectum
  • Suffer from Crohn's disease , which is a type of chronic inflammatory bowel disease
  • Suffering from a sexually transmitted disease ( STD ) or fungal infection of the skin in the anal area
  • Suffering from rectal ulcer syndrome or ulcers in the rectum
  • Experiencing coccydynia , which is pain that occurs in the coccyx
  • Experiencing prostatitis or inflammation of the prostate gland
  • Suffering from anal cancer or rectal cancer
  • Suffering from rectal prolapse , namely the descent of the rectum to come out of the anus

Anal Pain Symptoms

Symptoms of anal pain depend on the cause. Common complaints of anal pain include:

  • Pain in the anus when defecating
  • A burning or burning sensation in the anus that lasts several hours after having a bowel movement
  • Throbbing pain that gets worse when sitting
  • Pain or pressure around the anus that may last for a few hours or days
  • Pain in the anus that appears suddenly

Anal pain is generally a symptom of certain diseases or health conditions. For this reason, anal pain is often accompanied by other symptoms.

For example, anal pain caused by cancer of the anus or rectum can cause symptoms such as lumps and itching in the anus, bleeding from the anus, weight loss, or loss of appetite.

Meanwhile, if anal pain is caused by an infection, complaints that can occur can include fever, chills, swollen anus, and even pus coming out of the anus.

When to see a doctor

Anal pain is generally infrequent and goes away on its own within 1–2 days. If anal pain persists and the symptoms are getting worse, see a doctor immediately .

You also need to see a doctor immediately if your symptoms get worse and don't improve after a few days, especially if anal pain is accompanied by fever, chills, discharge from the anus, or bleeding from the rectum.

If needed, the doctor will carry out a supporting examination to find out the underlying cause of anal pain. Some of the types of inspection that will be carried out are:

  • Proctoscopy , to see whether there is a fistula or anal fissure
  • Anoscopy , to check whether there are abnormalities in the rectum and anus, such as anal fissures, hemorrhoids, or other tissue growths, including cancer
  • Sigmoidoscopy , to examine the rectum and lower colon if anal pain is suspected to be caused by IBS
  • Scanning with a CT scan , ultrasound, or MRI , to see and examine the condition of the organs in the abdomen which can be the cause of anal pain
  • Urine test and swab test , to check for the presence of bacteria or viruses in the urine or genital fluids if anal pain is suspected to be caused by an STD
  • Blood tests , to detect infections that can be the cause of anal pain
  • Biopsy by taking and examining anal tissue samples, to see whether there is abnormal cell or tissue growth
  • Lactose intolerance test , to see if anal pain is triggered by IBS

Anal Pain Treatment

Treatment of anal pain aims to relieve pain and treat the cause. Some methods that can be done to treat anal pain are:


When experiencing anal pain, there are several independent treatment steps that can be taken to relieve pain, namely:

  • Soak in warm water
  • Taking pain relievers, such as paracetamol
  • Apply pain cream around the anus

In addition, to prevent anal pain from having difficult bowel movements, take the following steps:

  • Increase the consumption of high-fiber foods , including fruits and vegetables
  • Drink lots of water
  • Exercise regularly
  • Not holding bowel movements

Patients are also advised to always keep the anal area clean. If you want to use a tissue, use a soft, wet wipe that doesn't contain alcohol or fragrance.

Treatment by a doctor

Doctors can provide medicines or perform surgical procedures if independent treatment is not effective in treating anal pain. The method that can be done is:


Several types of drugs that can be given by doctors are creams that contain glyceryl trinitrate , pain medications , or topical medications that contain diltiazem. In some conditions, doctors can give botox injections to relieve anal pain.

If anal pain is caused by a sexually transmitted infection, such as gonorrhea or syphilis, your doctor may prescribe antibiotics.


The doctor will recommend the patient to undergo surgery if the above treatments are not effective in dealing with anal pain. Some of the surgical procedures that doctors can perform are:

  • Lateral internal sphincterotomy (LIS), to relieve pressure and tension on the anal sphincter muscles
  • Fistulotomy, to open the entire anal fistula so that it becomes a flat scar
  • Hemorrhoidectomy or hemorrhoid stapling , to treat hemorrhoids

Anal Pain Complications

Anal pain can interfere with activities and cause discomfort. If it is caused by certain diseases or medical conditions, the complications that can arise due to anal pain depend on the underlying disease.

For example, anal pain due to sexually transmitted diseases that are not treated can lead to the spread of infection and complications such as pelvic inflammation, meningitis, and even sepsis .

Meanwhile, anal pain due to hemorrhoids (hemorrhoids) can cause complications in the form of:

  • Anemia
  • Twisted hemorrhoids
  • Blood clot in the anus
  • Anal skin damage

Anal Pain Prevention

Some efforts that can be made to reduce the risk of anal pain are:

  • Don't hold back the urge to defecate
  • Do not consume alcoholic beverages
  • Manage stress in a positive way
  • Avoid sitting for long periods of time
  • Keep the anal area clean and don't use cleansers that contain alcohol or fragrance
  • Drink water at least 6-8 glasses per day or as needed
  • Eat high fiber food sources
  • Exercise regularly for at least 30 minutes each week
  • Have healthy sex and don't have anal sex
  • Undergoing HPV vaccination as scheduled
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