Digestive Health Irritable Bowel Syndrome Related Conditions What to Do for Anal Pain Common Causes and When to See the Doctor By Barbara Bolen, PhD twitter Barbara Bolen, PhD, is a licensed clinical psychologist and health coach. She has written multiple books focused on living with irritable bowel syndrome. Learn about our editorial process Barbara Bolen, PhD Medically reviewed by Medically reviewed by Robert Burakoff, MD, MPH on June 05, 2020 linkedin Robert Burakoff, MD, MPH, is board-certified in gastroentrology. He is the vice chair for ambulatory services for the department of medicine at Weill Cornell Medical College in New York, where he is also a professor. He was the founding editor and co-editor in chief of Inflammatory Bowel Diseases. Learn about our Medical Review Board Robert Burakoff, MD, MPH Updated on June 10, 2020 Print Anal pain is not something that is talked about a lot, though it can be quite significant. There are a lot of nerve endings in the area of the rectum and anus, so any issues with them can result in anything from mild discomfort to excruciating pain. Most of the time the causes of anal pain are benign, even if there is bleeding. Still, if your anal pain doesn't ease within a few days, it is essential that you get a proper diagnosis. While this might not be a conversation you're eager to have, it's an important one. Learn the most common causes of anal pain, when to see your doctor, and tips for self-care. Verywell / Nusha Ashjaee Causes While only a doctor can confirm the reason behind your anal pain, there are some symptoms that can hint that a certain condition is to blame. Explore the most likely causes. Anal Fissure The pain associated with an anal fissure is typically located at the opening of the anus and is acute and sharp. The pain is experienced during a bowel movement but may persist over time. You may also experience anal itching as well as see bright red blood on the outside of the stool or on your toilet paper. Overview and Treatment of Anal Fissures Hemorrhoids A hemorrhoid is a swollen, inflamed vein in the rectum or on the anus. Although some hemorrhoids can cause no symptoms, others can be quite painful. You may experience itchiness and see bright red blood in the stool or on your toilet paper. A thrombosed hemorrhoid is an especially painful, but not necessarily serious type of hemorrhoid that involves a blood clot in the vein. An Overview of Hemorrhoids Rectal Tenesmus Tenesmus is the urge to pass stool even when there is no more stool to pass. It is often accompanied by pain, straining or cramping. Tenesmus typically manifests itself alongside other medical conditions. Rectal Tenesmus Symptoms, Causes, and Treatment Muscle Spasms Anal pain can also be the result of muscle spasms in the pelvic area. This manifests itself as a sharp pain that goes away quickly. Other Causes Pain on the outside of the anus could be the result of a yeast infection, itchiness associated with a hemorrhoid, or the result of rough cleaning of the skin on the outside of the anus. Associated Health Conditions Other health conditions may also be the reason behind anal pain. They include, but are not limited to: Anal abscessAnal fistulaBenign tumorChronic constipation or diarrheaChronic proctalgiaCrohn's diseaseFecal impactionInfectionInjury/trauma (e.g., from anal sex, foreign objects)Levator ani syndromeProctalgia fugaxProctitis (rectal inflammation)Pruritus ani (anal itching)Rectal cancerRectal prolapseSolitary rectal ulcer syndromeUlcerative colitis When to See Your Doctor If your pain symptoms do not ease within a few days, make an appointment with your doctor to get an accurate diagnosis. Seek immediate medical care if you experience:Significant rectal bleedingWorsening pain accompanied by high fever Self-Care While anal care certainly doesn't need to be an everyday focus, if you experience discomfort, try these tips for easing and avoiding anal pain: Remember to always wash gently with warm water. Avoid soap. Gently pat the area dry.Wear underwear that "breathes," such as choices made from cotton or moisture-wicking fabric.Do not use any creams in the anal area other than those prescribed by your doctor.Take an over-the-counter pain reliever, if necessary.If your anal pain is caused by an anal fissure or hemorrhoid, start taking regular sitz baths. Soaking the anus in warm water will both soothe and treat the underlying cause.If you engage in anal intercourse, always use a condom. Otherwise, never insert any foreign objects into your rectum. Was this page helpful? Thanks for your feedback! One of the most challenging aspects of having IBS is trying to figure out what's safe to eat. Our recipe guide makes it easier. Sign up and get yours now! Sign Up You're in! Thank you, {{form.email}}, for signing up. There was an error. Please try again. What are your concerns? Other Inaccurate Hard to Understand Submit Article Sources Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Villalba H, Villalba S, Abbas MA. Anal fissure: a common cause of anal pain. Perm J. 2007;11(4):62‐65. doi:10.7812/tpp/07-072 Mueller K, Karimuddin AA, Metcalf C, Woo A, Lefresne S. Management of malignant rectal pain and tenesmus: A systematic review. J Palliat Med. 2019. doi:10.1089/jpm.2019.0139 Additional Reading American Society of Colon & Rectal Surgeons, "Anal Pain" National Institutes of Health, Medline Plus, "Anal Disorders"