Pain in the anus


Pain in the anus are relatively common. The causes can be varied and range from harmless irritation of the mucous membranes to diseases that require treatment, such as anal vein thrombosis. Many affected people avoid going to the doctor out of shame. However, the discrete and professional approach on the part of the doctor quickly removes those concerned about their reservations and lets fears and shame take a back seat. A more accurate one Clarification through a Professional is especially indispensable for long-term pain, increased pain, bloody stool, weight loss or night sweats.
By the family doctor or by a specialist in rectal diseases, the so-called Proctologists the underlying cause can be found and targeted treatment initiated.

Causes of pain in the anus

To the others causes For Pain in the anus include:

  • hemorrhoids
  • Tears in the mucous membrane
  • Anal vein thrombosis / perianal vein thrombosis
  • Anal abscess / perianal abscess


The most common cause of pain is around the anus hemorrhoids when it comes to hemorrhoids sagging veinsthat are located in the area of ​​the rectum. A weak connective tissue is often to blame for the development of hemorrhoids. The hemorrhoids are subdivided according to their location, extent and size. The extent and size do not necessarily determine the suffering of those affected. So it may well be that the small hemorrhoids cause more discomfort than the large ones.

Hemorrhoids can be felt and seen in the area of ​​the anus, depending on their size. You can visibly protrude from the intestines. Depending on the severity, a manual relocation can then be carried out. Hemorrhoids are common with itch, Burn (please refer: Burning of the anus) and Pain connected in the area of ​​the anus (see: Hemorrhoid symptoms). If you press very hard when you go to the toilet or if you have solid stools, the hemorrhoids can tear open and close Bleeding in the intestines to lead.

The treatment is seldom performed surgically today. Usually be Anoint used to cause the bulging veins to contract. cooling and preventive measures help alleviate the discomfort in the anus. Of the chair should, in order to avoid excessive pressing, soft being held. Here one helps high fiber, healthy nutrition as well as a sufficient amount of Drinking liquid.

Tears in the mucous membrane

Other causes of pain in the anus can be minor Tears in the mucous membrane be, these are called in medical terminology Fissures designated. They usually occur on Outer edge of the anus and can be a few millimeters to just under a centimeter. Fissures can be caused by very firm bowel movements or by strong pressure during bowel movements, but in other cases the cause remains unknown.

Please also read our article on this Painful bowel movements

Tears in the mucous membrane on the anus can be extreme painful be. Especially the one bowel movement is considered extremely by those affected unpleasant perceived, since the stool has to push past the tear site when it is excreted and as a result further or even deeper tears can occur.

Here you can find out more about: Anal fissures

Anal vein thrombosis / perianal vein thrombosis

It can also be caused by a blood clot in the area of ​​a small vein in the area of ​​the anus Anal vein thrombosis or Perianal vein thrombosis pain in the anus.
The clinical picture is comparable to a thrombosis of the legs. However, swelling, as is typical for a thrombosis on the leg, is rare here.
In the foreground are above all pulling or pressing pain in the area of ​​the anus. The pain occurs mainly when sitting and is usually aggravated by going to the toilet (especially with firm stools). The pain of an anal vein thrombosis can be so severe that it is largely impossible to sit.

While anal vein thrombosis was almost always operated on in the past (the vein was incised in the anus and the blood clot was cleared out), surgery has become more cautious today.

In many cases they go away complaints and also the thrombosis in the anal vein within less days by itself again. However, should the symptoms persist or worsen, a Proctologist to be visited. Can help relieve pain Hip baths, cooling pads and contribute to exercise. The stool should be kept soft to facilitate passage. Furthermore, a treatment with Bepanthen® wound ointment be helpful.

Anal abscess

However, pain in the anus can also be triggered by more serious causes, including the Anal abscess or the Perianal abscess (if the abscess is next to the anus).
An abscess is a cavity filled with pus and inflammatory fluid. It occurs when bacteria (mostly staphylococci) overcome the skin barrier and enter the body. In order to prevent further spread, the body forms a shell around the bacteria. Immune cells begin to fight and break down the bacteria, which eventually leads to the well-known pus formation.
Abscesses fall through one swelling, the pressure painful can be on. In some cases, these are caused by an anal abscess Pain so strong that it is hardly possible for those affected to sit.

To therapy from small abscesses can e.g. Pull ointments be used. Treatment for larger abscesses is usually one surgery necessary. The abscess is removed under general anesthesia. The postoperative wound is usually left open and must be showered regularly by the patient during follow-up treatment. Wound healing is often slow and can take up to 6-8 weeks.

A dreaded sequela of an abscess is the Fistula on the anus A fistula is a duct that has attached itself to an abscess and that can reach deep into the body. A fistula can also cause pain in the anus. Fistulas almost always have to operated on because the tunnels harbor the risk that the bacteria can spread deep into the body. Fortunately, fistulas around the anus are not common.
If abscess formation is known, ultrasound is usually used to check whether a fistula has already formed.

