Anus pain is known as proctalgia and can have many causes. The anus is where your large intestine opens into your buttocks at the rectum. The anus is the last passageway of the gastrointestinal (GI) tract.

The anus is surrounded by muscles known as sphincter muscles. These tighten and relax the anus when you pass waste. Your tailbone (coccyx), the last bone in your spine, and many nerves are also near your anus.

Read on to learn what causes anus pain, how you can treat it at home, what medical treatments are available, and how you can help prevent this type of pain.

Anal pain can have a variety of causes.

1. Sitting for a long time

Sitting down for a long time, especially on a hard surface, can cause temporary anal pain by putting pressure on anal nerves and muscles. Even sitting for a short time on a hard surface can cause anal pain that lasts for hours after you get up.

You don’t need to see your doctor for this kind of pain.

If the pain persists for a few days after a long period of sitting, see your doctor. They can diagnose any injury to your anus muscles, tailbone, or the surrounding structures.

2. Diarrhea

Diarrhea happens when you pass watery, loose stool more than three times in a day. Diarrhea can have many causes, such as dietary changes (being dehydrated or not eating enough fiber), and infections like gastroenteritis, colitis, or diverticulitis.

Frequently passing stool can make your anus sore. This can get worse from wiping or cleaning. Your anal tissue can become raw and bleed, too.

Other diarrhea symptoms include:

  • feeling bloated or gassy
  • cramping in your lower abdomen
  • feeling nauseous
  • not being able to hold in your stool

Diarrhea often goes away on its own. Seek emergency medical attention if you have any of the following symptoms, though:

3. Injury

Falling on your butt can injure the muscles, bones, or nerves around the anus. The sudden impact of a hard surface can bruise or damage your skin, muscles, or nerve endings as well as potentially fracture bones.

This type of injury is most common during activities like contact sports, such as football and soccer, or activities like skateboarding, rollerblading, or gymnastics.

Depending on how severe the injury is, pain may radiate up from your anus to your lower back and feel like a constant ache or throb. You may notice bruises on your buttocks.

Seek immediate medical attention if:

  • the pain is sharp and constant
  • you can’t walk or get up without severe pain
  • you lose sensation in your lower back or in one or both legs

4. Fissures

Anal fissures happen when your anal tissues tear. Passing especially hard or large stool is the most common culprit. The pain is often sudden and sharp at first. Your anus may ache for hours or days afterward until the fissure heals.

Symptoms of an anal fissure include:

  • feeling sudden, unusual pain in or around your anus when you pass stool
  • bleeding from your anus, especially when you wipe
  • pain that lasts for hours after you pass stool

Fissures don’t always require immediate medical treatment. See your doctor if the pain persists or gets significantly worse when you sit down, pass stool, or walk.

5. Hemorrhoids

Hemorrhoids happen when anal blood vessels are swollen. Straining to pass stool or being constipated are often the causes of hemorrhoids.

When you have a hemorrhoid, you may feel a lump near your anus. The pain may be generally dull but sharp when you sit down. You may not feel comfortable sitting without a special cushion or pillow. In some cases, you may not notice any symptoms.

Common symptoms of hemorrhoids include:

  • constant pain, soreness, or itching around your anus
  • bleeding from your anus when you pass stool
  • sharp anal pain if blood in the hemorrhoid becomes clotted

Hemorrhoids can go away on their own, but severe hemorrhoids may require medical treatment. See your doctor right away if you:

6. Menstruation

Menstruation can cause anal pain along with other symptoms related to your digestive tract.

Your rectum and anus may be more sensitive during this time. This can make your anus feel tender, sore, or uncomfortable. Common period symptoms, such as diarrhea and bloating, can make anal pain even more pronounced.

You don’t need to see your doctor to treat these symptoms. They usually go away once your period is over.

7. Anal spasms (proctalgia fugax)

Anal spasms happen when you get sharp, unexpected anal pain due to anal sphincter muscle contractions. It’s relatively common. A 2013 review estimates it affects between 8 and 18 percent of people.

