Anal pain

Anal pain (pain in the bottom) is common. There are things you can do to ease it, but see a GP if you're in a lot of pain or it does not get better.

Anal pain has many different causes.

Your symptoms might give you an idea of what is causing anal pain. Do not self-diagnose, see a GP if you're worried.

Symptoms Possible cause
Pooing less than normal for you and pain when pooing Constipation
Itchy anus, feeling a lump around the anus, blood on the paper after wiping Piles (haemorrhoids)
Sharp pain when pooing, burning pain after doing a poo and blood on the paper after wiping Anal fissures
Constant throbbing pain, pus and blood on the paper after wiping, high temperature Anal fistulas and abscesses

Less often, anal pain can be caused by something else like a sexually transmitted infection (STI) or fungal infection. Rarely, it can be a sign of something serious like anal cancer.

Do

  • drink lots of fluid and eat plenty of fibre to keep your poo soft

  • exercise regularly

  • wipe your bottom with damp toilet paper

  • take paracetamol

  • take a warm bath to ease itching and pain

  • put an ice pack (or bag of frozen peas) in a towel on the painful area for up to 20 minutes every 2 to 3 hours

Don't

  • do not scratch around your anus

  • do not ignore the urge to poo

  • do not push too hard when pooing

  • do not use fragranced products, such as shower gels or soaps around your anus

  • do not eat spicy food or drink alcohol and caffeine

  • do not lift or carry anything heavy

  • do not take ibuprofen if your anus is bleeding

A pharmacist can recommend medicines to reduce constipation and anal pain such as:

  • painkillers like ibuprofen or paracetamol
  • creams or suppositories (medicines you put into your bottom) to ease itching, pain and swelling
  • medicines that help make it easier to poo (laxatives)

Many pharmacies have private areas if you do not want to be overheard.

Find a pharmacy

See a GP if:

  • anal pain is severe
  • the pain does not improve after a few days
  • you've had blood in your poo or bleeding from your bottom for 3 weeks

Do not feel embarrassed to see a GP. Anal pain is a common problem that they're used to treating.

What we mean by severe pain
Severe pain:
  • always there and so bad it's hard to think or talk
  • you cannot sleep
  • it's very hard to move, get out of bed, go to the bathroom, wash or dress
Moderate pain:
  • always there
  • makes it hard to concentrate or sleep
  • you can manage to get up, wash or dress
Mild pain:
  • comes and goes
  • is annoying but does not stop you doing daily activities

Ask for an urgent GP appointment or get help from NHS 111 if:

  • you have severe anal pain and you have a high temperature or feel hot and shivery
  • your poo is black or dark red

You can call 111 or get help from 111 online.

What we mean by severe pain
Severe pain:
  • always there and so bad it's hard to think or talk
  • you cannot sleep
  • it's very hard to move, get out of bed, go to the bathroom, wash or dress
Moderate pain:
  • always there
  • makes it hard to concentrate or sleep
  • you can manage to get up, wash or dress
Mild pain:
  • comes and goes
  • is annoying but does not stop you doing daily activities

Go to A&E or call 999 if:

  • you're bleeding non-stop from your bottom
  • there's a lot of blood coming from your bottom – for example, the toilet water turns red or you see large blood clots
Find your nearest A&E

Treatment for anal pain depends on what's causing it.

A GP will examine you and may prescribe:

  • a cream or ointment to ease your pain
  • laxatives to help you poo more easily
  • antibiotics if you have an infection

The GP may also recommend changes to your diet or arrange for tests to look for a cause of the anal pain.

Sometimes surgery or other treatments may be needed if the pain is caused by severe anal fissures, piles or fistulas.