Common causes of anal pain

Anal fissures

An Anal fissure is asmall tear in the skin of the anus that can be caused by passing a large orhard poo.

Symptoms of an anal fissure can include:

• a severe, sharp pain when doing a poo
• a burning or gnawing pain that lasts several hours after doing a poo
• rectal bleeding you may noticea small amount of blood on the toilet paper after you wipe

Anal fissures can be very painful, but many heal on their own in a few weeks. Increasing the amount of fibre in your diet, drinking plenty of fluids and taking laxatives and over-the-counter painkillers can help.

If the pain persists, you may need special ointment that relaxes the ring of muscle around your anus. Occasionally, surgery may be needed to help the fissure heal.

They're often thought to be caused by straining on the toilet as a result ofprolonged constipation .

In many cases, haemorrhoids don't cause symptoms. When symptoms do occur, they may include:

• bleeding after doing a poo
• an itchy bottom
• feeling like there's a lump in or around your anus
• soreness and redness around your anus
• anal pain, if the blood supplyto the haemorrhoid becomes blocked or interrupted for example, by a blood clot

The symptoms often passafter a few days.Increasing the amount of fibre in your diet, drinking plenty of fluids and taking laxatives and over-the-counter painkillers can help.

If the blood supply to the haemorrhoid has been blocked by a clot,a simple procedure can be carried out to remove the clot under local anaesthetic (where the area is numbed).

It's usually caused by an infection near the anusresulting ina collection of pus(an abscess ).

Symptoms of an anal fistula or abscess can include:

• a constant, throbbing pain that may be worse when you sit down
• skin irritation around the anus
• passing pus or blood when you poo
• swelling and redness around your anus
• a high temperature (fever)

Your GP may prescribe antibiotics if an abscess is picked up early on. If it persists, it may need to be drained in hospital,possibly under general anaesthetic (while you're asleep).

If a fistula develops, surgery will usually be needed because they rarely heal by themselves.

Your GP can try to work out what the problem is and give youtreatment advice.

They'll probably ask toseeyour bottom and may carry out a rectal examination (where they gently insert a gloved finger into your bottom) to check for any abnormalities.

If the cause is not immediately obvious, they may refer you to a specialist for advice and further tests.