Read more on the topic: Anal cancer

Pain in the anus after hard stool

A inadequate hydration in conjunction with a lack of exercise often leads to hard stool. Going to the toilet can be very uncomfortable or cause pain, especially if the stool is hardened.
The cause of the pain is due to the relatively narrow anus. A normal, soft stool consistency prevents excessive stretching of the rectum and therefore does not cause pain. At solid stool on the one hand it comes from the tension or Dilatation of the rectumas well as through irritation the inside of the Mucous membrane of the anus to a painful excretion of stool.
Often requires stool with hardened consistency a strong pressingwhich is the training of hemorrhoids can favor. Hemorrhoids can be associated with pain, which occurs especially when going to the toilet.

Pain inside the anus

Sometimes it comes with the urge to stool to strengthen, cramping pain in the area of ​​the anus and the anus. These complaints are called in medical terminology Tenesmen designated. The cause of the pain associated with the urge to defecate is the spasmodic contraction (contraction) of the muscles of the rectum. Tenesmen occur e.g. as part of inflammatory bowel disease on, but can also be based on other causes. The pain that arises in connection with the urge to defecate is often discontinuous. Those affected have phases of several days or weeks in which no tenesms occur.
In order to be able to initiate a suitable therapeutic measure, it is important to have a medical examination carried out in which the cause can be found.

hemorrhoidsthat are also on the inside of the rectum can also be too Pain on the inside of the rectum and the anus. In this case, a proctologist or internist should also be consulted to examine the rectum (Proctoscopy). The presentation to the specialist should take place above all if the symptoms occur frequently and increase in intensity.

Nocturnal pain in the anus

Nocturnal pain in the area of ​​the anus can lead to sleep problems and, as a result, create a high level of suffering in those affected.
One of the main causes of sudden, shooting, nocturnal Pain is the so-called Proctalgia fugax, about the origin of which we know very little to date. It is thought to be spasms of the sphincter. The exact causes, diagnoses and treatment have not yet been clearly clarified.

The symptoms can occur during the day or at night. The Pain at Proctalgia fugax can occur in waves, spasms or continuously. Most of the time the entire anal area is affected, sometimes it also occurs Side effects, how nausea or Vomit and thus increasingly worsen the general condition of the person concerned. The symptoms usually disappear after a few minutes. However, an attack can last 30 minutes.
There are some treatment strategies that exist Proctalgia fugax, but their effects are controversial.
If the symptoms recur, a treatment attempt with clonidine, nifedipine or salbutamol can be undertaken.

Nocturnal anal pain can basically be caused by any cause that also causes daily anal pain. A precise search for the cause is necessary in any case. It is advisable to have a colonoscopy if the symptoms recur.

Anal pain after mirroring

After a Colonoscopy anal pain or pain in the anus can usually be short-lived. The reason is that the anus is stretched when the proctoscope is inserted and while the intestines are examined. This can cause pain in the anus area that can last a few hours to a few days.
Rare it occurs with a rectoscopy Injuries or even Tears in the area of ​​the anus. As a rule, the anus is examined for tears after the procedure and treated immediately if necessary. In very rare cases the inner wall of the intestine is injured during the examination through the proctoscope or colonoscope. Here, too, discomfort and pain in the area of ​​the anus can occur after the actual examination. Should be after the investigation Blood in the stool be visible or the pain in the anus does not go away within a few days, a doctor should be visited.

Anal pain when sitting down

Pain in the area of ​​the anus, the Sit down occur can have different causes. The pain is common hemorrhoids owed. These can be symptom-free, but if they are severe, they can also lead to severe pain while sitting.
Also Anal vein thrombosis can be the cause of the symptoms, albeit less often. These are small blood clots that have settled in a vein of the anus and can lead to corresponding pain, especially when sitting.
Other causes of pain when sitting can also be Anal abscesses represent. These pus cavities can cause severe pain while sitting and sometimes even make it impossible. Abscesses should if they severe discomfort prepare, operational removed. After an abscess dissection by surgery, it takes a few weeks for the wound to heal and for the person affected to sit symptom-free.

Swollen anus

For pain in the area of ​​the anus, which is associated with a swelling, is of one inflammatory events to go out. The cause of swelling in the area of ​​the anus can be next to one Anal vein thrombosis also highly educated hemorrhoidsthat come out of the anus and make it swell.
Inflammation of the sphincter and the inner lining of the anus can also lead to a complete swelling of the anus. If the underlying cause is found, an attempt can be made to reduce the swelling of the anus symptomatically with cooling pads. The further therapeutic measures are then carried out as directed by the doctor.