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Anal Pain

Having an anal sore or anal pain is a common health complaint, yet many people are still uncomfortable talking about it. In the majority of instances, the cause of anal pain is benign – even in cases where you have rectal bleeding.

However, because there are a lot of nerve endings in this part of the body, the pain itself can be severe. As such, you may find that symptoms such as piles pain or anal lesions have a significant negative impact on your quality of life. Luckily there are lots of ways to ease anal pain, whether you need haemorrhoid pain relief or to soothe an anal fissure. 

This page will cover some of the most common causes of anal pain, along with symptoms to look out for and treatment options available.

Causes of anal pain

There are many different possible causes of anal pain. The specific symptoms that you experience will help to determine what’s behind yours – although it’s important to speak to a doctor to get an accurate diagnosis.

This, in turn, will indicate the best course of treatment for you to recover from anal pain.

Haemorrhoids / Piles pain

One common cause of anal pain is haemorrhoids. Also known as piles, these are inflamed and swollen veins that feel like lumps in or around the rectum or anus. There are lots of reasons why you might develop piles, including:

  • Chronic constipation 
  • Straining or pushing too hard when defecating
  • Lifting something very heavy
  • As a result of pregnancy or childbirth
  • Muscle weakness due to ageing

In addition to haemorrhoid pain, other possible symptoms of piles include swelling around the anus, bright red blood after bowel movements, finding a slimy mucus on the toilet paper after wiping your bottom, and feeling as though you still need to defecate after going to the toilet. 

In the majority of cases, piles will go away on their own after a few days. However, if you’re experiencing severe haemorrhoid pain or you notice a large amount of bleeding after using the toilet, it’s best to speak to a doctor.

Even in less serious cases, it may be helpful to get a cream for piles pain or suppositories that you insert inside the rectum, in order to soothe the area and reduce the itchiness. You can also take a pain killer for pilesif it’s impacting your quality of life.

Haemorrhoids / Piles pain

An anal fissure is a tear, lesion, or anal sore in the lining of the large intestine or delicate skin around the anus. In some cases, the break in the skin is deep enough to expose the muscle tissue beneath. This can be especially painful and may also take longer to heal.

The most common symptoms of an anal sore or fissure include:

  • A sharp pain when you defecate
  • A deep, burning pain after defecation (this could last a few hours)
  • Bleeding during bowel movements
  • Depending on the exact location, you might be able to see a visible tear in the skin

There are a number of different reasons why you might get an anal fissure. The injury is often caused by constipation as the result of passing a particularly large or hard stool that damages the lining of the anal canal.

An anal sore can also be the result of severe diarrhoea, inflammatory bowel disease, an STI, or straining during childbirth.

Whatever the cause, normally, you can recover from this type of anal pain without the need for treatment. Having said that, getting pain relief can make you more comfortable, so don’t be embarrassed about going to the doctor.

Your GP can also do a quick check to make sure it’s not anything more serious.


Constipation is another common reason for experiencing anal pain. Contrary to popular belief, constipation doesn’t necessarily mean that you don’t poo at all. The symptoms can include:

  • Defecating fewer than three times in a week
  • Passing stools that are large, dry, hard, or lumpy
  • Straining and/or feeling pain when defecating
  • Having a stomach ache
  • Feeling bloated

The condition can also lead to other related health concerns, such as an anal sore or piles pain, so it’s important not to ignore these symptoms.

There are a very wide range of potential causes of constipation in adults, so you might find it difficult to pinpoint the specific reason behind yours. Some of the most frequent causes are:

  • A lack of fibre in your diet
  • Dehydration or not drinking sufficient fluids
  • Inactivity (e.g., sitting down all day and not exercising)
  • Stress, depression, and anxiety
  • Delaying going to the toilet when you feel the need to
  • Side effects of certain medications
  • Pregnancy and childbirth
  • Lifestyle changes or travel
  • Other medical conditions

In the vast majority of cases, it’s possible to deal with constipation through simple changes to your diet and lifestyle (see Treatment section below). Alternatively, a pharmacist can suggest a suitable laxative to speed things up.

If you are constipated or bloated for a prolonged period of time, notice blood in your stool, or experience other symptoms such as tiredness or weight loss, you should speak to your doctor.

Other medical conditions

In some severe cases, anal pain may be caused by a more serious medical condition. For instance, if you notice a constant throbbing pain, an anal sore that is emitting pus, or experience other symptoms such as fever, then you might be suffering from an anal fistula. These often require surgery, so it’s vital to seek medical advice promptly. 

Other medical conditions that can cause anal pain include:

  • Levator ani syndrome (where the muscles that surround the anus spasm)
  • Proctitis (inflammation of the lining of the rectum)
  • Perianal abscess (where pus builds up in the deep tissue around the anus)
  • Infection
  • Crohn’s disease (a type of inflammatory bowel disease)
  • Faecal impaction (often a result of chronic constipation)
  • Injury or trauma

Due to this broad range of potential causes, if the anal pain you experience is severe or doesn’t get better after a few days, it’s wise to speak to your GP about it. They can run tests to ensure that you are not suffering from a more serious medical condition – or begin treatment promptly if you are.