The cause of this condition isn’t well known. It’s more likely to occur if you have irritable bowel syndrome (IBS) or anxiety as well as after hemorrhoid surgery or a hysterectomy.

When you’re pregnant, your uterus becomes enlarged, which puts pressure on your anus. That can lead to discomfort or pain. This extra pressure can also cause hemorrhoids, which can make your anus uncomfortable.

Anal pain during pregnancy is most common during the third trimester, when your baby is larger and may put more pressure on your anal nerves. Contractions during labor can also cause pain in your anus.

In many cases, you should be able to treat anal pain at home. Here are some home remedies to try:

  • Take a sitz bath. Buy a sitz bath at your local drugstore or online and mount it in your toilet bowl. Fill it with warm water and Epsom salt, then sit on top of the sitz bath with the water immersing your anus. Soak for 15 to 20 minutes.
  • Use over-the-counter (OTC) creams or ointments. Apply a small amount of cream or ointment, such as lidocaine or cortisone, to reduce pain and speed up the healing process of irritated skin.
  • Use a cold compress. You can make your own cold compress at home by wrapping an ice pack or bag of frozen vegetables in a towel. Press it against your anal area to help relieve pain. Do this 20 minutes at a time, three to four times daily.
  • Take OTC pain medicine for pain relief. Ibuprofen (Advil, Motrin) or acetaminophen (Tylenol) can temporarily relieve anal pain until any cuts or injuries heal.

Seek emergency medical treatment if:

  • Your anal pain makes you unable to walk, pass waste, stand, or sit.
  • You notice blood in your stool.
  • You have a fever.
  • You’re severely dehydrated.
  • You can’t eat or pass stool.

Medical treatment depends on the cause of pain and the severity of your symptoms.

Treatment for injuries

You may need X-rays or other imaging tests to see the extent of any damage to your tailbone or spine. Severe spinal injuries may require surgery or long-term rehabilitation to restore any lost mobility.

Treatment for diarrhea

If you’re severely dehydrated, you may need intravenous fluids (IV) to replenish your body fluids. If a bowel disorder is causing diarrhea, such as IBS or Crohn’s disease, your doctor may prescribe you medication or a treatment plan to help reduce symptoms.

Treatment for a fissures

Chronic anal fissures may require surgery so that you can pass stool without injuring your sphincter muscles. Your doctor may also recommend adding fiber to your diet to help you pass stool more easily.

Treatment for hemorrhoids

Your doctor may wrap the hemorrhoid with a rubber band until it shrinks. Surgery to cut or freeze the hemorrhoid are also possible treatment options. In severe cases, your doctor may need to remove the hemorrhoid tissues and blood vessels in a hemorrhoidectomy procedure.

It may not always be possible to prevent anal pain. But there are things you can do to reduce your risk:

  • Stay hydrated. Drink at least 64 ounces of water per day to make your stool easier to pass.
  • Sit with good posture. When sitting, straighten your back and keep your knees bent at a 90-degree angle.
  • Get up and walk around at least once every 30 to 50 minutes. This reduces long-term pressure on muscles and nerves in your anus and lower spine.
  • Don’t strain when you pass stool. Straining can cause discomfort, hemorrhoids, and anal fissures.
  • Eat a healthy diet. Eat plenty of fiber so that you regularly pass stool and prevent constipation.
  • Wear loose, breathable underwear. Wear 100 percent cotton underwear to prevent your anus from becoming moist with sweat, which could lead to irritation.
  • Consider using moist wipes or jets of water instead of toilet paper. Toilet paper can scratch and cut your anal skin, making you more prone to infections. Moist wipes and bidets are gentler on your skin.
  • Don’t eat raw, uncooked, or untrustworthy food. Food and unfiltered water can contain bacteria or other microbes that can lead to diarrhea. Make sure your food is properly cooked and that your water is clean.

Many things can lead to anal pain, some serious and others not.

If the pain is bearable and starts to fade quickly after it starts, there’s no need for concern. If pain persists for more than a few days and accompanies other painful or disruptive symptoms, see your doctor for immediate treatment.

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