What causes anal pain?

The anus is an opening ringed by muscles that control your bowel movements. You can develop anal pain any time the area becomes irritated or inflamed. For example, a severe case of diarrhoea can damage the tissues and cause burning anal pain.

The conditions that most often cause anal pain include:

Anal fissures

An anal fissure is a tiny tear in the skin lining the anal opening. Fissures cause severe pain and bleed when you have a bowel movement. They’re also a common problem that’s often confused with haemorrhoids.

The top causes of anal fissures include constipation, persistent diarrhoea, inflammatory bowel disease, and childbirth. Medication

  • Nitrate ointment: This helps raise blood flow to the anal canal and sphincter, which helps fissures get better faster.
  • Calcium channel blockers: These are blood pressure-lowering medications. Some of the topical ones can treat anal fissures, too.
  • Botox injections: Injecting botulinum toxin type A (Botox) into the sphincter may relieve pain and encourage healing.


For cases of chronic anal fissures that do not heal on their own, your doctor may recommend surgery. This is rare.

If surgery is suggested, the surgeon will cut a portion of the anal muscle to relax it (lateral internal sphincterotomy). This will reduce pain and help healing. Studies have found that for chronic fissure, surgery is much more effective than any medical treatment. However, surgery has a small risk of causing incontinence. Further detailed information about anal fissures is available on

Anal abscesses and fistulas

An abscess is an infected, pus-filled area. Anal abscesses usually develop in a gland near the opening of the anus, then they enlarge to cause an infection under the skin. Anal abscess usually needs an urgent incision and drainage under anaesthesia.

Anal fistula refers to an abnormal tunnel that develops after the abscess drains. The tunnel runs from the gland to the skin’s surface. Fistulas may discharge pus or bloody fluid, or they can close, potentially making the abscess flare up again. Various forms of surgical intervention are available depending on the complexity of the fistula and patients’ choice. Further detailed information about anal fistula is available on

Haemorrhoid thrombosis

Haemorrhoids are enlarged, bulging veins that occur when the vein walls weaken, stretch, and become filled with blood. Internal haemorrhoids form in the anus below the lining. They’re painless unless they slide out of the anus and get a clot or thrombosis.

External haemorrhoids develop around your anus, typically appearing under the skin. These haemorrhoids are usually quite painful, especially when they develop a thrombosis, or a blood clot. Thrombosed external haemorrhoids lead to a large, extremely painful mass. These are usually self-healing with conservative management and improve in a week or two and rarely need an urgent surgery. Further detailed information on haemorrhoids is available on

Anal skin tags

Anal skin tags are growths of excess skin around the anus. They are often caused by straining or inflammation. They are not cancerous but can be itchy or sensitive to the touch and painful. These are also common in pregnant women. Skin tags during pregnancy become visible towards the end of the second and beginning of the third trimester.

After a skin tag is diagnosed, you and your doctor will need to decide if it should be removed or left alone. If your skin tags are causing symptoms or discomfort, it might be worth removing them with surgery. Further detailed information about anal skin tags is available on

Does anal cancer cause pain?

Anal cancer develops when cells grow out of control, forming a mass that turns into cancer. The top risk factor for anal cancer is being infected with the human papillomavirus (HPV), a sexually transmitted virus that can also cause anal warts.

When symptoms appear, you may experience:

  • Anal pain or pressure
  • Bleeding from the anal area
  • Itching or a discharge
  • A lump or swelling near the anus

Many people also notice a change in bowel habits or that their stool is narrower than normal.

If you have concerns, please visit our specialists at piles clinic uk.

How is anal pain treated?

Professionals at piles clinic UK will chooses from a wide array of treatments, recommending the option that’s best for the underlying cause of your anal pain. You may need dietary changes, medications, or surgery to drain an abscess, remove a haemorrhoid, skin tag, remove a tumour, or repair a fistula.

To get help for anal pain, schedule an appointment with our specialists at piles clinic uk.