Lots of people are embarrassed by the thought of talking to a doctor about anal pain. This is natural. However, it’s important that you don’t let it prevent you from seeking medical help when you need it.

Whether you have an anal sore, haemorrhoid pain, anal lesions, or constipation, your doctor will have dealt with cases similar to yours many times before. Rest assured that they will do their best to ensure that you’re comfortable and treat your concerns with dignity and respect.

Discuss symptoms with a doctor

In most cases, your GP will want to start by talking to you about your symptoms. This might involve asking some personal questions about the type of pain you’re experiencing and your toilet habits.

Physical examination

Depending on the nature of your condition, they may also want to do a physical examination. This could be a simple visual external examination, or they may wish to do an internal rectal examination if required.

A rectal exam involves the GP inserting a lubricated, gloved finger into your bottom in order to check for abnormalities. You will be lying down on your side during the procedure. If your pain is severe, they may be able to numb the area with anaesthetic first to minimise your discomfort.

You’ll be able to specify whether you would prefer a man or woman to examine you, and also choose to have a friend or family member with you for moral support if that helps.

Your doctor’s appointment is also a good time to ask any questions you may have about anal pain, rectal health, constipation, or other related topics.

Whether you want to ask your doctor, “do haemorrhoids itch?”, how to ease constipation, or what the best pain killer for piles is, they will be able to provide detailed, personalised, and confidential advice to help you out.

Treatment of anal pain

The specific treatment that you are prescribed will depend on the exact cause of your anal pain. However, a doctor will likely recommend a cream or suppositories to soothe or provide piles pain relief, dietary and lifestyle changes to help remedy constipation, or antibiotics if you have an infected anal sore or similar condition.

In cases where you’re suffering from severe haemorrhoid pain, persistent anal fissures, or other more serious issues, surgical treatment might also be a possibility.

Diet and lifestyle changes

In addition to medical treatment, your GP may recommend that you make certain changes to your diet and lifestyle in order to help you recover from anal pain. For example, these might include:

  • Drinking lots of water (try to have six to eight glasses every day)
  • Adding more fibre to your diet (such as pulses, fresh fruit, and vegetables, wholewheat pasta, brown rice, and oats)
  • Taking regular exercise (even just going for a walk will help)
  • Avoiding sitting down for prolonged periods of time
  • Not ignoring the need to defecate
  • Not straining when using the toilet

Trying home remedies

There are also a number of simple home remedies you can try that might help to soothe the pain of an anal sore or provide haemorrhoid pain relief. Some of the most helpful suggestions include:

  • Taking a warm bath to ease itchiness 
  • Wringing out a clean cloth in ice water and holding it against the area
  • Using damp toilet paper rather than dry when wiping your bottom
  • Keeping the area clean and dry

Anal pain FAQs

Do piles itch? 

Yes, they can. In fact, an itchy anus is a characteristic symptom of haemorrhoids. Although not necessarily painful, having itchy piles at night can be frustrating if it prevents you from sleeping.

Is anal pain a sign of anal cancer?

In extremely rare cases, anal pain can be a symptom of anal cancer. Other symptoms of this rare disease include bleeding from the anus, small lumps in and around the anus, bowel incontinence, and a discharge of mucus from the anus.

These symptoms are often similar to those of the conditions mentioned above, such as an anal sore or piles, which is another reason why it’s important to go to the doctor if you experience them. Catching cancer early gives patients the best chance of a full recovery.

When should I go to the doctor for anal pain?

People are often reluctant to see a doctor regarding anal pain. This is partly due to embarrassment but can also be because of a fear that you’ll be wasting the GP’s time. However, you shouldn’t worry about either of these. As a rough guide, you should speak to a doctor if any of the following criteria apply:

  • Your symptoms are not improving after a few days
  • You are experiencing severe haemorrhoid pain or pain from a significant anal sore
  • You have anal pain that keeps coming back
  • You’re experiencing other symptoms such as a fever or weight loss
  • You are bleeding heavily or non-stop from your bottom

When in doubt, it’s always better to book an appointment. Even if you just get some advice and a cream for piles pain, having the peace of mind that your anal pain is not a sign of something serious is well worth it.

What can cause anal itching at night?

There are a few different reasons why you might experience anal itching during the nighttime. Firstly, you might simply be more aware of the sensation when you’re in bed because there are fewer other stimuli to distract you from it. Haemorrhoids are a common cause, and if you experience itchy piles at night, then the following tips might help:

  • Don’t wipe too hard when you use the toilet, as this can irritate the skin
  • Avoid eating very spicy food
  • If you have night sweats, this can also irritate the skin, so try keeping your bedroom cool and wearing loose, breathable pyjamas

How long does anal pain last?

Unfortunately, there is no easy answer to this question. It very much depends on the specific cause of your anal pain and how severe your condition is. In the majority of cases, constipation and haemorrhoid pain get better after a few days, while an anal soreor fissure will usually heal in a few weeks. However, for all these conditions, recovery can take longer than this in some instances.

You can help to speed things up by following the advice above on diet and lifestyle, as well as avoiding scratching around your anus or using perfumed products (such as shower gel) on the area. It’s also important to keep your bottom clean and dry, as this will give you the best chance of healing quickly and smoothly.

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